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Sample records for delayed hepatobiliary imaging

  1. Delayed hepatobiliary imaging in the diagnosis of hepatocellular carcinoma

    International Nuclear Information System (INIS)

    Chen, S.; Ma, Z.; Tang, Z.

    2000-01-01

    In recent years, the use of ultrasonography (US), X-CT and MRI has reduced the employment of isotopic explorations in the detection of hepatocellular carcinoma (HCC). But sometime the results of US, X-CT or MRI were different and diagnosis was very difficult. This present investigation was aimed to assess the usefulness of delayed hepatobiliary imaging in the diagnosis of HCC in these patients. Forty-eight patients consisting of 33 males and 15 females were entered into the research protocol. The mean age was 46 yr old (range 12-71 yr old). All of the patients were performed by surgery and verified histologically after nuclear examination. The subject was in a supine position under a gamma camera (Elscint, Apex Ap-6) and 555 MBq of Tc-99m-PMT were injected intravenously. The initial scinphotos obtained within 1 min after injection were used to image the blood pool phase. Subsequently, hepatic scans were obtained at 5 min, 1,2 and 5 hr. Anterior, right lateral and posterior hepatic images were recorded. According to the radioactive uptake by the lesion in delayed phase, the negative (no or minor uptake), positive (equal or greater uptake) or very strong positive (almost equal to the activity, of gallbladder) were judged. The positive were considered as diagnostic of HCC. And the very strong positive, were considered as diagnostic of benign hepatoma, such as adenoma or FNH. Thirty-seven of the forty-eight patients were HCC based on histology. Delayed imaging revealed increased or equilibrated uptake of radioactivity by the tumors in 22 of 37 patients with hepatocellular carcinoma. The sensitivity was 59.5%. One patient final diagnosis based on histology was focal nodular regenerative hyperplasia, and only the diagnosis with delayed hepatobiliary imaging before surgery was correct. Compared with US, X-CT and MRI, delayed hepatobiliary imaging had the highest specificity for diagnosis of hepatocellular carcinoma. In recent group, the specificity of Tc-99m-PMT delayed

  2. Specific diagnosis of hepatocellular carcinoma by delayed hepatobiliary imaging

    International Nuclear Information System (INIS)

    Hasegawa, Y.; Nakano, S.; Ibuka, K.

    1986-01-01

    For assessment of the value of delayed hepatobiliary imaging with technetium 99m (/sup 99m/Tc)-(Sn)-N-pyridoxyl-5-methyltryptophan (/sup 99m/Tc-PMT) for specific diagnosis of hepatocellular carcinoma, 88 patients with various malignant and benign liver diseases (49 with hepatocellular carcinoma, 4 with cholangiocellular carcinoma, 10 with metastatic liver carcinoma, 2 with liver cysts, 2 with liver hemangioma, 1 with liver abscess, 2 with intrahepatic lithiasis, 12 with liver cirrhosis, and 6 with chronic hepatitis) were studied. In 20 (41%) of the 49 patients with hepatocellular carcinoma, greater uptake of /sup 99m/Tc-PMT by the tumor than by the surrounding liver tissue was seen in delayed hepatobiliary images, whereas in eight patients (16%), equilibrated uptake was seen. No increased uptake of the radioisotope by hepatic lesions was seen in 21 patients with localized liver diseases other than hepatoma. Moreover, in 18 patients with diffuse liver diseases, no focal accumulation of the radioisotope was seen in delayed /sup 99m/Tc-PMT images. In addition, of 28 patients with hepatocellular carcinoma in whom the serum alpha-fetoprotein level showed little or no increase, 12 showed increased uptake of /sup 99m/Tc-PMT by the tumor. In assessing delayed /sup 99m/Tc-PMT images, however, it was necessary to consider following complications: accumulation of tracer in obstructed and dilated biliary trees; retention of radioactivity in nonneoplastic liver tissues; difficulties in evaluating /sup 99m/Tc-PMT uptake by small hepatic tumors; overlapping of radioactivity in the gut and gallbladder in delayed /sup 99m/Tc-PMT images of tumors. This study indicates that delayed /sup 99m/Tc-PMT images can be useful in the diagnosis of hepatocellular carcinoma

  3. Imaging in hepatobiliary disease

    International Nuclear Information System (INIS)

    Dooley, J.

    1987-01-01

    This book covers the diagnostic and interventional use of imaging techniques in hepatobiliary disease. The first of the book's two sections describes the role of imaging in the diagnostic work up of common clinical syndromes. The second part is concerned with therapy and reviews interventional techniques for hepatobiliary disease

  4. Hepatobiliary system functional analysis by blood flow and clearance delay model

    International Nuclear Information System (INIS)

    Aboltins, A.; Reinholds, E.

    2002-01-01

    A mathematical model for describing liver uptake-excretion is developed and approved. Model is based on different timing delays in hepatobiliary and blood flow system elements. Series of scintigraphic images with 99m Tc-mebrofenins or 99m Tc-HIDA taken with standard nuclear medicine gamma camera are used as the real data for calculations. The time-activity curves are obtained from many regions of human body - heart, liver, gallbladder, spleen, aorta, vein, etc. Both first pass and dynamic acquisition data are used. Results are calculated using real system parameters and compared to real scintigraphy data. Mathematical simulations are made to show difference of hepatobiliary system function at three main points: normal function, good blood flow with bad hepatic function and bad blood flow with good hepatic function. (authors)

  5. Evaluation of hepatobiliary imaging using Tc-99m-DISIDA in hepatobiliary disease

    International Nuclear Information System (INIS)

    Kim, Yong Ga; Chung, Duck Soo; Kim, Ok Dong

    1985-01-01

    Hepatobiliary scintigraphy using Tc-labelled radiopharmaceuticals is employed primarily for the diagnosis of acute cholecystitis and for demonstration of biliary tract patency. We concluded a retrospective study of 55 patients with hepatobiliary disease from Jun. '84 to Sep. '84 at Taegu Catholic Hospital and tried to determine the etiology and find the possible differential points by analyzing the scintigraphic findings. The following results were obtained; 1. Tree-like photon defect on hepatic parenchyme was suggested characteristic of complete obstructive biliary disease, but could be seen in either benign or malignant etiology. 2. The grade of hepatocyte clearance was not useful in determining whether the cause of obstructive biliary disease was benign or malignant in this study. 3. Hepatocyte clearance was more severely impaired in hepatocellular disease than in obstructive biliary disease. 4. The photon defect in porta hepatis with complete biliary obstruction was suggested characteristic of common bile duct cancer. 5. The meniscus appearance at obstructed site of common bile duct was pathognomonic sign of choledocholithiasis. 6. When the gallbladder was not visualized, the differential diagnosis between acute and chronic cholecystitis was possible without delayed image by observing the transit time to bowel. The delayed transit to bowel was a favorable of chronic cholecystitis rather than of acute cholecystitis. 7. Acute pancreatitis could be easily differentiated from partial biliary obstruction by clinical and laboratory examination, but the finding of abrupt narrowing of pancreatic common bile duct with slight proximal dilatation on cholescintigraphy was also a key point in acute pancreatitis. 8. The segmental dilatation of intrahepatic duct was thought meaningful sign of clonorchiasis

  6. Evaluation of hepatobiliary imaging using Tc-99m-DISIDA in hepatobiliary disease

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Yong Ga; Chung, Duck Soo; Kim, Ok Dong [Taegu Catholic Hospital, Daegu (Korea, Republic of)

    1985-06-15

    Hepatobiliary scintigraphy using Tc-labelled radiopharmaceuticals is employed primarily for the diagnosis of acute cholecystitis and for demonstration of biliary tract patency. We concluded a retrospective study of 55 patients with hepatobiliary disease from Jun. '84 to Sep. '84 at Taegu Catholic Hospital and tried to determine the etiology and find the possible differential points by analyzing the scintigraphic findings. The following results were obtained; 1. Tree-like photon defect on hepatic parenchyme was suggested characteristic of complete obstructive biliary disease, but could be seen in either benign or malignant etiology. 2. The grade of hepatocyte clearance was not useful in determining whether the cause of obstructive biliary disease was benign or malignant in this study. 3. Hepatocyte clearance was more severely impaired in hepatocellular disease than in obstructive biliary disease. 4. The photon defect in porta hepatis with complete biliary obstruction was suggested characteristic of common bile duct cancer. 5. The meniscus appearance at obstructed site of common bile duct was pathognomonic sign of choledocholithiasis. 6. When the gallbladder was not visualized, the differential diagnosis between acute and chronic cholecystitis was possible without delayed image by observing the transit time to bowel. The delayed transit to bowel was a favorable of chronic cholecystitis rather than of acute cholecystitis. 7. Acute pancreatitis could be easily differentiated from partial biliary obstruction by clinical and laboratory examination, but the finding of abrupt narrowing of pancreatic common bile duct with slight proximal dilatation on cholescintigraphy was also a key point in acute pancreatitis. 8. The segmental dilatation of intrahepatic duct was thought meaningful sign of clonorchiasis.

  7. Radiopharmaceuticals for hepatobiliary imaging

    International Nuclear Information System (INIS)

    Chervu, L.R.; Nunn, A.D.; Loberg, M.D.

    1982-01-01

    Tests for liver function have by and large centered around clinical laboratory diagnostic procedures for a number of years. Besides these, radiographic imaging procedures, including oral cholecystography and intravenous cholangiography, serve a very useful purpose, but several of them are invasive and involve a certain degree of risk from the administered contrast media as well as discomfort to the patient. The cholescintigraphic procedures, though noninvasive, have not played a significant role in the evaluation of hepatobiliary disorders prior to the introduction of the currently available /sup 99m/Tc-labeled IDAs. These new hepatobiliary agents offer many advantages over the previously utilized radiopharmaceuticals ( 131 I-rose bengal in particular) in terms of the high degree of specificity for localization in the gallbladder with rapid extraction rates by the polygonal cells of the liver and very low excretion via the GU tract. A detailed understanding of the structure distribution relationship of the various groups in the complex enable the design of agents with an improvement in hepatobiliary specificity and other desirable characteristics. In many clinical situations, even in patients with high bilirubin levels, the /sup 99m/Tc-labeled IDAs offer far superior clinical information over the alternative diagnostic imaging modalities. Further, the absorbed radiation dose imparted to the critical organs is far lower than with the older agents. Thus, the introduction of the cholescintigraphic procedures with the /sup 99m/Tc-labeled IDAs have ushered in a new phase in the diagnostic workup of patients with impaired hepatocellular function and other biliary disorders

  8. Evaluation of the hepatobiliary function with 99mTc-EHIDA imaging during total parenteral nutrition

    International Nuclear Information System (INIS)

    Zhou Qian; Jiang Zhouming; Yang Meifang

    1988-01-01

    14 surgical patients with non-hepatobiliary diseases were studied with 99m Tc-EHIDA imaging to evaluate the effect of total parenteral nutrition (TPN) on the hepatobiliary function. Duration of TPN ranged from 6-56 days, 10 of the 14 patients Beijing within 10 days. The results showed that: (1) 11 of 14 patients had abnormal scintigraphic features. The most prominet findings were delayed liver excretion and prolonged blood clearance time. This fact suggests that not only the rate of excretion of the bile from the liver is decreased but the uptake ability of the hepatorcyte is also impaired. (2) The effect of TPN on liver function is reversible. It was concluded that in order to prevent irreversible damage of hepatobiliary function caused by TPN, the duration of TPN should not be too long and oral intake of nutrients should be resumed as soon as possible

  9. Hepatobiliary scan in neonatal Jaundice

    International Nuclear Information System (INIS)

    Nahar, Nurun; Hasan, Mizanul; Karim, M.A.

    2002-01-01

    Jaundice is more or less common in newborn babies. Through physiological jaundice is most common cause of neonatal jaundice, possibility of obstructive jaundice especially biliary atresia should be kept in mind. Early diagnosis of biliary atresia followed by surgical treatment can save baby's life. Otherwise death is inevitable due to liver failure. Hepatobiliary scan is the imaging study of choice in neonatal jaundice especially when there is persistent conjugated hyperbilirubinaemia. Total 27 newborn babies of suspected biliary atresia, aged 14 days to 4 months were referred to Institute of Nuclear Medicine for Hepatobiliary scan. All of them had high serum bilirubin ranged from 6.0 mg/dl with an average of 9.35 ng/dl serum bilirubin level. Ultrasonography of hepatobiliary system was performed in 14 cases showing normal sized liver in 4 cases and hepatomegaly in 10 cases. Hepatobiliary scan was done with 99m Tc-Mebrofenin (Br IDA) after preparing the baby with phenobarbitone for 3-5 days. 20 (67%) cases were scan positive suggesting biliary atresia (BA) and 7(27%) cases were scan negative. In BA there will be increased hepatic uptake of the radionuclide without any significant excretion even in 24 hours delayed images. Presence of radiotracer in the bowel exclude the diagnosis of BA. Early diagnosis of biliary atresia is very important because in this condition surgery should be performed early (within 60 days of life). Studies suggest that hepatobiliary scan after hepatic stimulation with phenobarbitone for a period of 3-5 days is highly accurate for differentiating biliary atresia from other causes of neonatal jaundice. It is very important to perform hepatobiliary scan in a case of neonatal jaundice to exclude biliary atresia for the sake of baby's life.(author)

  10. 99Tcm-MIBI hepatobiliary scintigraphy in peadiatric patients with severe cholestatic infant hepatitis syndrome

    International Nuclear Information System (INIS)

    Chen Guibing; Huang Jinxiong; He Xiaojiang; Luo Zuoming; Lu Zhengyuan; Wu Hua

    2010-01-01

    Objective: Because of the limited of 99 Tc m -diethyl iminodiacetic acid ( 99 Tc m -EHIDA) hepatobiliary scintigraphy in the diagnosis of severe cholestatic infant hepatitis syndrome, trial use 99 Tc m -methoxy isobutyl isonitrile ( 99 Tc m -MIBI) as a new hepatobiliary scintigraphy imaging agent to understand its applied basis and primary evaluate value in diagnosis of severe cholestatic infant hepatitis syndrome. Methods: constructed choledochal atresia animal model and investigated the application basis of 99 Tc m -MIBI hepatobiliary scintigraphy. Twenty-seven children patients of severe cholestatic who finally confirmed infant hepatitis syndrome were underwent firstly 99 Tc m -EHIDIA hepatobiliary scintigraphy. After 24 h delay imaging next day, 99 Tc m -MIBI hepatobiliary scintigraphy was underwent after 1 h. Two imaging agents of value in the diagnosis of severe cholestatic infant hepatitis syndrome were compared. Results: It was proved that 99 Tc m -MIBI was surely excreted by hepatobiliary and had no intestinal autocrine phenomenon in animal test. So 99 Tc m -MIBI can be used to undergo hepatobiliary scintigraphy. The sensitivity of 99 Tc m -MIBI hepatobiliary scintigraphy in the diagnosis of severe cholestatic infant hepatitis syndrome was 100% in our primary clinical study. Its sensitivity was higher than which of 99 Tc m -EHIDA hepatobiliary scintigraphy (66.67%) by far. Conclusion: With regard to those children patients who suspected highly severe cholestatic infant hepatitis syndrome in clinical, the sensitivity of 99 Tc m -MIBI hepatobiliary scintigraphy is obviously superior to conventional 99 Tc m -EHIDA hepatobiliary scintigraphy. (authors)

  11. Hepatobiliary fascioliasis

    OpenAIRE

    Andrade, Daniel Ramos; Andrade, Luísa; Antunes, Célia; Donato, Paulo; Semedo, Luís Curvo; Alves, Filipe Caseiro

    2017-01-01

    Hepatobiliary fascioliasis is a parasitic disease caused by Fasciola hepatica, which is a trematode that primarily infects cattle and sheep, but may also affect humans in endemic areas.There are two phases of the disease: the acute one - where the parasites infect the liver parenchyma; and the subacute / chronic phase - when the parasites reach the biliary ducts and gallbladder, providing typical imaging findings.Because this disease may mimic several hepatobiliary disorders, misdiagnosis or ...

  12. Gastroesophageal reflux demonstrated by hepatobiliary imaging in scleroderma

    Energy Technology Data Exchange (ETDEWEB)

    Sawaf, N.W.; Orzel, J.A.; Weiland, F.L.

    1987-03-01

    Radionuclide hepatobiliary imaging was performed on a patient with a longstanding history of scleroderma who presented with abdominal pain suggestive of biliary disease. Cystic duct patency was documented after 10 min with tracer accumulation in the second portion of the duodenum which failed to progress consistent with the duodenal hypomotility of scleroderma. The patient was given intravenous Kinevac resulting in gastroesophageal reflux of radionuclide.

  13. Gastroesophageal reflux demonstrated by hepatobiliary imaging in scleroderma

    International Nuclear Information System (INIS)

    Sawaf, N.W.; Orzel, J.A.; Weiland, F.L.

    1987-01-01

    Radionuclide hepatobiliary imaging was performed on a patient with a longstanding history of scleroderma who presented with abdominal pain suggestive of biliary disease. Cystic duct patency was documented after 10 min with tracer accumulation in the second portion of the duodenum which failed to progress consistent with the duodenal hypomotility of scleroderma. The patient was given intravenous Kinevac resulting in gastroesophageal reflux of radionuclide

  14. Enhancements in hepatobiliary imaging: the spectrum of gadolinium-ethoxybenzyl diethylenetriaminepentaacetic acid usages in hepatobiliary magnetic resonance imaging.

    Science.gov (United States)

    Channual, Stephanie; Pahwa, Anokh; Lu, David S; Raman, Steven S

    2016-09-01

    Gadolinium-ethoxybenzyl diethylenetriaminepentaacetic acid (Gd-EOB-DTPA) is a unique hepatocyte-specific contrast agent approved for clinical use in the United States in 2008. Gd-EOB-DTPA-enhanced MR has shown to improve detection and characterization of hepatic lesions. Gd-EOB-DTPA is now being routinely used in daily clinical practice worldwide. Therefore, it is important for radiologists to be familiar with the potential uses and pitfalls of Gd-EOB-DTPA, which extends beyond the assessment of focal hepatic lesions. The purpose of this article is to review the various usages of Gd-EOB-DTPA in hepatobiliary MR imaging.

  15. 99mTc-O2S4: a new generation hepatobiliary imaging agent

    International Nuclear Information System (INIS)

    Babbar, A.K.; Mathur, R.; Katiyar, N.; Dutta, M.; Flora; Mishra, A.K.; Yadav, A.

    2010-01-01

    Full text: Hepatobiliary imaging radionuclide - 99m Tc-Mebrofenin is indicated as a hepatobiliary imaging agent for the evaluation of hepatobiliary tract patency to differentiate jaundice resulting from hepatocellular causes from jaundice resulting from partial or complete biliary obstruction; to differentiate extrahepatic biliary atresia from neonatal hepatitis; to detect cystic duct obstruction associated with acute cholecystitis; and to detect bile leaks. Also, 99m Tc-Mebrofenin may be useful to detect intrahepatic cholestasis and to distinguish it from other hepatobiliary diseases, which involve hepatocyte damage. However, the Mebrofenin kit has to be obtained at an exorbitant cost and there was need to develop an indigenous kit that was readily available and could give similar results. For the first time in India, a derivative of DMSA developed by DRDE, Gwalior and modified at INMAS, Delhi to adopt early transition metals, was successfully labelled with 99m Tc (LE>99%). The reaction conditions were optimized after studying the effects of amount of SnCl 2 , pH of the reaction and effect of incubation time. The labelled product 99m Tc-O 2 S 4 , was characterized by ITLC-SG using acetone and saline. The complex was found to be fairly stable at room temperature and showed>95% plasma protein binding. The biodistribution studies showed that after intravenous administration, there was immediate accumulation of radioactivity in liver, the activity kept on increasing in gall bladder with time and thereafter the radioactivity moved to common bile duct (CBD) and small intestines. No significant radioactivity was found in kidneys and blood. Clear visualization of the gallbladder and intestines, within 15 to 45 minutes of administration of 99m Tc-O 2 S 4 in normal rabbit, demonstrates hepatobiliary tract patency of the newly developed radiotracer. The dynamic and static images showed that the newly developed radiopharmaceutical 99m Tc-O 2 S 4 has full potential in studying

  16. Development of a novel fusion imaging technique in the diagnosis of hepatobiliary-pancreatic lesions

    International Nuclear Information System (INIS)

    Soga, Koichi; Ochiai, Jun; Miyajima, Takashi; Kassai, Kyoichi; Itani, Kenji; Yagi, Nobuaki; Naito, Yuji

    2013-01-01

    Multi-row detector computed tomography (MDCT) and magnetic resonance cholangiopancreatography (MRCP) play an important role in the imaging diagnosis of hepatobiliary-pancreatic lesions. Here we investigated whether unifying the MDCT and MRCP images onto the same screen using fusion imaging could overcome the limitations of each technique, while still maintaining their benefits. Moreover, because reports of fusion imaging using MDCT and MRCP are rare, we assessed the benefits and limitations of this method for its potential application in a clinical setting. The patient group included 9 men and 11 women. Among the 20 patients, the final diagnoses were as follows: 10 intraductal papillary mucinous neoplasms, 5 biliary system carcinomas, 1 pancreatic adenocarcinoma and 5 non-neoplastic lesions. After transmitting the Digital Imaging and Communication in Medicine data of the MDCT and MRCP images to a workstation, we performed a 3-D organisation of both sets of images using volume rendering for the image fusion. Fusion imaging enabled clear identification of the spatial relationship between a hepatobiliary-pancreatic lesion and the solid viscera and/or vessels. Further, this method facilitated the determination of the relationship between the anatomical position of the lesion and its surroundings more easily than either MDCT or MRCP alone. Fusion imaging is an easy technique to perform and may be a useful tool for planning treatment strategies and for examining pathological changes in hepatobiliary-pancreatic lesions. Additionally, the ease of obtaining the 3-D images suggests the possibility of using these images to plan intervention strategies.

  17. Ruthenium-97 hepatobiliary agents for delayed studies of the bilary tract I: Ru-97 PIPIDA: concise communication

    International Nuclear Information System (INIS)

    Schachner, E.R.; Gil, M.C.; Atkins, H.L.; Som, P.; Srivastava, S.C.; Badia, J.; Sacker, D.F.; Fairchild, R.G.; Richards, P.

    1981-01-01

    Failure of early diagnosis of biliary atresia results in the development of cirrhosis and death. Commonly used hepatobiliary agents are not ideal for follow-up studies because of their unfavorable physical properties or short half-life. The excellent physical properties of Ru-97 should overcome these limitations. Therefore, Ru-97 PIPIDA (N,α-(p-isopropyl acetanilide) iminoacetic acid) is being investigated as a potential hepatobiliary agent that would allow an improved diagnosis of the disease. Ruthenium-97 PIPIDA and Tc-99m PIPIDA showed similar blood clearance rates in dogs. Ru-97 PIPIDA scintigrams in dogs showed early uptake in liver and gallbladder and slow excretion through the gastrointestinal tract. Biodistribution studies were performed in normal rats and rats with biliary obstruction. The findings suggest that Ru-97 PIPIDA should be useful for delayed studies ( 1 to 3 days) of the biliary tract

  18. Tc99m- hepatobiliary iminodiacetic acid (HIDA) scintigraphy in clinical practice

    International Nuclear Information System (INIS)

    Lambie, H.; Cook, A.M.; Scarsbrook, A.F.; Lodge, J.P.A.; Robinson, P.J.; Chowdhury, F.U.

    2011-01-01

    There have been evolutionary changes in the management of pathological conditions of the hepatobiliary system over recent years, particularly with an increasing emphasis on modern hepatobiliary surgical techniques. Concurrent advances have occurred in imaging technology and availability, leading to a greater use of ultrasound, multidetector computed tomography (CT), and magnetic resonance imaging (MRI) in the primary evaluation of hepatobiliary disease. Radionuclide imaging using technetium 99m (Tc 99m ) hepatobiliary iminodiacetic acid (HIDA) derivatives is an established technique that complements morphological imaging, providing valuable functional information in both pre- and postoperative evaluation of patients with suspected or known hepatobiliary disease. This review discusses the current clinical indications for Tc 99m HIDA scintigraphy using clinical cases to demonstrate how this technique continues to play a valuable diagnostic role in the assessment of the functional integrity of the hepatobiliary system.

  19. Diagnostic imaging of digestive tract involvement in cystic fibrosis. Part 1: hepatobiliary disease

    International Nuclear Information System (INIS)

    Miralles, M.; Gonzalez, G.; Serrano, C.; Manzanares, J.; Berrocal, T.

    1998-01-01

    Cystic fibrosis is a severe hereditary disease characterized by epithelial chloride channel dysfunction, leading to the production of abnormally thick secretions. The abnormal gene is located on the long arm of chromosome 7. Hepatobiliary involvement derives from ductal obstruction causing cholestasis, steatosis, cirrhosis and portal hypertension. Biliary sludge, cholelithiasis and gallbladder sclerosis and atrophy are common findings. As the correlation between the hepatobiliary changes and their clinical and analytical impact is very limited, imaging techniques are essential in this disease. Ultrasound is the basic imaging tool, both for initial evaluation and follow-up of the hepatic and biliary involvement, although other techniques such as radionuclide imaging, magnetic resonance and computed tomography can be highly useful. Given the long-term, chronic nature of this disease, the use of aggressive techniques or irradiation should be carefully weighed. (Author) 38 refs

  20. Diagnostic imaging in the study of human hepatobiliary fascioliasis.

    Science.gov (United States)

    Cantisani, V; Cantisani, C; Mortelé, K; Pagliara, E; D'Onofrio, M; Fernandez, M; D'Ambrosio, U; Lombardi, V; Marigliano, C; Ricci, P

    2010-02-01

    Fascioliasis is a rare zoonotic disease caused by the trematode Fasciola hepatica. We present the typical patterns of hepatobiliary fascioliasis observed in ten patients studied with multimodality imaging. Between 2002 and 2005, ten women with fascioliasis were admitted to the Brigham and Women's Hospital, Harvard Medical School (BWH), with abdominal pain and mild fever. All imaging modalities, including ultrasound (US), computed tomography (CT), magnetic resonance (MR) imaging (n = 2) and endoscopic retrograde cholangiopancreatography (ERCP) (n = 1) were reviewed by two expert radiologists working in consensus. In all patients (10/10, 100%), US showed parenchymal heterogeneity characterised by multiple subcapsular and peribiliary hypoechoic nodular lesions that were ill-defined and coalesced into tubular or tortuous structures. In six patients (6/10, 60%), the lesions appeared hypoechoic, whereas in four patients (4/10, 40%), there was an alternation of hyperechoic and hypoechoic nodules. On CT, all patients (10/10, 100%) showed hypodense patchy lesions in subcapsular, peribiliary or periportal locations, which coalesced to form tubular structures and were more evident during the portal phase. Lesion diameter ranged from 2 cm to 7 cm. Capsular enhancement was seen in four cases on CT (4/10, 40%) and in one also at MR imaging. MR imaging, performed in two patients, confirmed the presence of the lesions, which appeared hyperintense on T2-weighted images and were characterised by mild peripheral enhancement after gadolinium administration. Four patients had gallbladder wall thickening (4/10, 40%), with parasites in the gallbladder lumen. Although rare, hepatobiliary fascioliasis should be considered in the differential diagnosis in the appropriate clinical scenario, especially in patients coming from endemic areas. The typical imaging pattern of fascioliasis is the presence of subcapsular, peribiliary or periportal nodules that are usually ill-defined and coalesce

  1. Hepatobiliary scanning using /sup 99m/Tc--pyridoxylideneglutamate

    International Nuclear Information System (INIS)

    Matolo, N.M.; Stadalnik, R.C.; Wolfman, E.F. Jr.

    1977-01-01

    Technetium 99m-pyridoxylideneglutamate (99mTc-PG) administered intravenously is excreted by hepatocytes into the bile canaliculi and enters the gallbladder through the cystic duct and consequently, can be used for scanning the hepatobiliary ductal system. A total of 166 patients representing 27 normal subjects, 84 patients referred for investigation for pain in the upper right quadrant of the abdomen and 55 jaundiced patients were evaluated with 99mTc-PG. In normal human volunteers, the agent reached the liver in five minutes, and the common bile duct, gallbladder, and duodenum within 15 minutes. Satisfactory images of the hepatobiliary tract were obtained using small dosages of 99mTc-PG. The gallbladder was not visualized when the cystic duct was occluded. In the presence of acute cholecystitis, cystic duct obstruction, or in chronic cholecystitis where other roentgenographic studies showed a nonfunctioning gallbladder, there was no concentration of 99mTc-PG in the gallbladder. In partial common bile duct obstruction, distended common bile duct was visualized along with delay in transit of radioactivity into the duodenum. Complete common bile duct obstruction was associated with no radioactivity in either the biliary or the gastrointestinal tracts up to 24 hours after injection. Hepatocellular disease was characterized by delayed liver clearance and delayed visualization of biliary and gastrointestinal tracts. 99mTc-PG scanning proved capable of differentiating betweenhepatocellular disease and extrahepatic biliary tract obstruction

  2. 99Tcm-EHIDA hepatobiliary imaging for neonatal intrahepatic cholestasis caused by citrin deficiency

    International Nuclear Information System (INIS)

    Gong Jian; Deng Mei; Song Yuanzong; Xu Hao

    2012-01-01

    Objective: To evaluate the imaging characteristics of 99 Tc m -EHIDA hepatobiliary scintigraphy in neonatal intrahepatic cholestasis caused by citrin deficiency (NICCD). Methods: 99 Tc m -EHIDA hepatobiliary scan was performed on 12 NICCD infants (aged (127 ±27) d) and 5 infants as a control group (including 4 cases with hepatitis syndrome and 1 with abnormal lipid metabolism, aged (164 ± 15) d). The differences of hepatic activity retention time and bowel activity visualization time between the two groups were observed. The two-sample Wilcoxon rank sum test was used to analyze the data. Results: In the NICCD group, both hepatic activity retention time and bowel activity visualization time were 180-1440 min (median=360 min). In the control group, hepatic activity retention time and bowel activity visualization time were 60-180 min (median=60 min) and 15-30 min (median=15 min), respectively. The differences of hepatic activity retention time and bowel activity visualization time between the two groups were statistically significant (Z=-3.20 and -3.17, both P<0.05). Three NICCD infants showed minimal hepatic uptake of the tracer. The bowel activity was not visible in 1 NICCD case.The hepatic uptake and biliary excretion function of this infant were significantly improved on hepatobiliary scintigraphy after treatment, with a bowel activity visualization time of 15 min. Conclusion: NICCD infants show impaired hepatic uptake and biliary excretion function on 99 Tc m -EHIDA hepatobiliary imaging, which may be used in NICCD diagnosis and treatment response evaluation. (authors)

  3. Potential Pitfalls on the (99m)Tc-Mebrofenin Hepatobiliary Scintigraphy in a Patient with Biliary Atresia Splenic Malformation Syndrome

    DEFF Research Database (Denmark)

    Maestri Brittain, Jane; Borgwardt, Lise

    2016-01-01

    the first years of life. Kasai portoenterostomy restores bile flow and delay the progressive liver damage thereby postponing liver transplantation. An early diagnosis is of most importance to ensure the effectiveness of the operation. The (99m)Tc-Mebrofenin hepatobiliary scintigraphy is part...... of BA. Laparotomy with antegrade cholangiography is then performed giving the final diagnosis when the remains of the obliterated biliary tree are revealed in the case of BA. We present a case demonstrating some of the challenges of interpreting the (99m)Tc-Mebrofenin hepatobiliary scintigraphy...... in an infant with BASM and stress the importance that the (99m)Tc-Mebrofenin hepatobiliary scintigraphy is part of a spectrum of imaging modalities in diagnosing BA....

  4. Hepatobiliary cystadenoma exhibiting morphologic changes from simple hepatic cyst shown by 11-year follow up imagings

    Directory of Open Access Journals (Sweden)

    Sato Koichi

    2008-12-01

    Full Text Available Abstract Background A long-term follow up case of hepatobiliary cystadenoma originating from simple hepatic cyst is rare. Case presentation We report a case of progressive morphologic changes from simple hepatic cyst to hepatobiliary cystadenoma by 11 – year follow up imaging. A 25-year-old man visited our hospital in 1993 for a simple hepatic cyst. The cyst was located in the left lobe of the liver, was 6 cm in diameter, and did not exhibit calcification, septa or papillary projections. No surgical treatment was performed, although the cyst was observed to gradually enlarge upon subsequent examination. The patient was admitted to our hospital in 2004 due to epigastralgia. Re-examination of the simple hepatic cyst revealed mounting calcification and septa. Abdominal CT on admission revealed a hepatic cyst over 10 cm in diameter and a high-density area within the thickened wall. MRI revealed a mass of low intensity and partly high intensity on a T1-weighted image. Abdominal angiography revealed hypovascular tumor. The serum levels of AST and ALT were elevated slightly, but tumor markers were within normal ranges. Left lobectomy of the liver was performed with diagnosis of hepatobiliary cystadenoma or hepatobiliary cystadenocarcinoma. The resected specimen had a solid component with papillary projections and the cyst was filled with liquid-like muddy bile. Histologically, the inner layer of the cyst was lined with columnar epithelium showing mild grade dysplasia. On the basis of these findings, hepatobiliary cystadenoma was diagnosed. Conclusion We believe this case provides evidence of a simple hepatic cyst gradually changing into hepatobiliary cystadenoma.

  5. Liver cysts associated with polycystic kidney disease: Role of Tc-99m hepatobiliary imaging

    International Nuclear Information System (INIS)

    Salam, M.; Keeffe, E.B.

    1989-01-01

    A 42-year-old woman with multiple hepatic cysts associated with autosomal polycystic kidney disease was evaluated for abdominal discomfort and new liver test abnormalities following blind aspirations of her liver cysts. Tc-99m mebrofenin hepatobiliary imaging revealed a markedly enlarged liver with multiple photon deficient areas, focal retention of isotope in the left hepatic ductal system, no accumulation of radionuclide in cysts, and an unusual medial gallbladder position. Endoscopic retrograde cholangiography confirmed all of these findings. Abdominal discomfort and liver biochemical abnormalities were attributed to cyst compression of nearby structures, including bile ducts. Hepatobiliary imaging is useful to exclude communication of bile ducts with hepatic cysts, to detect incidental abnormalities such as partial bile duct obstruction, and to distinguish the gallbladder from nearby hepatic cysts

  6. Added value of Gd-EOB-DTPA-enhanced Hepatobiliary phase MR imaging in evaluation of focal solid hepatic lesions

    International Nuclear Information System (INIS)

    Haimerl, Michael; Wächtler, Max; Platzek, Ivan; Müller-Wille, Rene; Niessen, Christoph; Hoffstetter, Patrick; Schreyer, Andreas Georg; Stroszczynski, Christian; Wiggermann, Philipp

    2013-01-01

    Correct characterization of focal solid hepatic lesions has always been a challenge and is of great diagnostic and therapeutic relevance. The purpose of this study was to determine the added value of hepatobiliary phase images in Gd-EOB-DTPA-enhanced magnetic resonance imaging (MRI) for differentiating focal solid hepatic lesions. In this retrospective trial 84 consecutive patients underwent Gd-EOB-DTPA-enhanced MR examinations. MRI was conducted for 64 patients with malignant focal hepatic lesions (34 hepatocellular carcinoma (HCC), 30 metastases) and for 20 patients with benign hepatic lesions (14 focal nodular hyperplasia (FNH), 3 adenoma, 3 hemangioma). Five radiologists independently reviewed three sets of MR images by means of a 5-point confidence scale from score 1 (definitely benign) to score 5 (definitely malignant): set 1: unenhanced images; set 2: unenhanced and Gd-EOB-DTPA-enhanced dynamic images; set 3: hepatobiliary phase images in addition to set 2. Accuracy was assessed by the alternative free-response receiver operating characteristic curve (A z ) and the index of diagnostic performance was calculated. Diagnostic accuracy was significantly improved by the addition of Gd-EOB-DTPA-enhanced dynamic images: A z in set 1 was 0.708 and 0.833 in set 2 (P = 0.0002). The addition of hepatobiliary phase images increased the A z value to 0.941 in set 3 (set 3 vs set 2, P < 0.0001; set 3 vs set 1, P < 0.0001). The index of diagnostic performance was lowest in set 1 (45%), improved in set 2 (71%), and highest in set 3 (94%). Hepatobiliary phase images obtained after Gd-EOB-DTPA-enhanced dynamic MRI improve the differentiation of focal solid hepatic lesions

  7. Technetium-99m-labeled N-(2,6-dimethylphenylcarbamoylmethyl) iminodiacetic acid (/sup 99m/Tc HIDA): a new radiopharmaceutical for hepatobiliary imaging studies

    International Nuclear Information System (INIS)

    Ryan, J.; Cooper, M.; Loberg, M.; Harvey, E.; Sikorski, S.

    1977-01-01

    An easily formulated, stable kit preparation of technetium-99m HIDA, suitable for use in humans, was developed and tested in mice and dogs. The tracer was cleared rapidly from the blood and excreted predominantly by the liver in both species. In dogs, the hepatobiliary clearance of Tc-99m HIDA was significantly greater than that of C-14 HIDA and Sn-113 HIDA. The LD 50 for HIDA in mice, 168 mg/kg, exceeded the average human dose by a factor of 1000 on a per-weight basis. Blood clearance curves for Tc-99m HIDA in 12 normal subjects were biexponential with half-times of 4.6 +- 1.0 min and 31.5 +- 7.0 min, and cumulative 90-min urine samples contained 14.2 +- 1.8% of the injected dose. Images in normal subjects and nonjaundiced patients showed rapid concentration of tracer by the liver and activity was present within the biliary system in 10 to 20 min. In jaundiced patients, the tracer blood clearance was delayed and urinary excretion increased, but intestinal activity, indicating biliary patency, was imaged in those patients without complete focal obstruction of the common duct. Technetium-99m HIDA is a nontoxic radiopharmaceutical useful for clinical evaluation of hepatobiliary disorders in humans

  8. Emergency surgeon-performed hepatobiliary ultrasonography.

    LENUS (Irish Health Repository)

    Kell, M R

    2012-02-03

    BACKGROUND: Acute hepatobiliary pathology is a common general surgical emergency referral. Diagnosis requires imaging of the biliary tree by ultrasonography. The accuracy and impact of surgeon-performed ultrasonography (SUS) on the diagnosis of emergent hepatobiliary pathology was examined. METHODS: A prospective study, over a 6-month period, enrolled all patients with symptoms or signs of acute hepatobiliary pathology. Patients provided informed consent and underwent both SUS and standard radiology-performed ultrasonography (RUS). SUS was performed using a 2-5-MHz broadband portable ultrasound probe by two surgeons trained in ultrasonography, and RUS using a 2-5-MHz fixed unit. SUS results were correlated with those of RUS and pathological diagnoses. RESULTS: Fifty-three consecutive patients underwent 106 ultrasonographic investigations. SUS agreed with RUS in 50 (94.3 per cent) of 53 patients. SUS accurately detected cholelithiasis in all but two cases and no patient was inaccurately diagnosed as having cholelithiasis at SUS (95.2 per cent sensitivity and 100 per cent specificity). As an overall complementary diagnostic tool SUS provided the correct diagnosis in 96.2 per cent of patients. Time to scan was significantly shorter following SUS (3.1 versus 12.0 h, P < 0.05). CONCLUSION: SUS provides a rapid and accurate diagnosis of emergency hepatobiliary pathology and may contribute to the emergency management of hepatobiliary disease.

  9. Hepatobiliary scintigraphy and function test with sup(99m)Tc-N-pyridoxyl-5-methyltryptophan (sup(99m)Tc-PMT)

    International Nuclear Information System (INIS)

    Sugimura, Kazuro; Nishiyama, Shoji; Narabayashi, Isamu

    1985-01-01

    The authors studied the effectiveness of sup(99m)Tc-N-pyridoxyl-5-methyltryptophan (sup(99m)Tc-PMT) for dynamic imaging and function on 40 patients with various hepatobiliary diseases and on healthy individuals. In healthy subjects, sup(99m)Tc-PMT is rapidly removed from the blood by the parenchymal cells of the liver and is excreted through the biliary system. The imaging of the liver, bile ducts, gallbladder and intestines with sup(99m)Tc-PMT was satisfactory. There was no renal visualization. In the case of serial images of healthy individuals, the gallbladder, intrahepatic bile duct and small intestine were visualized after 18.8 +- 7.2, 8.8 +- 1.4, and 16.7 +- 6.3 min, respectively; the mean peak time on the hepatogram was 8.0 +- 5.3 min. The bile ducts of patients with liver disorders were visualized later than those of healthy individuals. Particularly in the case of severe liver parenchymal diseases, the appearance time for the bile duct was significantly delayed. However, the delays in appearance time did not correlate well with low scores on the liver function test. At 70 min after the intravenous administration of sup(99m)Tc-PMT, 2.5 +- 1.5 % of the injected dose was excreted into the urine of the healthy individuals. The urinary excretion of sup(99m)Tc-PMT by the patients with hepatobiliary diseases showed no increase, and it was not entirely related to the results of the serum function tests. However, a larger amount of sup(99m)Tc-PMT was retained in the blood of the patients with hepatobiliary diseases. The blood retention values at 20 min after injection into those with liver cirrhosis and hepatoma were significantly delayed. (author)

  10. Evaluation gallbladder function in patients with spinal cord injury using 99Tcm-DISIDA hepatobiliary imaging

    International Nuclear Information System (INIS)

    Xia Changsuo; Li Hong; Hong Guangxiang

    2005-01-01

    Objective: To investigate gallbladder function in patients with spinal cord injury (SCI). Methods: Eighteen normal control subjects, 16 other traumatic control subjects and 46 SCI patients were include. Gallbladder function was quantitatively evaluated by 99 Tc m labeled imino-diacetic acid analogue (DISIDA) hepatobiliary imaging using two parameters as filling fraction (FF) and ejection fraction (EF). The gallbladder function of SCI patients was further analyzed according to age, sex, body weight, injury gradient (with ASIA criteria), cord injury level and the duration of injury. Results: 52% of SCI patients had abnormal FF and 59% with abnormal EF. Significantly decreased FF and EF values were found in SCI patients, especially in those who were female, severe and high-level injuries of spinal cord. Conclusion: With the use of quantitative 99 Tc m -DISIDA hepatobiliary imaging, significant impairment of the gallbladder function was found in SCI patients. (authors)

  11. Hepatobiliary scintigraphy

    International Nuclear Information System (INIS)

    Velchik, M.G.

    1988-01-01

    This chapter describes the role of nuclear medicine in the evaluation of the hepatobiliary system. The technical aspects of hepatobiliary scintigraphy, or cholescintigraphy (radiopharmaceutical, radiation dosimetry, instrumentation, and method) are briefly presented, followed by a discussion of each of the indications for such examination. Its relative advantages and disadvantages with respect to alternative radiographic examinations are emphasized. Logical, efficient, cost-effective sequences of diagnostic studies are recommended whenever appropriate in order to derive the maximum information with the least time and expense. It is hoped that the reader will come away with an appreciation of the type of diagnostic information provided by hepatobiliary scintigraphy, its accuracy, its application in the workup of the patient with hepatobiliary disease, and its strengths and limitations compared with other radiologic studies

  12. The role of Tc-99m IDA hepatobiliary and Tc-99m colloid hepatic imaging in primary biliary cirrhosis

    International Nuclear Information System (INIS)

    Aburano, T.; Yokoyama, K.; Shuke, N.; Kinuya, S.; Takayama, T.; Tonami, N.; Hisada, K.

    1991-01-01

    To assess the presence of primary biliary cirrhosis, 15 patients at various histopathologic stages were studied by Tc-99m IDA hepatobiliary and/or Tc-99m colloid hepatic imaging. In the earlier stages (I and II), seven of eight patients (88%) showed uniform hepatic retention of Tc-99m IDA. Of seven patients in the same stage, however, four (57%) showed no abnormality on Tc-99m colliod imaging. In three of these four negative patients (75%), uniform hepatic retention of Tc-99m IDA was noted. In the later stages (III and IV), all seven patients showed decreased clearance with or without delayed tracer appearance in the intestine and prominent hepatic retention on Tc-99m IDA imaging; with Tc-99m colloid imaging there was enlargement of the spleen and increased activity in the spleen and bone marrow. Thus, Tc-99m IDA imaging is considered to be more useful in revealing this functional disorder at the earlier stage of primary biliary cirrhosis and in evaluating progression from an earlier to a later stage of disease. Tc-99m colloid imaging also effectively evaluated progression

  13. Sphincter of Oddi stenosis: diagnosis using hepatobiliary scintigraphy and endoscopic manometry

    International Nuclear Information System (INIS)

    Lee, R.G.L.; Gregg, J.A.; Koroshetz, A.M.; Hill, T.C.; Clouse, M.E.

    1985-01-01

    To determine the role of radionuclide imaging in diagnosing sphincter of Oddi stenosis, 21 patients with symptoms suggesting this disorder underwent endoscopic retrograde cholangiopancreatography, cholescintigraphy, and, when possible, endoscopic manometry. Those patients with abnormal hepatobiliary scintigraphy results had a mean basal sphincter pressure of 38.5 mm Hg. Sphincter pressures could not be measured in six patients with sphincters too tight to cannulate. Ten patients who underwent hepatobiliary scanning both before and after sphincter surgery had normal scan results of the repeat study. Hepatobiliary imaging appears useful for diagnosis of sphincter of Oddi stenosis in selected patients in whom manometry cannot be performed and for objective assessment of response to therapy

  14. Iron-EHPG as an hepatobiliary MR contrast agent: initial imaging and biodistribution studies

    International Nuclear Information System (INIS)

    Lauffer, R.B.; Greif, W.L.; Stark, D.D.; Vincent, A.C.; Saini, S.; Wedeen, V.J.; Brady, T.J.

    1988-01-01

    A paramagnetic relaxation agent targeted to functioning hepatocytes of the liver and excreted into the bile would be useful in the enhancement of normal liver and biliary anatomy in MR imaging. We sought to demonstrate the feasibility of this approach using the prototype hepatobiliary MR contrast agent, iron(III) ethylenebis-(2-hydroxyphenylglycine) (Fe(EHPG) - ). The biodistribution, relaxation enhancement, and imaging characteristics of Fe(EHPG) - were compared to those of the non-specific iron chelate iron(III) diethylenetriaminepentaacetic acid (Fe(DTPA) 2- ), which has a comparable effect on water proton relaxation times. (author)

  15. Value of an hepatobiliary imaging agent for diagnosing hepatoma. Example of diethyl-IDA

    Energy Technology Data Exchange (ETDEWEB)

    Bourguet, P; Estable, P; Herry, J Y

    1985-01-01

    A comparative study was performed using two hepatic tracers, a Tc 99m labelled colloid and an hepatobiliary agent Tc 99m labelled diethyl-IDA. In some patients with isolated primary hepatocarcinoma the uptake of the hepatobiliary agent was observed but the colloid was not taken up. In the contrary, the hepatobiliary agent has proved to be of limited value for the diagnosis of hepatomas coexisting with cirrhosis and for the detection of secondary hepatocarcinoma.

  16. MR imaging evaluation of pancreas and hepatobiliary system in cystic fibrosis

    International Nuclear Information System (INIS)

    Murayama, S.; Robinson, A.E.; Stallworth, J.; Mulvihill, D.; Beckerman, R.; Davis, S.

    1988-01-01

    The pancreas and hepatobiliary system of 20 patients with cystic fibrosis were analyzed with a 1.5-T magnet. T1-weighted, T2-weighted, and proton-density images were obtained, and the T1 and T2 values of the pancreas were calculated. Signal intensity ratios were calculated for the signal intensities of the pancreas and the liver relative to that of muscle and fat on each pulse sequence. Fatty replacement of the pancreas and regenerating nodules of biliary cirrhosis were readily identified on T1-weighted images. The T1 values for pancreatic tissue showed promise as a good marker for pancreatic disease progression. Pancreas-to-fat signal intensity ratios on 300/20 (repetition time msec/echo time msec) and 2,000/75 images were considered to be a good standard for evaluating the level of pancreatic involvement

  17. Value of an hepatobiliary imaging agent for diagnosing hepatoma. Example of diethyl-IDA

    International Nuclear Information System (INIS)

    Bourguet, P.; Estable, P.; Herry, J.Y.

    1985-01-01

    A comparative study was performed using two hepatic tracers, a Tc 99m labelled colloid and an hepatobiliary agent Tc 99m labelled diethyl-IDA. In some patients with isolated primary hepatocarcinoma the uptake of the hepatobiliary agent was observed but the colloid was not taken up. In the contrary, the hepatobiliary agent has proved to be of limited value for the diagnosis of hepatomas coexisting with cirrhosis and for the detection of secondary hepatocarcinoma [fr

  18. Application status of three-dimensional CT reconstruction in hepatobiliary surgery

    Directory of Open Access Journals (Sweden)

    JIANG Chao

    2017-02-01

    Full Text Available With the development of imaging technology, three-dimensional CT reconstruction has been widely used in hepatobiliary surgery. Three-dimensional CT reconstruction can divide and reconstruct two-dimensional images into three-dimensional images and clearly show the location of lesion and its relationship with the intrahepatic bile duct system. It has an important value in the preoperative assessment of liver volume, diagnosis and treatment decision-making process, intraoperative precise operation, and postoperative individualized management, and promotes the constant development of hepatobiliary surgery and minimally invasive technology, and therefore, it holds promise for clinical application.

  19. Hepatocellular carcinoma: clinical significance of signal heterogeneity in the hepatobiliary phase of gadoxetic acid-enhanced MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Fujita, Nobuhiro; Nishie, Akihiro; Asayama, Yoshiki; Ushijima, Yasuhiro; Moirta, Koichiro; Honda, Hiroshi [Kyushu University, Department of Clinical Radiology, Graduate School of Medical Sciences, Fukuoka (Japan); Kubo, Yuichiro; Aishima, Shinichi [Kyushu University, Department of Anatomic Pathology, Graduate School of Medical Sciences, Fukuoka (Japan); Takayama, Yukihisa [Kyushu University, Department of Molecular Imaging and Diagnosis, Graduate School of Medical Sciences, Fukuoka (Japan); Shirabe, Ken [Kyushu University, Department of Surgery and Science, Graduate School of Medical Sciences, Fukuoka (Japan)

    2015-01-15

    To clarify the relationship between the biological behaviour of hepatocellular carcinomas (HCCs) and their signal intensity in the hepatobiliary phase of gadoxetic acid-enhanced MR imaging with a special focus on the signal heterogeneity. A total of 68 patients with 70 pathologically proven HCCs were enrolled. On the basis of the signal intensity in the hepatobiliary phase, the lesions were classified into three groups: group 1, homogeneous hypointensity (n = 44); group 2, heterogeneous hyperintensity (n = 20); and group 3, homogeneous hyperintensity (n = 6). The clinicopathological findings were compared among the three groups. The tumour size and the serum level of protein induced by vitamin K absence or antagonist-II (PIVKA-II) were significantly higher in group 2 compared to group 1 (p = 0.0155, p = 0.0215, respectively) and compared to group 3 (p = 0.0330, p = 0.0220, respectively). The organic anion transporting polypeptide 8 (OATP8) expression in group 2 and group 3 was significantly higher than in group 1 (p < 0.0001, p < 0.0001, respectively). Group 2 showed a significantly lower disease-free survival rate compared to group 1 (p = 0.0125), and group 2 was an independent prognostic factor for disease-free survival (p = 0.0308). HCCs in the hepatobiliary phase that are heterogeneously hyperintense on gadoxetic acid-enhanced MR imaging have more malignant potential than other types of HCCs. (orig.)

  20. Hepatobiliary scanning

    Energy Technology Data Exchange (ETDEWEB)

    Verdegaal, W P

    1978-01-01

    The use of hepatobiliary scintigraphy is discussed on the basis of personal observations with sup(99m)Tc-pyridoxylideneglutamate (sup(99m)Tc-PG). Hepatobiliary scintigraphy appears to be a useful tool in differentiating the causes of jaundice. Its value as a test for biliary reflux to the stomach and as a method to evaluate the function of intestinal and bilidigestive anastomoses needs further investigation.

  1. Evaluation of 99mTc-Mercaptoacetyltriglycine-Biocytin as a new hepatobiliary imaging agent in mice coinjected with bilirubin

    International Nuclear Information System (INIS)

    Kim, Meyoung-kon; Seidel, Juergen; Le Nhat; Kim, In-Sook; Yoo, Tae-Moo; Barker, Craig; Kobayashi, Hisataka; Green, Michael V.; Carrasquillo, Jorge A.; Paik, Chang H.

    1999-01-01

    We evaluated 99m Tc-labeled mercaptoacetyltriglycine ( 99m Tc-MAG3)-biocytin as a hepatobiliary imaging agent in the absence and presence of bilirubin in mice. We then compared its pharmacokinetic parameters; peak liver/heart activity ratio (r max ) and half clearance time (HCT) with those of 99m Tc-labeled diisopropyl-iminodiacetic acid ( 99m Tc-disofenin). Balb/c mice were injected intravenously with hepatobiliary agent ( 99m Tc-MAG3-biocytin or 99m Tc-disofenin) alone or in combination with bilirubin at two doses (7 and 14 mg/kg) dissolved in 5% human serum albumin. Images were acquired every 15 s for 30 min with a gamma-camera equipped with a pinhole collimator. Dynamic images showed rapid hepatic uptake of 99m Tc-MAG3-biocytin, with rapid clearance from the blood and rapid excretion via the biliary system. Its hepatic uptake was not affected by bilirubin coinjection, whereas 99m Tc-disofenin coinjected with bilirubin showed a higher blood background than 99m Tc-disofenin alone. These qualitative findings were reflected in pharmacokinetic parameters, r max and HCT. The r max was obtained from plots of time versus liver/heart activity ratios obtained in equal-area regions of interest over the heart and liver. The HCT was calculated from the hepatic clearance curve from plots of time versus liver activity. 99m Tc-MAG3-biocytin without bilirubin coinjection showed an r max of 8.9±1.3 and an HCT of 399±36 s. These values did not change even when 14 mg/kg of bilirubin were coinjected. By contrast, the parameters for 99m Tc-disofenin with bilirubin were significantly (p max was decreased from 7.9±2.5 to 1.4±0.2 and HCT was increased from 292±32 s to 782±133 s. 99m Tc-MAG3-biocytin hepatobiliary scintigraphy in mice is not affected by bilirubin coinjection, and this hepatobiliary agent appears to offer promise for estimating hepatic function in patients with high bilirubin levels

  2. Technetium-99m-labeled N-(2,6-dimethylphenylcarbamoylmethyl) iminodiacetic acid (/sup 99m/Tc HIDA): a new radiopharmaceutical for hepatobiliary imaging studies. [/sup 14/C, /sup 113/Sn

    Energy Technology Data Exchange (ETDEWEB)

    Ryan, J.; Cooper, M.; Loberg, M.; Harvey, E.; Sikorski, S.

    1977-10-01

    An easily formulated, stable kit preparation of technetium-99m HIDA, suitable for use in humans, was developed and tested in mice and dogs. The tracer was cleared rapidly from the blood and excreted predominantly by the liver in both species. In dogs, the hepatobiliary clearance of Tc-99m HIDA was significantly greater than that of C-14 HIDA and Sn-113 HIDA. The LD/sub 50/ for HIDA in mice, 168 mg/kg, exceeded the average human dose by a factor of 1000 on a per-weight basis. Blood clearance curves for Tc-99m HIDA in 12 normal subjects were biexponential with half-times of 4.6 +- 1.0 min and 31.5 +- 7.0 min, and cumulative 90-min urine samples contained 14.2 +- 1.8% of the injected dose. Images in normal subjects and nonjaundiced patients showed rapid concentration of tracer by the liver and activity was present within the biliary system in 10 to 20 min. In jaundiced patients, the tracer blood clearance was delayed and urinary excretion increased, but intestinal activity, indicating biliary patency, was imaged in those patients without complete focal obstruction of the common duct. Technetium-99m HIDA is a nontoxic radiopharmaceutical useful for clinical evaluation of hepatobiliary disorders in humans.

  3. Characteristic MR and CT imaging findings of hepatobiliary paragonimiasis and their pathologic correlations

    Energy Technology Data Exchange (ETDEWEB)

    Lu, Chunyan; Hu, Yajun; Chen, Weixia [Dept of Radiology, West China Hospital of Sichuan Univ., Sichuan (China)], e-mail: wxchen25@126.com

    2012-06-15

    Background: Hepatobiliary paragonimiasis (HP) is not commonly encountered and may be confused with hepatobiliary tumors; however, computed tomography (CT) and magnetic resonance imaging (MRI) features of HP allow this entity to be distinguished from other diseases. Purpose: To present the CT and MRI findings in patients with HP and to describe some specific imaging findings along with their pathological correlations. Material and Methods: Imaging and clinical findings of 21 patients (9 boys/men and 12 girls/women; age range 3-67 years; mean age 40 years) who were diagnosed with HP were retrospectively evaluated. Among these patients, 16 underwent CT examination only, two had MR examination only, and three underwent both CT and MR. All patients underwent surgery, and the HP diagnosis was confirmed by the surgical and histopathologic results. Results: Chronic abdominal pain or back pain was reported by 14 patients, severe abdominal pain with acute onset was reported by one patient, and six patients were asymptomatic and were discovered incidentally. Peripheral eosinophilia was present in 14 patients (14/21, 66.7%), and abnormal liver function tests were found in 16 patients (16/21, 76.2%). Of the 19 patients who underwent CT imaging, 17 patients showed multiple mixed hypodense lesions or multiple cysts with inlaying septation with separate irregular rims or circular enhancement on post-contrast CT images. Tunnel-shaped micro abscesses and necrotic cavities were found in the lesions of 12 of those 17 patients. The other two patients showed smaller cystic masses. MRI showed faveolate T1 hypointense and T2 hyperintense areas in the liver parenchyma with rim or peripheral enhancement. Nodular or circular hyperintense materials were found scattered in the lesions on T1-weighted imaging. Conclusion: CT and MRI can reveal the radiological-pathological features of HP. Together with laboratory findings, MRI and CT findings may provide diagnostic clues, especially in endemic

  4. Characteristic MR and CT imaging findings of hepatobiliary paragonimiasis and their pathologic correlations

    International Nuclear Information System (INIS)

    Lu, Chunyan; Hu, Yajun; Chen, Weixia

    2012-01-01

    Background: Hepatobiliary paragonimiasis (HP) is not commonly encountered and may be confused with hepatobiliary tumors; however, computed tomography (CT) and magnetic resonance imaging (MRI) features of HP allow this entity to be distinguished from other diseases. Purpose: To present the CT and MRI findings in patients with HP and to describe some specific imaging findings along with their pathological correlations. Material and Methods: Imaging and clinical findings of 21 patients (9 boys/men and 12 girls/women; age range 3-67 years; mean age 40 years) who were diagnosed with HP were retrospectively evaluated. Among these patients, 16 underwent CT examination only, two had MR examination only, and three underwent both CT and MR. All patients underwent surgery, and the HP diagnosis was confirmed by the surgical and histopathologic results. Results: Chronic abdominal pain or back pain was reported by 14 patients, severe abdominal pain with acute onset was reported by one patient, and six patients were asymptomatic and were discovered incidentally. Peripheral eosinophilia was present in 14 patients (14/21, 66.7%), and abnormal liver function tests were found in 16 patients (16/21, 76.2%). Of the 19 patients who underwent CT imaging, 17 patients showed multiple mixed hypodense lesions or multiple cysts with inlaying septation with separate irregular rims or circular enhancement on post-contrast CT images. Tunnel-shaped micro abscesses and necrotic cavities were found in the lesions of 12 of those 17 patients. The other two patients showed smaller cystic masses. MRI showed faveolate T1 hypointense and T2 hyperintense areas in the liver parenchyma with rim or peripheral enhancement. Nodular or circular hyperintense materials were found scattered in the lesions on T1-weighted imaging. Conclusion: CT and MRI can reveal the radiological-pathological features of HP. Together with laboratory findings, MRI and CT findings may provide diagnostic clues, especially in endemic

  5. PIPIDA excretory scintigraphy in the diagnosis of hepatobiliary disorders

    International Nuclear Information System (INIS)

    Pelot, D.; Berk, J.E.; Wistow, B.W.; Morton, M.E.

    1981-01-01

    The diagnostic accuracy of hepatobiliary radionuclide imaging using 99 mTC-labeled para-isopropyl acetanilido-iminodiacetic acid ( 99 mTc-PIPIDA) in patients with hepatobiliary disorders was assessed in 50 patients. Thirty of the study group were jaundiced; the remaining 20 had other clinical features suggestive of some hepatobiliary disorder. The findings using PIPIDA proved to be correct in 22 (73%) of the 30 jaundiced patients and in 18 (90%) of 20 patients without jaundice. There appears to be a close relationship between the diagnostic accuracy of the test and the level of serum bilirubin. Thus, the diagnosis indicated by the PIPIDA test was correct in 30 (88%) of 34 patients in whom the serum bilirubin was less than 5 mg./dl. but only in 10 (62%) of 16 patients whose serum bilirubin exceeded 5 mg./dl. It is concluded from these observations that: 1. PIPIDA is diagnostically useful in the evaluation of hepatobiliary disorders, especially when the serum bilirubin is less than 5 mg./dl. and 2. the accuracy of this test is not absolute and the findings are not always definitive

  6. Obstructive jaundice due to hepatobiliary cystadenoma or cystadenocarcinoma

    NARCIS (Netherlands)

    Erdogan, Deha; Busch, Olivier R. C.; Rauws, Erik A. J.; van Delden, Otto M.; Gouma, Dirk J.; van-Gulik, Thomas M.

    2006-01-01

    Hepatobiliary cystadenomas (HBC) and cystadenocarcinomas are rare cystic lesions. Most patients with these lesions are asymptomatic, but presentation with obstructive jaundice may occur. The first patient presented with intermittent colicky pain and recurrent obstructive jaundice. Imaging studies

  7. Preparation of N-(3-BROMO-2,4,6-trimethylacetanilide) iminodiacetic acid and its 99MTc-complex for hepatobiliary imaging

    International Nuclear Information System (INIS)

    Choi, Ok Ja; Hong, Young Don; Gwon, Hui Jeong; Choi, Sang Mu; Choi, Sun Ju

    2005-01-01

    N-(3-bromo-2,4,6-trimethylacetanilide) iminodiacetic acid (BrTIDA) was synthesized using nitrilotriacetic anhydride prepared in situ, and lyophilized vials were prepared which contained 20 mg of BrTIDA and 0.4 mg of SnCl 2 . To evaluate the clinical efficacy of the in-house prepared lyophilized kit, a technetium-99m complex of BrTIDA was prepared; its in vivo pharmacokinetic behavior was evaluated via animal studies to assess the hepatocytic function and the functional status of the cystic duct and the gallbladder. Serial static image scans of rabbits and the biodistribution in mice injected with 99m Tc-BrTIDA revealed that none of the tissues except for the hepatobiliary system showed radioactivity concentrations, and a rapid clearance from the organs was observed. In conclusion, a lyophilized kit and its prepared 99m Tc-BrTIDA can be applied as a hepatobiliary imaging agent for the evaluation of the functional status of the hepatocytes and the patency of the biliary duct

  8. Hepatobiliary Hands of Hopkins.

    Science.gov (United States)

    Pitt, Henry A

    2018-02-01

    This historical perspective documents the role that John L. Cameron played in advancing hepatobiliary research, education, and surgery at Johns Hopkins in the 1970s, 1980s, and 1990s. Dating back to William S. Halsted in the 19th century, leaders of the Department of Surgery at Johns Hopkins have been interested in hepatobiliary disease and surgery. John L. Cameron had broad hepato-pancreato-biliary (HPB) interests when he completed his surgical training. Over the next 3 decades, he focused on the pancreas. As a result, many faculty and trainee hepatobiliary careers were launched. This perspective is based on 18 years of service as a surgical resident and faculty member at Johns Hopkins. An extensive literature search on the hepatobiliary publications of Halsted, Trimble, Blalock, Longmire, Zuidema, and Cameron was undertaken for this manuscript. Numerous hepatobiliary publications from Johns Hopkins from the 1970s, 1980s, 1990s, and early 2000s were also reviewed. John L. Cameron's early biliary interests included stones, infections, malignancies, and strictures. He was innovative with respect to portal hypertension and Budd-Chiari surgery and supportive when liver transplantation emerged in the 1980s. Volume-outcome studies in the 1990s included hepatic and complex biliary surgery. He supported and encouraged studies of biliary lithotripsy, laparoscopic cholecystectomy, clinical pathways, hepatobiliary cysts, and gallstone pathogenesis. Lessons learned by many who worked with John L. Cameron included the importance of mentorship, innovation, friendship, and collaboration. He taught leadership and change management by example. He fostered a multidisciplinary approach and encouraged randomized controlled trials.

  9. The usefulness of hepatobiliary scan in insulin dependent diabetic patients (IDDM)

    International Nuclear Information System (INIS)

    Taddei, G.; Carletto, M.; Santaniello, B.; Curti, G.; Villa, G.; Altrinetti, V.; Tommasi, L.; Piccardo, A.; Gianiorio, F.

    2002-01-01

    Aim:The purpose of the study is to point out morpho-functional alterations of intra-extrahepatic biliary tract in IDDM patients and to verify any possible correlation between the seriousness of such disorders and the presence of autonomic neuropathy. Material and method: there have been studied 47 pts. (20 females and 27 males), average age 35.(yrs (range 18-73) with normal blood levels of HbA1C (2.5-4.6%), fructosamine (285 mmol/l), fasting glycemia between 120 and 140 mg/dl. The average duration of the illness was 14.53 yrs. (range 3-31); The daily intensive treatment of insulin was 38 U/I p.day (average dose). No pt. showed any clinical, instrumental or laboratory signs referring to hepatobiliary pathology; 1 pt. had undergone cholecystectomy. All pts. have been submitted to a hepatobiliary scan after i.v. injection of 5 mCi of Tc-99m DIDA using a large-field gamma-camera (SP-6 Elscint). The presence autonomic neuropathy was evaluated according to Ewing's parameters. The statistical analysis was performed with Man-Whitney's U test. Results: a mild delay in the visualization of the intrahepatic biliary ducts was observed in 3 pts. The dismission of the radiotracer from the gallbladder was normal in 3 pts, in 2 of them there was a mild delay while in the remainders such abnormality was very significant. The presence of radioactivity in the bowel was delayed in 7 pts. Duodena-gastric backflow was observed in 10 pts. The statistical analysis showed a good correlation between score of neuropathy and duodena-gastric backflow (p<0.01) and between score of neuropathy and delayed dismission of the radiotracer from the gallbladder (p<0.003). Conclusion: hepatobiliary scan seems to give a good contribution to the study of autonomic neuropathy of gastroenteric apparatus in IDDM pts. in absence of comparative studies on the subject

  10. Specific preoperative diagnosis of choledochal cysts by combined sonography and hepatobiliary scintigraphy

    International Nuclear Information System (INIS)

    Papanicolaou, N.; Abramson, S.J.; Teele, R.L.; Treves, S.

    1985-01-01

    The combined use of sonography and hepatobiliary scintigraphy correctly identified a choledochal cyst preoperatively in seven consecutive infants and children. The high resolution anatomic images provided by sonography coupled with physiologic data on filing of the cyst, biliary patency and liver function derived from radionuclide scanning offer valuable information in the diagnosis and planning of corrective surgery of the cyst and coexisting hepatobiliary anomalies. Invasive diagnostic procedures should be reserved for occasional problematic cases [fr

  11. Synthesis And Characterization Of Mebrofenin For Hepatobiliary Imaging

    International Nuclear Information System (INIS)

    Purwoko; Tamat, Swasono R.; Yunita, Fitri; Kristanti, Eti

    2003-01-01

    Mebrofenin labeled with Technetium-99m is a new radiopharmaceutical having superior and ideal characteristic as a hepatobiliary-imaging agent. The synthesis and characterization of Mebrofenin (3-Bromo-2,4,6-trimethyl acetanilido iminodiacetic acid) as IDA derivative has been carried out involving three steps of reaction i.e. : acetyllization of 2,4,6-Trimethyl aniline to get 2,4,6-trimethyl chloro acetanilide which upon bromination gives the intermediate bromotrimethyl derivative and [mally by nucleophilic substitution this intermediate product with iminodiacetic acid (IDA) gives mebrofenin. The acetylation and bromination reactions were carried out in acetic acid condition while the substitution was carried out by reflux for 5 hours in ethanol and water adjusted at pH 11. The ethanol was then removed under low pressure, and the unreacted compound was removed by filtration. The filtrate was adjusted to pH 2 - 2.5, and the resulting mebrofenin was isolated by filtration and recrystallized 3 times in ethanol. Characterization of the mebrofenin product was performed by observing its melting point (197-l99 o C), ultra violet and infra red spectra as well as mass spectrometric and high performance liquid chromatographic analysis. The results showed that the product was highly pure and the yield was around 20%

  12. Surgical, pathological and clinical correlation of Tc-99m DISIDA hepatobiliary imaging in 138 adult males, in the diagnosis of functional cystic duct obstruction VS acute or chronic cholecystitis

    International Nuclear Information System (INIS)

    Yoo, J.H.K.; Beal, W.H.; Ware, R.W.; Straw, J.D.; Chaudhuri, T.K.

    1985-01-01

    Despite the wide acceptance of the hepatobiliary scintigraphy as a popular diagnostic imaging modality for gallbladder and hepatobiliary disease, correlation between radionuclide diagnoses and the final clinical and/or pathologic findings have not been thoroughly evaluated. The lack of correlative studies frequently generates difficulties in making appropriate diagnostic interpretation of the objective findings. A retrospective clinical pathological and surgical correlative study was undertaken by the authors in 138 male veteran patients, who underwent computer assisted minute by minute Tc-99m DISIDA cholescintigraphy. A very high percentage (75%) revealed abnormalities; non-visualization of gallbladder (GB) with normal choledochus system (46%), choledochal obstruction with no GB visualization (13%), choledochal obstruction with normal GB visualization (6%), severe hepatocellular disease with non-diagnostic GB (4%), and delayed GB visualization (longer than 60 minutes) (3%). Non-visualization of GB but normal choledochus demonstrated diverse pathologic etiologies, acute and chronic cholecystitis (64%), S/P cholecystectomy (8%), functional obstruction secondary to sepsis or pancreatitis (6%), and various other pathologies including porcelain GB and cholangitis (22%). The most important cause of choledochal obstruction was mass lesions or local infiltration with metastases (33%) rather than acute cholecystitis (27%). Although the sensitivity (98%) and specificity (92%) for cystic duct obstruction were very high, the specificity decreases significantly for cholecystitis

  13. Hepatobiliary fascioliasis: a case with unusual radiological features.

    Science.gov (United States)

    Yeşildağ, Ahmet; Senol, Altuğ; Köroğlu, Mert; Koçkar, Cem; Oyar, Orhan; Işler, Mehmet

    2010-12-01

    We report a case of hepatobiliary fascioliasis presenting with unusual radiological findings that have not been reported previously. Imaging studies revealed hepatic cystic pouches communicating with intrahepatic bile ducts. Snail-like, oval shaped and conglomerated echogenic particles with no acoustic shadowing, suggesting F. hepatica, were detected in these cystic pouches. In addition, secondary sclerosing cholangitis developed after fascioliasis.

  14. Pathophysiological analysis of hepatobiliary function on sup(99m)Tc-labeled-cholescintigram

    Energy Technology Data Exchange (ETDEWEB)

    Oyama, K; Hayashi, S; Kogure, T; Hirakawa, K; Akaike, A [Tokyo Univ. (Japan). Faculty of Medicine

    1979-05-01

    sup(99m)Tc-pylidoxylideneisoleucine (PI) was injected into 106 patients in order to study the mechanism of bile accumulation in the gallbladder in analysis of the visualization time of the gallbladder, intrahepatic bile duct, common bile duct and duodenum on sup(99m)Tc-PI cholescintigrams relating to hepatobiliary function. In cases of normal hepatobiliary function, sup(99m)Tc-PI is rapidly cleared from the blood by hepatocytes and is rapidly excreted through the biliary tree into the duodenum. The common bile duct was seen within 15 min of injection in 93.5% of the patients, the gallbladder within 20 min in 80.8%, the intrahepatic bile duct within 20 min in 96.3%, and the duodenum within 30 min in 58%. Marked accumulation of sup(99m)Tc-PI was noted in the gallbladder within 30 min. In cases of hepatobiliary dysfunction, the duodenum is visualized earlier than the gallbladder and intrahepatic bile duct, and the visualization ratio of the gallbladder and intrahepatic bile duct is decreased with an increased degree of hepatobiliary dysfunction. In regard to serum bilirubin level, the gallbladder was seen up to 3.5 mg%, the intrahepatic bile duct up to 4.0 mg% and the common bile duct up to 22.6 mg%. The duodenum was seen in all but two cases of complete obstruction of the common bile duct. In regard to meal time, marked accumulation of sup(99m)Tc-PI in the gallbladder was seen within 30 min and re-dilatation was seen with in 90 min after the beginning of contraction. In cases of normal hepatobiliary function, the gallbladder was seen in over 70% of the cases more than two hours after meals. This study shows that the hepatobiliary tract can be easily imaged by sup(99m)Tc-PI in proportion to hepatobiliary function and that this agent may be useful in the diagnosis of abnormal hepatobiliary tract and the jaundiced patient with hyperbilirubinemias. (Bell, E.).

  15. Approach to biliary imaging amongst consultant and specialist registrars in gastroenterology in a national setting.

    LENUS (Irish Health Repository)

    Murray, T

    2010-12-01

    Radiological investigation plays an important role in the management of conditions affecting the hepatobiliary system. However, multiple imaging modalities exist and inappropriate requesting can lead to delays in diagnosis and subsequent treatment.

  16. Benzimidazolyl methyliminodiacetic acids: new bifunctional chelators of technetium for hepatobiliary scintigraphy

    International Nuclear Information System (INIS)

    Hunt, F.C.; Wilson, J.G.; Maddalena, D.J.

    1979-01-01

    Dimethyl- and chloro- substituted benzimidazolyl methyliminodiacetic acids have been synthesized and evaluated as new bifunctional chelators of /sup 99m/Tc. Stannous chelates of these compounds were prepared as freeze-dried kits and labeled with /sup 99m/Tc. The radiopharmaceuticals thus prepared were rapidly excreted by the hepatobiliary system of rats and rabbits with little urinary excretion. The chloro- compound had a higher biliary and lesser urinary excretion than the dimethyl- however both technetium complexes provided good scintigraphic images of the hepatobiliary system in animals. The compounds behaved similarly to the /sup 99m/Tc-lidocaine iminodiacetic acid [HIDA] complexes with respect to their biliary elimination

  17. Chronological evaluation of liver enhancement in patients with chronic liver disease at Gd-EOB-DTPA-enhanced 3-T MR imaging. Does liver function correlate with enhancement?

    International Nuclear Information System (INIS)

    Nakamura, Shinichi; Utsunomiya, Daisuke; Namimoto, Tomohiro; Yamashita, Yasuyuki; Awai, Kazuo; Nakaura, Takeshi; Morita, Kosuke

    2012-01-01

    The purpose of this study was to investigate the chronological relationship between scan delay and liver enhancement for the hepatobiliary phase on Gd-EOB-DTPA-enhanced MRI and evaluate the effects of liver function on liver enhancement. Hepatobiliary-phase images were retrospectively evaluated in 125 patients with chronic liver disease. Hepatobiliary phase images were obtained at 5, 10, 15, and 20 min after injection. We calculated relative liver enhancement (RLE) at t min after injection by dividing the signal intensity (SI) of the liver at t min by precontrast SI. We compared RLE values at 5, 10, 15, and 20 min and evaluated the detectability of focal hepatic lesions. We analyzed the effect of liver function on RLE with the generalized linear model. There was not significant difference in RLE and lesion detectability at 15 and 20 min. RLE in the Child-Pugh C group was significantly lower than in the Child-Pugh A and B groups. The serum albumin level and prothrombin time were significantly correlated with the liver enhancement. A delay time of 15 min for the hepatobiliary phase was thought to be adequate in patients with mild liver dysfunction. The serum albumin level and prothrombin time would be predictive of liver enhancement in the hepatobiliary phase. (author)

  18. Diagnosis of acute cholecystitis using hepatobiliary scan with technetium-99m PIPIDA

    International Nuclear Information System (INIS)

    Bennett, M.T.; Sheldon, M.I.; dos Remedios, L.V.; Weber, P.M.

    1981-01-01

    Sixty patients were evaluated for acute abdominal pain using technetium-99m PIPIDA hepatobiliary imaging. The sensitivity of the test was 90.6 percent in all patients and the accuracy was 93.3 percent. In the evaluation of acutely ill patients with right upper quadrant pain, fever, nausea and vomiting, hepatobiliary imaging with PIPIDA is the preferred test for diagnosing acute cholecystitis. If the test is positive, disease of the gallbladder and probably acute cholecystitis are present. Early operation can proceed if desirable. If the test is negative and the bilirubin level is less than 5.0 mg/dl, acute cholecystitis is not present. In such cases conservative treatment is appropriate, and follow-up tests should be performed to evaluate the possibility of chronic cholecystitis. When the bilirubin level exceeds 5.0 mg/dl, the test is often indeterminate

  19. Correcting for respiratory motion in liver PET/MRI: preliminary evaluation of the utility of bellows and navigated hepatobiliary phase imaging

    International Nuclear Information System (INIS)

    Hope, Thomas A.; Verdin, Emily F.; Bergsland, Emily K.; Ohliger, Michael A.; Corvera, Carlos University; Nakakura, Eric K.

    2015-01-01

    The purpose of this study was to evaluate the utility of bellows-based respiratory compensation and navigated hepatobiliary phase imaging to correct for respiratory motion in the setting of dedicated liver PET/MRI. Institutional review board approval and informed consent were obtained. Six patients with metastatic neuroendocrine tumor were imaged using Ga-68 DOTA-TOC PET/MRI. Whole body imaging and a dedicated 15-min liver PET acquisition was performed, in addition to navigated and breath-held hepatobiliary phase (HBP) MRI. Liver PET data was reconstructed three ways: the entire data set (liver PET), gated using respiratory bellows (RC-liver PET), and a non-gated data set reconstructed using the same amount of data used in the RC-liver PET (shortened liver PET). Liver lesions were evaluated using SUV max , SUV peak , SUV mean , and Vol isocontour . Additionally, the displacement of each lesion between the RC-liver PET images and the navigated and breath-held HBP images was calculated. Respiratory compensation resulted in a 43 % increase in SUVs compared to ungated data (liver vs RC-liver PET SUV max 26.0 vs 37.3, p < 0.001) and a 25 % increase compared to a non-gated reconstruction using the same amount of data (RC-liver vs shortened liver PET SUV max 26.0 vs 32.6, p < 0.001). Lesion displacement was minimized using navigated HBP MRI (1.3 ± 1.0 mm) compared to breath-held HBP MRI (23.3 ± 1.0 mm). Respiratory bellows can provide accurate respiratory compensation when imaging liver lesions using PET/MRI, and results in increased SUVs due to a combination of increased image noise and reduced respiratory blurring. Additionally, navigated HBP MRI accurately aligns with respiratory compensated PET data.

  20. Correcting for respiratory motion in liver PET/MRI: preliminary evaluation of the utility of bellows and navigated hepatobiliary phase imaging

    Energy Technology Data Exchange (ETDEWEB)

    Hope, Thomas A. [Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA (United States); Department of Radiology, San Francisco VA Medical Center, San Francisco, CA (United States); Verdin, Emily F. [Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA (United States); Bergsland, Emily K. [Division of Hematology/Oncology, Department of Medicine, University of California, San Francisco, San Francisco, CA (United States); Ohliger, Michael A. [Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA (United States); Department of Radiology, San Francisco General Hospital, San Francisco, CA (United States); Corvera, Carlos University; Nakakura, Eric K. [Division of Surgical Oncology, Department of Surgery, University of California, San Francisco, San Francisco, CA (United States)

    2015-09-18

    The purpose of this study was to evaluate the utility of bellows-based respiratory compensation and navigated hepatobiliary phase imaging to correct for respiratory motion in the setting of dedicated liver PET/MRI. Institutional review board approval and informed consent were obtained. Six patients with metastatic neuroendocrine tumor were imaged using Ga-68 DOTA-TOC PET/MRI. Whole body imaging and a dedicated 15-min liver PET acquisition was performed, in addition to navigated and breath-held hepatobiliary phase (HBP) MRI. Liver PET data was reconstructed three ways: the entire data set (liver PET), gated using respiratory bellows (RC-liver PET), and a non-gated data set reconstructed using the same amount of data used in the RC-liver PET (shortened liver PET). Liver lesions were evaluated using SUV{sub max}, SUV{sub peak}, SUV{sub mean}, and Vol{sub isocontour}. Additionally, the displacement of each lesion between the RC-liver PET images and the navigated and breath-held HBP images was calculated. Respiratory compensation resulted in a 43 % increase in SUVs compared to ungated data (liver vs RC-liver PET SUV{sub max} 26.0 vs 37.3, p < 0.001) and a 25 % increase compared to a non-gated reconstruction using the same amount of data (RC-liver vs shortened liver PET SUV{sub max} 26.0 vs 32.6, p < 0.001). Lesion displacement was minimized using navigated HBP MRI (1.3 ± 1.0 mm) compared to breath-held HBP MRI (23.3 ± 1.0 mm). Respiratory bellows can provide accurate respiratory compensation when imaging liver lesions using PET/MRI, and results in increased SUVs due to a combination of increased image noise and reduced respiratory blurring. Additionally, navigated HBP MRI accurately aligns with respiratory compensated PET data.

  1. Labeling of ursodeoxycholic acid with technetium-99m for hepatobiliary imaging

    International Nuclear Information System (INIS)

    Sanad, M.H.; El-Tawoosy, M.

    2013-01-01

    An adopted method for the preparation of high radiochemical purity 99m Tc-ursodeoxycholic acid (UDCA) was conducted with a high radiochemical yield up to 97.5 %. The reaction proceeds well using 2 mg UDCA, 50 μg tin chloride in solution of pH 8 at room temperature for 30 min. The radiochemical yield was up to 97.5 % as pure as 99m Tc-UDCA. Different chromatographic techniques (paper chromatography and electrophoresis) were used to evaluate the radiochemical yield and purity of the labeled product. Biodistribution studies were carried out in Albino Swiss mice at different time intervals after administration of 99m Tc-UDCA. The uptake of 99m Tc-UDCA in the liver gave the chance to diagnose it. The results indicate that the labeled compound cleared from the systematic circulation within 2 h after administration and majority of organs showed significant decrease in uptake of 99m Tc-UDCA. Finally, the liver uptake was high and the results indicate the possibility of using 99m Tc-UDCA for hepatobiliary imaging.

  2. Hepatobiliary cystadenoma can protrude and grow into the bile ducts.

    Science.gov (United States)

    Gadzijev, E M; Pleskovic, A; Stanisavljevic, D; Ferlan-Marolt, V; Trotovsek, B

    1998-01-01

    To evaluate the phenomenon and the potential reasons for protrusion and growth of hepatobiliary cystadenoma into the extrahepatic bile ducts in our patients, accomplished by a review of the data regarding hepatobiliary cystadenomas published elsewhere. In a retrospective open study conducted over the last eight years, five patients with hepatobiliary cystadenoma and one patient with hepatobiliary cystadenocarcinoma were operated on. All the patients were females aged between 25 to 61 years. Diagnostic procedures, laboratory, operative and histopathological findings and treatment were evaluated. Most of our patients were found to have hepatobiliary cystadenoma located in the left surgical liver. In three out of five patients with HBC mesenchymal stroma was histologically detected. In two of the three, protrusion and growth into the extrahepatic bile ducts was found. Considering the pathogenesis, location and the morphology of HBC, the mesenchymal stroma may present the competent potential for intraductal progression of the tumor. Radical excision should be performed for successful treatment of hepatobiliary cystadenomas, because of the potential for reoccurrence.

  3. Utility of morphine-augmented hepatobiliary scanning in evaluation of acute cholecystitis

    International Nuclear Information System (INIS)

    Kistler, A.M.; Ziessman, H.A.; Gooch, D.; Bitterman, P.

    1989-01-01

    The authors review experience with morphine sulfate-augmented cholescintigraphy in suspected acute cholecystitis. MS has been recommended to reduce study time while maintaining accuracy of hepatobiliary scans. Patients received 5-mCi injections of Tc-99m mebrofenin and imaged on a low-field-view gamma camera. In 32 patients with nonvisualization of the gallbladder at 30-40 minutes after injection, 2 mg MS was given intravenously, and imaging continued for an additional 30 minutes

  4. Hepatobiliary contrast agents for contrast-enhanced MRI of the liver: properties, clinical development and applications

    International Nuclear Information System (INIS)

    Reimer, Peter; Schneider, Guenter; Schima, Wolfgang

    2004-01-01

    Hepatobiliary contrast agents with uptake into hepatocytes followed by variable biliary excretion represent a unique class of cell-specific MR contrast agents. Two hepatobiliary contrast agents, mangafodipir trisodium and gadobenate dimeglumine, are already clinically approved. A third hepatobiliary contrast agent, Gd-EOB-DTPA, is under consideration. The purpose of this review is to provide an overview on the properties, clinical development and application of these three hepatobiliary contrast agents. Bolus injectable paramagnetic hepatobiliary contrast agents combine established features of extracellular agents with the advantages of hepatocyte specificity. The detection and characterisation of focal liver disease appears to be improved compared to unenhanced MRI, MRI with unspecific contrast agents and contrast-enhanced CT. To decrease the total time spent by a patient in the MR scanner, it is advisable to administer the agent immediately after acquisition of unenhanced T1-w MRI. After infusion or bolus injection (with dynamic FS-T1-w 2D or 3D GRE) of the contrast agent, moderately and heavily T2w images are acquired. Post-contrast T1-w MRI is started upon completion of T2-w MRI for mangafodipir trisodium and Gd-EOB-DTPA as early as 20 min following injection, while gadobenate dimeglumine scans are obtained >60 min following injection. Post-contrast acquisition techniques with near isotropic 3D pulse sequences with fat saturation parallel the technical progress made by MSCT combined with an unparalleled improvement in tumour-liver contrast. The individual decision that hepatobiliary contrast agent one uses is partly based on personal preferences. No comparative studies have been conducted comparing the advantages or disadvantages of all three agents directly against each other. (orig.)

  5. Clinical evaluation of sup(99m)Tc-(Sn)-PI (sup(99m)Tc-(Sn)-pyridoxylidene isoleucine) in the various hepatobiliary disorders

    Energy Technology Data Exchange (ETDEWEB)

    Kawaguchi, S; Iio, M; Yamada, H; Murata, H; Chiba, K [Tokyo Metropolitan Geriatric Medical Center (Japan)

    1978-12-01

    The purpose of this study is to evaluate the hepatobiliary scanning using sup(99m)Tc-(Sn)-PI in clinical diagnosis of various hepatobiliary disorders. Nineteen patients were scanned with sup(99m)Tc-(Sn)-PI. The results were as follows: 1) The stability of sup(99m)Tc-(Sn)-PI examined by paper chromatography using saline as a solvent showed satisfied result at scanning time. sup(99m)Tc-(Sn)-PI in the blood was assumed to be bound to serum proteins immediately after injection. sup(99m)Tc-(Sn)-PI in the urine was assumed to keep the form of sup(99m)Tc-(Sn)-PI. 2) The appearance times of kidney, liver, bile duct, gallbladder, and intestine in the normal case were 5, 5, 10 and 15 minutes respectively after injection. The peak times of hepatogram in the normal case, drug induced hepatitis and obstructive jaundice were 12, 15 and 18 minutes respectively after injection. The images obtained by sup(99m)Tc-(Sn)-PI was superior to the images obtained by /sup 131/I-BSP. 3) The blood clearance and urinary excretion rate of sup(99m)Tc-(Sn)-PI also provided us clinical usefulness. 4) The scanning of Dubin-Johnson syndrome of sup(99m)Tc-(Sn)-PI showed almost normal hepatobiliary image similar to the sequential scan by /sup 131/I-RB as was reported previously by authors. In conclusion, the hepatobiliary scan using sup(99m)Tc-(Sn)-PI provided clear hepatobiliary images. Other parameters such as blood clearance, urinary excretion rate and diameter of choledochus were also favorable. By combining it with sup(99m)Tc-HIDA a differential diagnosis of congenital jaundice is also expected.

  6. Clinical evaluation of sup(99m)Tc-(Sn)-PI [sup(99m)Tc-(Sn)-pyridoxylidene isoleucine] in the various hepatobiliary disorders

    International Nuclear Information System (INIS)

    Kawaguchi, Schinichiro; Iio, Masahiro; Yamada, Hideo; Murata, Hajime; Chiba, Kazuo

    1978-01-01

    The purpose of this study is to evaluate the hepatobiliary scanning using sup(99m)Tc-(Sn)-PI in clinical diagnosis of various hepatobiliary disorders. Nineteen patients were scanned with sup(99m)Tc-(Sn)-PI. The results were as follows: 1) The stability of sup(99m)Tc-(Sn)-PI examined by paper chromatography using saline as a solvent showed satisfied result at scanning time. sup(99m)Tc-(Sn)-PI in the blood was assumed to be bound to serum proteins immediately after injection. sup(99m)Tc-(Sn)-PI in the urine was assumed to keep the form of sup(99m)Tc-(Sn)-PI. 2) The appearance times of kidney, liver, bile duct, gallbladder, and intestine in the normal case were 5, 5, 10 and 15 minutes respectively after injection. The peak times of hepatogram in the normal case, drug induced hepatitis and obstructive jaundice were 12, 15 and 18 minutes respectively after injection. The images obtained by sup(99m)Tc-(Sn)-PI was superior to the images obtained by 131 I-BSP. 3) The blood clearance and urinary excretion rate of sup(99m)Tc-(Sn)-PI also provided us clinical usefulness. 4) The scanning of Dubin-Johnson syndrome of sup(99m)Tc-(Sn)-PI showed almost normal hepatobiliary image similar to the sequential scan by 131 I-RB as was reported previously by authors. In conclusion, the hepatobiliary scan using sup(99m)Tc-(Sn)-PI provided clear hepatobiliary images. Other parameters such as blood clearance, urinary excretion rate and diameter of choledochus were also favorable. By combining it with sup(99m)Tc-HIDA a differential diagnosis of congenital jaundice is also expected. (author)

  7. Significance of delayed /sup 99m/Tc-PMT scintigraphy in diagnosis of hepatocellular carcinoma. Comparison between /sup 99m/Tc-PMT and /sup 67/Ga-citrate scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Hasegawa, Yoshihisa; Nakano, Shunichi; Hashizume, Terumi and others

    1985-03-01

    The usefulness of delayed hepatobiliary imaging with /sup 99m/Tc-PMT in diagnosis of hepatocellular carcinoma was studied in 30 patients with histologically verified hepatocellular carcinoma. Of 30 patients, delayed /sup 99m/Tc-PMT images showed 13 patients (43 %) of increased radioactivity and 4 (13 %) of equilibrated radioactivity in carcinoma as compared with that in the surrounding normal liver tissues. Furthermore, 3 of 6 patients who showed no filling defects in /sup 99m/Tc-Sn colloid liver images, showed increased uptake of radioactivity in carcinoma in delayed /sup 99m/Tc-PMT images. These results suggest that the complementary use of delayed /sup 99m/Tc-PMT imaging to /sup 99m/Tc-Sn colloid liver imaging is useful for detecting hepatoma lesions. The hepatic lesions were positively visualized on /sup 99m/Tc-PMT and/or /sup 67/Ga-citrate images in 21 (70 %) of 30 patients. These results indicate that use of delayed /sup 99m/Tc-PMT and /sup 67/Ga-citrate imaging in combination is useful for positive visualization of hepatocellular carcinoma.

  8. Imaging approach to persistent neonatal jaundice

    International Nuclear Information System (INIS)

    Kirks, D.; Coleman, R.E.; Filston, H.C.; Rosenberg, E.R.; Merten, D.F.

    1984-01-01

    Fifteen patients with persistent neonatal jaundice were evaluated by sonography and radionuclide scintigraphy. The sonographic features of both neonatal hepatitis and biliary atresia are nonspecific. Hepatobiliary scintigraphy after phenobarbital pretreatment in patients with neonatal hepatitis demonstrates normal hepatic extraction and delayed tracer excretion into the gastrointestinal tract. If there is neonatal hepatitis with severe hepatocellular damage, the hepatic extraction of tracer activity is decreased and excretion may be delayed or absent. Patients under 3 months of age with biliary atresia have normal hepatic extraction of tracer with no excretion into the gastrointestinal tract. Sonography in patients with a choledochal cyst shows a cystic mass in the porta hepatis with associated bile-duct dilatation. Hepatobiliary scintigraphy confirms that the choledochal cyst communicates with the biliary system. Initial sonography demonstrates hepatobiliary anatomy; subsequent phenobarbital-enhanced radionuclide scintigraphy determines hepatobiliary function. An expedient diagnostic approach is recommended for the evaluation of persistent neonatal jaundice

  9. Clinical evaluation of Tc-99m-mebrofenin and comparison with Tc-disofenin for radionuclide hepatobiliary imaging

    International Nuclear Information System (INIS)

    Klingensmith, W. III; Fritzberg, A.; Spitzer, V.

    1982-01-01

    The clinical comparison reported indicates that Tc-mebrofenin has a significantly lower level of renal excretion that Tc-disofenin at all bilirubin levels. At a total bilirubin level of 25 mg/dl the renal excretion of Tc-mebrofenin is still less than the renal excretion of Tc-disofenin in subjects with normal bilirubin levels. In addition, renal radioactivity in images was never seen in subjects with normal bilirubins while visualization of renal radioactivity is routine in normal subjects with Tc-disofenin. No significant differences were found in any other parameter including hepatocyte extraction efficiency, time of maximum hepatic radioactivity, and hepatic parenchymal washout. This study indicates that Tc-mebrofenin is equal to Tc-disofenin in its hepatobiliary characteristics and superior in its renal characteristics

  10. Hepatobiliary fascioliasis in non-endemic zones: a surprise diagnosis.

    Science.gov (United States)

    Jha, Ashish Kumar; Goenka, Mahesh Kumar; Goenka, Usha; Chakrabarti, Amrita

    2013-03-01

    Fascioliasis is a zoonotic infection caused by Fasciola hepatica. Because of population migration and international food trade, human fascioliasis is being an increasingly recognised entity in nonendemic zones. In most parts of Asia, hepatobiliary fascioliasis is sporadic. Human hepatobiliary infection by this trematode has two distinct phases: an acute hepatic phase and a chronic biliary phase. Hepatobiliary infection is mostly associated with intense peripheral eosinophilia. In addition to classically defined hepatic phase and biliary phase fascioliasis, some cases may have an overlap of these two phases. Chronic liver abscess formation is a rare presentation. We describe a surprise case of hepatobiliary fascioliasis who presented to us with liver abscess without intense peripheral eosinophilia, a rare presentation of human fascioliasis especially in non-endemic zones. Copyright © 2013 Arab Journal of Gastroenterology. Published by Elsevier Ltd. All rights reserved.

  11. Improved parenchymal liver enhancement with extended delay on Gd-EOB-DTPA-enhanced MRI in patients with parenchymal liver disease: associated clinical and imaging factors

    International Nuclear Information System (INIS)

    Esterson, Y.B.; Flusberg, M.; Oh, S.; Mazzariol, F.; Rozenblit, A.M.; Chernyak, V.

    2015-01-01

    Aim: To establish the effect of prolonged hepatobiliary phase (HBP) delay time on hepatic enhancement in patients with parenchymal liver disease (PLD). Materials and methods: Gadoxetate disodium (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) examinations with HBP were obtained after 20- (HBP-20) and 30-minute (HBP-30) delays in patients with PLD. For each patient, the Model for End-Stage Liver Disease (MELD) score, total and direct bilirubin, aspartate transaminase (AST), alanine transaminase (ALT), alkaline phosphatase (ALP), prothrombin time (PT), and partial thromboplastin time (PTT) were recorded. Signal intensities of the liver, main portal vein, and spleen on pre-contrast, HBP-20, and HBP-30 were documented. Signal intensities were used to calculate liver relative enhancement (LRE), liver–spleen index (LSI), and liver–portal vein index (LPI) for HBP-20 and HBP-30. Improved hepatic enhancement was considered if two or more indices were higher on HBP-30 than HBP-20. A logistic regression model was constructed with improved hepatic enhancement as the outcome. Results: One hundred and twenty-nine patients underwent 142 MRIs. Mean LRE, LSI, and LPI each increased from HBP-20 to HBP-30 (p = 0.004, p < 0.001, and p < 0.001, respectively). Seventy-two point five percent of cases demonstrated improved hepatic enhancement. The odds ratios for improved hepatic enhancement were 0.85 for MELD score (p = 0.02) and 3.2 for the 3 T scanner (p = 0.02), adjusted for age and sex. Conclusion: Increasing HBP delay to 30 minutes improves hepatic enhancement in patients with PLD, particularly if using a 3 T scanner. This effect is attenuated with higher MELD scores. -- Highlights: •Increasing hepatobiliary phase delay improves hepatic enhancement in liver disease. •This effect is enhanced if using a 3T scanner. •This effect is attenuated with higher MELD scores

  12. Phenolic aminocarboxylate chelates of 99mTc as hepatobiliary agents.

    Science.gov (United States)

    Hunt, F C; Maddalena, D J; Wilson, J G; Bautovich, G J

    1986-01-01

    A series of alkyl- and halogen-substituted derivatives of ethylenediamine di[o-hydroxyphenylacetic acid] (EDDHA) and N,N'-bis[2-hydroxybenzyl] ethylenediamine N,N'-diacetic acid (HBED) were complexed with 99mTc and their biodistribution was determined in rats. All complexes displayed substantial hepatobiliary excretion; of each series, 99mTc-Br-EDDHA and 99mTc-di-Cl-HBED had the maximum amount in the gastrointestinal tract. Scintigraphic studies of 99mTc-Cl-EDDHA in dogs revealed prompt imaging of the liver followed by imaging of the gall bladder as the complex was excreted into the bile.

  13. Radiology illustrated. Hepatobiliary and pancreatic radiology

    International Nuclear Information System (INIS)

    Choi, Byung Ihn

    2014-01-01

    Clear, practical guide to the diagnostic imaging of diseases of the liver, biliary tree, gallbladder, pancreas, and spleen. A wealth of carefully selected and categorized illustrations. Highlighted key points to facilitate rapid review. Aid to differential diagnosis. Radiology Illustrated: Hepatobiliary and Pancreatic Radiology is the first of two volumes that will serve as a clear, practical guide to the diagnostic imaging of abdominal diseases. This volume, devoted to diseases of the liver, biliary tree, gallbladder, pancreas, and spleen, covers congenital disorders, vascular diseases, benign and malignant tumors, and infectious conditions. Liver transplantation, evaluation of the therapeutic response of hepatocellular carcinoma, trauma, and post-treatment complications are also addressed. The book presents approximately 560 cases with more than 2100 carefully selected and categorized illustrations, along with key text messages and tables, that will allow the reader easily to recall the relevant images as an aid to differential diagnosis. At the end of each text message, key points are summarized to facilitate rapid review and learning. In addition, brief descriptions of each clinical problem are provided, followed by both common and uncommon case studies that illustrate the role of different imaging modalities, such as ultrasound, radiography, CT, and MRI.

  14. Radiology illustrated. Hepatobiliary and pancreatic radiology

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Byung Ihn (ed.) [Seoul National Univ. Hospital (Korea, Republic of). Dept. of Radiology

    2014-04-01

    Clear, practical guide to the diagnostic imaging of diseases of the liver, biliary tree, gallbladder, pancreas, and spleen. A wealth of carefully selected and categorized illustrations. Highlighted key points to facilitate rapid review. Aid to differential diagnosis. Radiology Illustrated: Hepatobiliary and Pancreatic Radiology is the first of two volumes that will serve as a clear, practical guide to the diagnostic imaging of abdominal diseases. This volume, devoted to diseases of the liver, biliary tree, gallbladder, pancreas, and spleen, covers congenital disorders, vascular diseases, benign and malignant tumors, and infectious conditions. Liver transplantation, evaluation of the therapeutic response of hepatocellular carcinoma, trauma, and post-treatment complications are also addressed. The book presents approximately 560 cases with more than 2100 carefully selected and categorized illustrations, along with key text messages and tables, that will allow the reader easily to recall the relevant images as an aid to differential diagnosis. At the end of each text message, key points are summarized to facilitate rapid review and learning. In addition, brief descriptions of each clinical problem are provided, followed by both common and uncommon case studies that illustrate the role of different imaging modalities, such as ultrasound, radiography, CT, and MRI.

  15. Renal enhancement and excretion of the hepatobiliary contrast agent Gd-EOB-DTPA

    International Nuclear Information System (INIS)

    Zangos, S.; Hammerstingl, R.; Mack, M.G.; Straub, R.; Engelmann, K.; Eichler, K.; Vogl, T.J.

    2001-01-01

    Purpose: To evaluate the clinical value of the renal clearance using MR imaging with different doses of gadolinium ethoxybenzyl-DTPA (Gd-EOB-DTPA) in comparison to gadolinium DTPA (Gd-DTPA). Material and Methods: In a double-blind and randomized clinical phase II study. MR imaging at 1.5 T was performed in 61 patients with five different doses of Gd-EOB-DTPA (3, 6, 12.5, 25 and 50 μmol/kg b.w. as a bolus injection). The study protocol comprised T 1 - and T 2 -weighted spin-echo magnetic resonance and two-dimensional fast low-angle shot imaging before and at increasing intervals for up to 45 min after injection of Gd-EOB-DTPA. These images were compared with Gd-DTPA-enhanced imaging (0.1 mmol/kg b. w. as a bolus injection). Results: After bolus injection of the hepatobiliary MR contrast agent Gd-EOB-DTPA a renal elimination was observed. Immediately after the injection of Gd-EOB-DTPA until the eighth minute a corticomedullary enhancement of the kidney was conspicuous. After the fourth minute a contrast enhancement could be seen in the renal pelvis. The best enhancement was noted after 20 minutes in the FLASH GRE and T 1 -weighted images with good pelvicaliceal contrast. After 45 minutes an outflow of Gd-EOB-DTPA into the ureter could be observed. Conclusion: In addition to the hepatobiliary secretion Gd-EOB-DTPA appears useful for the evaluation of renal structures and renal function on account of the renal excretion without diuretic preparation of the patients. (orig.) [de

  16. New series of Tc-99m-labeled hepatobiliary tracers: N'-acyl- and N'-sulfonyl ethylenediamine-N,N-diacetic acids

    International Nuclear Information System (INIS)

    Karube, Y.; Kono, A.; Maeda, T.; Ohya, M.; Matsushima, Y.

    1981-01-01

    Various Tc-99m-labeled N'-substituted derivatives of ethylenediamine-N,N-diacetic acid (EDDA) are evaluated as hepatobiliary imaging agents. N-substituted aromatic acyl and aromatic sulfonyl derivatives of EDDA, labeled with Tc-99m, were administered to rabbits and golden hamsters, and the distribution indicated clearance by the hepatobiliary system. N'-aromatic sulfonyl EDDAs were labeled with Tc-99m by the SnCl 2 method with more than 99% yield. Clearance of Tc-99m-p-toluenesulfonyl EDDA from the blood and the liver was as rapid as that of TC-99m N-(2,6-diethylphenylcarbamoylmethyl)iminodiacetic acid (Tc-99m benzenesulfonyl EDDA lowered urinary excretion. It is concluded that the sulfonyl EDDAs provide a fruitful source for Tc-99m-labeled hepatobiliary radiopharmaceuticals

  17. Evaluation of six new /sup 99m/Tc-IDA agents for hepatobiliary imaging

    Energy Technology Data Exchange (ETDEWEB)

    Chervu, L.R.; Joseph, J.A.; Chun, S.B.; Rolleston, R.E.; Synnes, E.I.; Thompson, L.M.; Aldis, A.E.; Rosenthall, L.

    1988-10-01

    IDA derivatives of three substituted benzothiazol, and two substituted chlorophenyl and one substituted pyrazoline compounds have been labeled with /sup 99m/Tc and screened with four rat models with hepatocellular dysfunction manifesting varying degrees of change of liver architecture and hepatocellular damage associated with an active parenchymal destruction, fatty metamorphosis and cirrhosis. Organ distribution studies at 1 h postinjection have been compared in normal and diseased animal models for each agent labeled with /sup 99m/Tc and with /sup 99m/Tc-Disofenin (Disida) and Lidofenin (Hida) and /sup 131/I-Rose Bengal. From the data obtained with the six new IDA derivatives, the distribution kinetics of /sup 99m/Tc-Arclophenin, (N-N'-2-benzoyl-4-chlorophenyl)carbamoylmethyl) imino diacetic acid (Phenida), are closely comparable to /sup 99m/Tc-Disofenin in all animal models. Crossover patient studies (n = 14) for clinical evaluation of /sup 99m/Tc-Arclophenin vs /sup 99m/Tc-Disofenin indicate the close similarity of the 2 agents with regard to blood pool retention, gross liver/heart ratios and liver washout, suggesting Arclophenin as a suitable agent for hepatobiliary function studies. The impaired hepatocellular animal models presented should serve for fast screening of hepatobiliary agents and enable comparison of a series of closely related compounds.

  18. Synthesis and animal experiment of 99mTc-labeled hepatobiliary imaging agents

    International Nuclear Information System (INIS)

    Zhou Xirui; Chen Shaoliang; Chen Guohui; Xu Qinfeng

    1993-01-01

    Six new compounds based on the principle of isosterism and hybridization had been synthesized. Methobrofenin was prepared by reduction of nitro mesitylene, followed by bromination and acylation with nitrilotriacetic acid. The 99m Tc-complexes of these compounds were prepared by stannous chloride reduction of sodium pertechnetate in aqueous solution. These labeled compounds, being similar to 99m Tc-mebrofenin, all were quick in the uptake by the liver cells, rapidly cleared off from the blood in mice, and had higher cumulative hepatobiliary excretion rates than Tc-99m-EHIDA

  19. Dynamic Study on the Hepatobiliary Diseases with Combination of 131I-Rose bengal and 198Au-Colloid Scintiphotography

    International Nuclear Information System (INIS)

    Rhee, Yong Kok

    1971-01-01

    The radioactive 131 I-Rose bengal serial scintiphotography was performed in 62 patients with the hepatobiliary diseases and in 20 normal subjects. This approach permitted visualization of the hepatic uptake of 131 I-Rose bengal from the circulation and its excretion into the biliary trees and the intestines. In some of these patients, gallbladder function was examined, using eggs as a gallbladder constrictor. The time of maximum hepatic uptake was well correlated to the conventional biochemical liver function tests. In addition to 131 I-Rose bengal scintiphotography, 198 Au-colloid scintiphotography was also performed to make comparison of these two tests. The results obtained were as follows: 1) In normal subjects, the maximum hepatic uptake of 131 I-Rose bengal occurred at 23±2.9 minutes, the initial hepatic excretion at 34±5.1 minutes, the visualization of the gallbladder at 29±5.7 minutes and the intestinal visualization at 54±25.8 minutes. The radioactivity in the gallbladder decreased to 10.7±5.0% one hour after the ingestion of eggs. 2) In the patients with cirrhosis of the liver, there was a delayed and decreased hepatic uptake. The maximum hepatic uptake occurred at 43±12.9 minutes. The differences in the results of uptake between the cirrhotic and the normal group were statistically significant. The initial hepatic excretion occurred at 60±18.5 minutes and had tendency of delaying compared with the normal controls. The gallbladder was visualized in 13 of 16 cases (81%) and its visualization occurred at 49±14.6 minutes with a tendency to be delayed compared with the normal controls. The intestinal visualization occurred at 63±15.8 minutes and its delaying tendency was somewhat more prominent. 3) In patients with hepatitis, the maximum hepatic uptake occurred at 59±21.4 minutes and was significantly delayed. The initial hepatic excretion occurred at 82±34.3 minutes and the results revealed a delaying tendency. The gallbladder was visualized in 15

  20. New series of Tc-99m-labeled hepatobiliary tracers: N'-acyl- and N'-sulfonyl ethylenediamine-N,N-diacetic acids

    International Nuclear Information System (INIS)

    Karube, Y.; Kono, A.; Maeda, T.; Ohya, M.; Matsushima, Y.

    1981-01-01

    Various Tc-99m-labeled N'-substituted derivatives of ethylenediamine-N,N-diacetic acid (EDDA) are evaluated as hepatobiliary imaging agents. N'-substituted aromatic acyl and aromatic sulfonyl derivatives of EDDA, labeled with Tc-99m, were administered to rabbits and golden hamsters, and the distribution indicated clearance by the hepatobiliary system. N'-aromatic sulfonyl EDDAs were labeled with Tc-99m by the SnCl 2 method with more than 99% yield. Clearance of Tc-99m-p-toluenesulfonyl EDDA from the blood and the liver was as rapid as that of Tc-99m N-(2,6-diethylphenylcarbamoylmethyl)iminodiacetic acid (Tc-99m diethyl IDA). Substitution of a bulky group at the aromatic ring in Tc-99m benzene-sulfonyl EDDA lowered urinary excretion. It is concluded that the sulfonyl EDDAs provide a fruitful source for Tc-99m-labeled hepatobiliary radiopharmaceuticals

  1. Comparison of the dynamics of bile emptying by quantitative hepatobiliary scintigraphy before and after cholecystectomy in patients with uncomplicated gallstone disease

    DEFF Research Database (Denmark)

    Madácsy, L; Toftdahl, D B; Middelfart, H V

    1999-01-01

    of cholecystectomy on the bile flow has not yet been investigated. The goal of the current study was to examine the dynamics and normal variations of bile flow by quantitative hepatobiliary scintigraphy before and after cholecystectomy in a group of patients with uncomplicated gallstone disease. METHODS: Twenty...... patients were evaluated before and after cholecystectomy through cholecystokinin octapeptide-augmented quantitative hepatobiliary scintigraphy, and quantitative parameters of bile emptying (Tmax: time to peak activity, T1/2: half-emptying time before and after cholecystokinin octapeptide and duodenum...... appearance time) were determined and then compared. RESULTS: Before operation, the bile outflow displayed wide variations, with a moderately delayed common bile duct emptying time in some patients. After cholecystectomy, the T1/2 of the common bile duct decreased significantly when compared...

  2. Feasibility of semiautomated MR volumetry using gadoxetic acid-enhanced MRI at hepatobiliary phase for living liver donors.

    Science.gov (United States)

    Lee, Jeongjin; Kim, Kyoung Won; Kim, So Yeon; Kim, Bohyoung; Lee, So Jung; Kim, Hyoung Jung; Lee, Jong Seok; Lee, Moon Gyu; Song, Gi-Won; Hwang, Shin; Lee, Sung-Gyu

    2014-09-01

    To assess the feasibility of semiautomated MR volumetry using gadoxetic acid-enhanced MRI at the hepatobiliary phase compared with manual CT volumetry. Forty potential live liver donor candidates who underwent MR and CT on the same day, were included in our study. Semiautomated MR volumetry was performed using gadoxetic acid-enhanced MRI at the hepatobiliary phase. We performed the quadratic MR image division for correction of the bias field inhomogeneity. With manual CT volumetry as the reference standard, we calculated the average volume measurement error of the semiautomated MR volumetry. We also calculated the mean of the number and time of the manual editing, edited volume, and total processing time. The average volume measurement errors of the semiautomated MR volumetry were 2.35% ± 1.22%. The average values of the numbers of editing, operation times of manual editing, edited volumes, and total processing time for the semiautomated MR volumetry were 1.9 ± 0.6, 8.1 ± 2.7 s, 12.4 ± 8.8 mL, and 11.7 ± 2.9 s, respectively. Semiautomated liver MR volumetry using hepatobiliary phase gadoxetic acid-enhanced MRI with the quadratic MR image division is a reliable, easy, and fast tool to measure liver volume in potential living liver donors. Copyright © 2013 Wiley Periodicals, Inc.

  3. Phenolic aminocarboxylate chelates of sup(99m)Tc as hepatobiliary agents

    Energy Technology Data Exchange (ETDEWEB)

    Hunt, F.C.; Maddalena, D.J.; Wilson, J.G.; Bautovich, G.J.

    1986-01-01

    A series of alkyl- and halogen-substituted derivatives of ethylenediamine di(omicron-hydroxyphenylacetic acid) (EDDHA) and N,N'-bis(2-hydroxybenzyl) ethylenediamine N,N'-diacetic acid (HBED) were complexed with sup(99m)Tc and their biodistribution was determined in rats. All complexes displayed substantial hepatobiliary excretion; of each series, sup(99m)Tc-Br-EDDHA and sup(99m)Tc-di-Cl-HBED had the maximum amount in the gastrointestinal tract. Scintigraphic studies of sup(99m)Tc-Cl-EDDHA in dogs revealed prompt imaging of the liver followed by imaging of the gall bladder as the complex was excreted into the bile.

  4. Phenolic aminocarboxylate chelates of sup(99m)Tc as hepatobiliary agents

    International Nuclear Information System (INIS)

    Hunt, F.C.; Maddalena, D.J.; Wilson, J.G.; Bautovich, G.J.

    1986-01-01

    A series of alkyl- and halogen-substituted derivatives of ethylenediamine di[omicron-hydroxyphenylacetic acid] (EDDHA) and N,N'-bis[2-hydroxybenzyl] ethylenediamine N,N'-diacetic acid (HBED) were complexed with sup(99m)Tc and their biodistribution was determined in rats. All complexes displayed substantial hepatobiliary excretion; of each series, sup(99m)Tc-Br-EDDHA and sup(99m)Tc-di-Cl-HBED had the maximum amount in the gastrointestinal tract. Scintigraphic studies of sup(99m)Tc-Cl-EDDHA in dogs revealed prompt imaging of the liver followed by imaging of the gall bladder as the complex was excreted into the bile. (author)

  5. Bile ascites in adults. Diagnosis using hepatobiliary scintigraphy and paracentesis

    International Nuclear Information System (INIS)

    Nagle, C.E.; Fink-Bennett, D.; Freitas, J.E.

    1985-01-01

    Hepatobiliary scintigraphy has been recognized as a useful diagnostic tool in detecting the presence and site of bile leaks. The authors report a case of bile ascites secondary to a postsurgical biliary leak, the scintigraphic findings in bile ascites, and the potential use of paracentesis, in combination with hepatobiliary scintigraphy, in confirming the presence of bile ascites and a bile leak

  6. Hepatobiliary sequential scintiscanning

    Energy Technology Data Exchange (ETDEWEB)

    Germann, G.; Hottenrott, C.; Maul, F.D.

    1985-01-04

    The duodeno-gastric reflux was evaluated in 33 patients following gastric surgery by functional hepato-biliary scintigraphy. In 16 of 26 patients with gastric resection a reflux was found. The Y-en-Roux and the retrocolic B II resection with Braun's Anastomosis showed the lowest incidence of reflux. The functional scintigraphy permits an objective diagnosis of reflux without provocation by diagnostic manipulations. The high percentage of accuracy in evaluating reflux recommends the scintigraphy as an optimal method in postoperative reflux control.

  7. {sup 99m}Tc sestamibi imaging. Can it be a useful substitute for hepatobiliary scintigraphy in infantile jaundice?

    Energy Technology Data Exchange (ETDEWEB)

    Sadeghi, R.; Kakhki, V.R.D.; Zakavi, R. [Mashhad Univ. of Medical Sciences (Iran). Nuclear Medicine Dept.; Kianifar, H.R. [Mashhad Univ. of Medical Sciences (Iran). Paediatric Dept.; Ansari, K. [Tehran Univ. of Medical Sciences (Iran). Nuclear Medicine Dept.

    2009-07-01

    Hepatobiliary scintigraphy is an integral part in the diagnostic work-up of the neonatal cholestasis syndrome. However, less than optimal specificity is its major disadvantage. Differentiation between biliary atresia and neonatal hepatitis is nearly impossible in some cases with poor hepatocellular function. {sup 99m}Tc sestamibi (MIBI) is a cationic lipophilic agent which is a substrate of P-glycoprotein. This glycoprotein is normally expressed in biliary canalicular surfaces of hepatocytes. This property provides a hepatic excretory mechanism which is different from bilirubin excretion. In this study we evaluated the value of {sup 99m}Tc MIBI in differential diagnosis of neonatal cholestasis. 20 infants with a mean age of 2.41 months (range, 0.1-5 months) were included in the study. Ten infants turned out to have extrahepatic biliary atresia and the other ten had neonatal hepatitis. Hepatobiliary (with {sup 99m}Tc BrIDA) and {sup 99m}Tc MIBI scintigraphy were performed for all the patients. {sup 99m}Tc MIBI scintigraphy has shown bowel activity in all patients, including the patients with biliary atresia. Hepatobiliary scintigraphy revealed bowel activity only in five patients with neonatal hepatitis. Bowel visualization with {sup 99m}Tc MIBI may be seen in patients with biliary atresia and {sup 99m}Tc MIBI has limited value in differential diagnosis of neonatal cholestasis. (orig.)

  8. Gastric Reflux on Routine Tc-99m DISIDA hepatobiliary Scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Kang Wook; Lee, Heon Young [Chungnam National University College of Medicine, Daejeon (Korea, Republic of)

    1995-06-15

    Reflux of bile and digestive enzymes from the small bowel and duodenum into stomach has been observed in patients with various gastroduodenal diseases. Tc-99m iminodiacetic acid derivatives hepatobiliary scan has been used as a noninvasive method to detect duodenogastric reflux. Sometimes, gastric reflux can be observed incidentally on routine Tc-99m DISA hepatobiliary scintigraphy. To evaluate the clinical meaning of gastric reflux on routine Tc-99m DISIDA hepatobiliary scan, we analyzed 36 patients showed gastric reflux incidentally on the routine Tc-99m-DISIDA hepatobiliary scintigraphy from December 1991 to June 1995 in Chungnam National University Hospital. The results were as follows: 1) The gastric reflux was observed in 2.3% of 1,553 cases of routine Tc-99m DISIDA Hepatobiliary scintigraphy for 43 months. 2) Nineteen percent of patients with gastric reflux had the past medical history of operations on stomach or biliary system. And that history was more prevalent in patients with reflux than those without reflux, significantly (p<0.01). 3) On fiberoptic gastroduodenpscopic examination, 87% of the patients with gastric reflux had the gastroduodenal diseases such as gastritis, gastric ulcer, duodenal ulcer, gastric cancer, duodenal cancer and ampullary diverticulosis. We thought that the gastric reflux can be observed considerably in patients without any operation history on stomach or duodenum, although the operation history is more prevalent in patients with gastric reflux than those without reflux, significantly and most of patients with gastric reflux on routine Tc-99m DISIDA scan has various gastroduodenal diseases.

  9. Gastric Reflux on Routine Tc-99m DISIDA hepatobiliary Scintigraphy

    International Nuclear Information System (INIS)

    Lee, Kang Wook; Lee, Heon Young

    1995-01-01

    Reflux of bile and digestive enzymes from the small bowel and duodenum into stomach has been observed in patients with various gastroduodenal diseases. Tc-99m iminodiacetic acid derivatives hepatobiliary scan has been used as a noninvasive method to detect duodenogastric reflux. Sometimes, gastric reflux can be observed incidentally on routine Tc-99m DISA hepatobiliary scintigraphy. To evaluate the clinical meaning of gastric reflux on routine Tc-99m DISIDA hepatobiliary scan, we analyzed 36 patients showed gastric reflux incidentally on the routine Tc-99m-DISIDA hepatobiliary scintigraphy from December 1991 to June 1995 in Chungnam National University Hospital. The results were as follows: 1) The gastric reflux was observed in 2.3% of 1,553 cases of routine Tc-99m DISIDA Hepatobiliary scintigraphy for 43 months. 2) Nineteen percent of patients with gastric reflux had the past medical history of operations on stomach or biliary system. And that history was more prevalent in patients with reflux than those without reflux, significantly (p<0.01). 3) On fiberoptic gastroduodenpscopic examination, 87% of the patients with gastric reflux had the gastroduodenal diseases such as gastritis, gastric ulcer, duodenal ulcer, gastric cancer, duodenal cancer and ampullary diverticulosis. We thought that the gastric reflux can be observed considerably in patients without any operation history on stomach or duodenum, although the operation history is more prevalent in patients with gastric reflux than those without reflux, significantly and most of patients with gastric reflux on routine Tc-99m DISIDA scan has various gastroduodenal diseases.

  10. Dynamic Study on the Hepatobiliary Diseases with Combination of {sup 131}I-Rose bengal and {sup 198}Au-Colloid Scintiphotography

    Energy Technology Data Exchange (ETDEWEB)

    Rhee, Yong Kok [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1971-03-15

    The radioactive {sup 131}I-Rose bengal serial scintiphotography was performed in 62 patients with the hepatobiliary diseases and in 20 normal subjects. This approach permitted visualization of the hepatic uptake of {sup 131}I-Rose bengal from the circulation and its excretion into the biliary trees and the intestines. In some of these patients, gallbladder function was examined, using eggs as a gallbladder constrictor. The time of maximum hepatic uptake was well correlated to the conventional biochemical liver function tests. In addition to {sup 131}I-Rose bengal scintiphotography, {sup 198}Au-colloid scintiphotography was also performed to make comparison of these two tests. The results obtained were as follows: 1) In normal subjects, the maximum hepatic uptake of {sup 131}I-Rose bengal occurred at 23+-2.9 minutes, the initial hepatic excretion at 34+-5.1 minutes, the visualization of the gallbladder at 29+-5.7 minutes and the intestinal visualization at 54+-25.8 minutes. The radioactivity in the gallbladder decreased to 10.7+-5.0% one hour after the ingestion of eggs. 2) In the patients with cirrhosis of the liver, there was a delayed and decreased hepatic uptake. The maximum hepatic uptake occurred at 43+-12.9 minutes. The differences in the results of uptake between the cirrhotic and the normal group were statistically significant. The initial hepatic excretion occurred at 60+-18.5 minutes and had tendency of delaying compared with the normal controls. The gallbladder was visualized in 13 of 16 cases (81%) and its visualization occurred at 49+-14.6 minutes with a tendency to be delayed compared with the normal controls. The intestinal visualization occurred at 63+-15.8 minutes and its delaying tendency was somewhat more prominent. 3) In patients with hepatitis, the maximum hepatic uptake occurred at 59+-21.4 minutes and was significantly delayed. The initial hepatic excretion occurred at 82+-34.3 minutes and the results revealed a delaying tendency. The

  11. Application of da Vinci surgical robotic system in hepatobiliary surgery

    Directory of Open Access Journals (Sweden)

    Chen Jiahai

    2018-01-01

    Full Text Available The development of minimally invasive surgery has brought a revolutionary change to surgery techniques, and endoscopic surgical robots, especially Da Vinci robotic surgical system, has further broaden the scope of minimally invasive surgery, which has been applied in a variety of surgical fields including hepatobiliary surgery. Today, the application of Da Vinci surgical robot can cover most of the operations in hepatobiliary surgery which has proved to be safe and practical. What’s more, many clinical studies in recent years have showed that Da Vinci surgical system is superior to traditional laparoscopy. This paper summarize the advantage and disadvantage of Da Vinci surgical system, and outlines the current status of and future perspectives on the robot-assisted hepatobiliary surgery based on the cases reports in recent years of the application of Da Vinci surgical robot.

  12. [Hepatobiliary System Diseases as the Predictors of Psoriasis Progression].

    Science.gov (United States)

    Smirnova, S V; Barilo, A A; Smolnikova, M V

    2016-01-01

    To assess the state of the hepatobiliary system in psoriasis andpsoriatic arthritis in order to establish a causal relationship and to identify clinical and functional predictors of psoriatic disease progression. The study includedpatients with extensive psoriasis vulgaris (n = 175) aged 18 to 66 years old and healthy donors (n = 30), matched by sex and age: Group 1--patients with psoriasis (PS, n = 77), group 2--patients with psoriatic arthritis (PsA, n = 98), group 3--control. The evaluation of functional state of the hepatobiliary system was performed by the analysis of the clinical and anamnestic data and by the laboratory-instrumental methods. We identified predictors of psoriasis: triggers (stress and nutritionalfactor), increased total bilirubin, aspartate aminotransferase, alkaline phosphatase, gamma-glutamyl transferase, eosinophilia, giardiasis, carriers of hepatitis C virus, ductal changes andfocal leisons in the liver, thickening of the walls of the gallbladder detected by ultrasound. Predictors ofpsoriatic arthritis: age over 50 years, dyspeptic complaints, the presence of hepatobiliary system diseases, the positive right hypochondrium syndrome, the clinical symptoms of chronic cholecystitis, excess body weight, high levels of bilirubin, cholesterol and low density lipoprotein, hepatomegaly, non-alcoholic fatty liver disease. High activity of hepatocytes cytolysis, cholestasis, inflammation, metabolic disorders let us considerpsoriatic arthritis as a severe clinical stage psoriatic disease when the hepatobiliary system, in turn, is one of the main target organs in systemic psoriatic process. Non-alcoholic fatty liver disease and chronic cholecystitis are predictors of psoriatic disease progression.

  13. Hepatobiliary scintigraphy in the assessment of long-term complication after biliary-enteric anastomosis: role in the diagnosis of post-operative segmental or total biliary obstruction

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jae Seung; Moon, Dae Hyuk; Lee, Sung Gyu; Lee, Yung Joo; Park, Kwang Min; Shin, Jung Woo; Ryu, Jin Sook; Lee, Hee Kyung [Asan Medicial Center, Seoul (Korea, Republic of)

    1998-07-01

    The purpose of this study was to investigate the accuracy of hepatobiliary scintigraphy (HBS) in the diagnosis of segmental or total biliary obstruction during long-term follow-up period after curative radical surgery with biliary-enteric anastomosis. The study population included 80 patients who underwent biliary-enteric anastomoses for benign (n=33) or malignant (n=47) biliary disease. Fifty-six of these 80 patients also underwent curative hepatic resection. Ninety eight hepatobiliary scintigrams using {sup 99m}Tc-DISIDA were performed at least 1 month after surgery (median 9 month). The scintigraphic criteria of total biliary obstruction we used were intestinal excretion beyond one hour or delayed hepatobiliary washout despite the presence of intestinal excretion. Segmental biliary obstruction was defined as delayed segmental excretion. The accuracy for biliary obstruction was evaluated according to different clinical situations. There were 9 instances with total biliary obstruction and 23 with segmental bile duct obstruction. Diagnosis of biliary obstruction was confirmed by percutaneous transhepatic cholangiography or surgery in 13, and follow-up clinical data for at least 6 months in 19 instances. Among the 32 instances with biliary symptoms and abnormal liver function, HBS allowed correct diagnosis in all 32(9 total, 14 segmental obstruction and 9 non-obstruction). Of the 40 with nonspecific symptom or isolated elevation of serum alkaline phosphatase, HBS diagnosed 8 of the 9 segmental biliary obstruction and 30 of the 31 non-obstruction. There were no biliary obstruction and no false positive result of scintigraphy in 26 instances which had no clinical symptom or signs of biliary obstruction. Diagnostic sensitivity of HBS was 100% (9/9) for total biliary obstruction, and 96%(22/23) for segmental bile obstruction. Specificity was 98%(39/40) in patients who had abnormal symptom or sign. Hepatobiliary scintigraphy is a highly accurate modality in the

  14. Hepatobiliary scintigraphy in the assessment of long-term complication after biliary-enteric anastomosis: role in the diagnosis of post-operative segmental or total biliary obstruction

    International Nuclear Information System (INIS)

    Kim, Jae Seung; Moon, Dae Hyuk; Lee, Sung Gyu; Lee, Yung Joo; Park, Kwang Min; Shin, Jung Woo; Ryu, Jin Sook; Lee, Hee Kyung

    1998-01-01

    The purpose of this study was to investigate the accuracy of hepatobiliary scintigraphy (HBS) in the diagnosis of segmental or total biliary obstruction during long-term follow-up period after curative radical surgery with biliary-enteric anastomosis. The study population included 80 patients who underwent biliary-enteric anastomoses for benign (n=33) or malignant (n=47) biliary disease. Fifty-six of these 80 patients also underwent curative hepatic resection. Ninety eight hepatobiliary scintigrams using 99m Tc-DISIDA were performed at least 1 month after surgery (median 9 month). The scintigraphic criteria of total biliary obstruction we used were intestinal excretion beyond one hour or delayed hepatobiliary washout despite the presence of intestinal excretion. Segmental biliary obstruction was defined as delayed segmental excretion. The accuracy for biliary obstruction was evaluated according to different clinical situations. There were 9 instances with total biliary obstruction and 23 with segmental bile duct obstruction. Diagnosis of biliary obstruction was confirmed by percutaneous transhepatic cholangiography or surgery in 13, and follow-up clinical data for at least 6 months in 19 instances. Among the 32 instances with biliary symptoms and abnormal liver function, HBS allowed correct diagnosis in all 32(9 total, 14 segmental obstruction and 9 non-obstruction). Of the 40 with nonspecific symptom or isolated elevation of serum alkaline phosphatase, HBS diagnosed 8 of the 9 segmental biliary obstruction and 30 of the 31 non-obstruction. There were no biliary obstruction and no false positive result of scintigraphy in 26 instances which had no clinical symptom or signs of biliary obstruction. Diagnostic sensitivity of HBS was 100% (9/9) for total biliary obstruction, and 96%(22/23) for segmental bile obstruction. Specificity was 98%(39/40) in patients who had abnormal symptom or sign. Hepatobiliary scintigraphy is a highly accurate modality in the evaluation of

  15. Percutaneous cholecystocentesis in cats with suspected hepatobiliary disease.

    Science.gov (United States)

    Byfield, Victoria L; Callahan Clark, Julie E; Turek, Bradley J; Bradley, Charles W; Rondeau, Mark P

    2017-12-01

    Objectives The objective was to evaluate the safety and diagnostic utility of percutaneous ultrasound-guided cholecystocentesis (PUC) in cats with suspected hepatobiliary disease. Methods Medical records of 83 cats with suspected hepatobiliary disease that underwent PUC were retrospectively reviewed. Results At the time of PUC, at least one additional procedure was performed in 79/83 cats, including hepatic aspiration and/or biopsy (n = 75) and splenic aspiration (n = 18). Complications were noted in 14/83 cases, including increased abdominal fluid (n = 11), needle-tip occlusion (n = 1), failed first attempt to penetrate the gall bladder wall (n = 1) and pneumoperitoneum (n = 1). There were no reports of gall bladder rupture, bile peritonitis or hypotension necessitating treatment with vasopressor medication. Blood products were administered to 7/83 (8%) cats. Seventy-two cats (87%) survived to discharge. Of the cats that were euthanized (9/83) or died (2/83), none were reported as a definitive consequence of PUC. Bacteria were identified cytologically in 10/71 samples (14%); all 10 had a positive aerobic bacterial culture. Bile culture was positive in 11/80 samples (14%). Of the cases with a positive bile culture, cytological description of bacteria corresponded to the organism cultured in fewer than 50% of cases. The most common cytologic diagnosis was hepatic lipidosis (49/66). The most common histopathologic diagnosis was cholangitis (10/21). Conclusions and relevance PUC was safe in this group of cats with suspected hepatobiliary disease. Complications were likely associated with ancillary procedures performed at the time of PUC. Bile analysis yielded an abnormal result in nearly one-third of cats with suspected hepatobiliary disease. Complete agreement between bile cytology and culture was lacking. Further evaluation of the correlation between bile cytology and bile culture is warranted.

  16. Biliary scintigraphy in children with sickle cell anemia and acute abdominal pain

    Energy Technology Data Exchange (ETDEWEB)

    D' Alonzo, W.A. Jr.; Heyman, S.

    1985-09-01

    The patterns of radionuclide hepatobiliary scans in nine children with sickle cell disease and acute right upper quadrant abdominal pain were reviewed. The most common pattern observed was delayed gall bladder visualization, consistent with chronic cholecystitis. The value of hepatobiliary imaging in distinguishing acute cholecystitis from crisis is presented.

  17. CGI delay compensation. [Computer Generated Image

    Science.gov (United States)

    Mcfarland, R. E.

    1986-01-01

    Computer-generated graphics in real-time helicopter simulation produces objectionable scene-presentation time delays. In the flight simulation laboratory at Ames Research Center, it has been determined that these delays have an adverse influence on pilot performance during agressive tasks such as nap of the earth (NOE) maneuvers. Using contemporary equipment, computer generated image (CGI) time delays are an unavoidable consequence of the operations required for scene generation. However, providing that magnitude distortions at higher frequencies are tolerable, delay compensation is possible over a restricted frequency range. This range, assumed to have an upper limit of perhaps 10 or 15 rad/sec, conforms approximately to the bandwidth associated with helicopter handling qualities research. A compensation algorithm is introduced here and evaluated in terms of tradeoffs in frequency responses. The algorithm has a discrete basis and accommodates both a large, constant transport delay interval and a periodic delay interval, as associated with asynchronous operations.

  18. Hepatobiliary transit times of gadoxetate disodium (Primovist) for protocol optimization of comprehensive MR imaging of the biliary system-What is normal?

    Energy Technology Data Exchange (ETDEWEB)

    Ringe, Kristina I., E-mail: ringe.kristina@mh-hannover.de [Duke University Medical Center, Department of Radiology, Box 3808, Durham, NC 27710 (United States); Hannover Medical School, Department of Radiology, Carl-Neuberg Str. 1, 30625 Hannover (Germany); Husarik, Daniela B., E-mail: danielahusarik@yahoo.com [Duke University Medical Center, Department of Radiology, Box 3808, Durham, NC 27710 (United States); Gupta, Rajan T., E-mail: rajan.gupta@duke.edu [Duke University Medical Center, Department of Radiology, Box 3808, Durham, NC 27710 (United States); Boll, Daniel T., E-mail: daniel.boll@duke.edu [Duke University Medical Center, Department of Radiology, Box 3808, Durham, NC 27710 (United States); Merkle, Elmar M., E-mail: elmar.merkle@duke.edu [Duke University Medical Center, Department of Radiology, Box 3808, Durham, NC 27710 (United States)

    2011-08-15

    Objective: The purpose of this study was to determine transit times for excretion of Gd-EOB-DTPA into different segments of the hepatobiliary system in patients with normal liver function. Methods: This retrospective study was IRB approved with a waiver of consent granted. 61 patients (39 female, 22 male, mean age 52.5 years) with normal liver and renal function who underwent contrast enhanced hepatic MRI after injection of 10 mLGd-EOB-DTPA at 1.5 T and 3 T were included. Two readers evaluated all delayed images (3-20 min post contrast) for the presence of contrast agent in the intrahepatic bile ducts (IBD), the common bile duct (CBD), the gallbladder and the duodenum. A two-tailed, unpaired Student's t-test with p < 0.05 deemed significant was used to determine whether transit times were affected by patient gender, age or body mass index. Results: 20 min after contrast initiation, Gd-EOB-DTPA could be detected in the IBD and the CBD in all patients (100%); gallbladder reflux was visible in 53 (86.9%), duodenal excretion in 40 patients (65.5%), respectively. Mean transit times for contrast appearance in the various segments were as follows: IBD 12 min 13 s; CBD 12 min 27 s; gallbladder 13 min 32 s. Transit times were not significantly affected by patient gender, age or BMI. Conclusion: Within 20 min post contrast initiation, Gd-EOB-DTPA can be expected in the IBD and the CBD in patients with normal liver function. However, functional information about the sphincter Oddi complex can be ascertained only in about two thirds of these patients within this timeframe.

  19. Phantom and animal studies of a new hepatobiliary agent for MR imaging: comparison of Gd-DTPA-DeA with Gd-EOB-DTPA.

    Science.gov (United States)

    Yoshikawa, Kohki; Inoue, Yusuke; Akahane, Masaaki; Shimada, Morio; Itoh, Sayaka; Seno, Atsushi; Hayashi, Sanshin

    2003-08-01

    To investigate the characteristics of Gd-DTPA-DeA as a hepatobiliary contrast agent for MR imaging in comparison with those of Gd-EOB-DTPA. We undertook phantom experiments to assess T1 relaxivity for Gd-DTPA-DeA, Gd-EOB-DTPA, and Gd-DTPA in human plasma. For Gd-DTPA-DeA and Gd-EOB-DTPA, we evaluated the contrast effect in rats using an SPGR sequence. The contrast ratios of liver and abdominal aorta were measured up to 21 minutes after intravenous administration of the agents. Visualization of the bile duct and renal pelvis was also assessed. In human plasma, T1 relaxivity was similar for Gd-DTPA-DeA and Gd-EOB-DTPA, and higher than those for Gd-DTPA. Whereas the contrast ratio of liver peaked about five minutes after the injection of Gd-EOB-DTPA and was followed by a subsequent decline, a continuous rise was shown for Gd-DTPA-DeA, resulting in a larger maximal contrast effect. Contrast ratios of the abdominal aorta were larger for Gd-DTPA-DeA. Biliary excretion was observed for both agents but occurred earlier with Gd-EOB-DTPA. While renal excretion was shown for all rats three minutes after the injection of Gd-EOB-DTPA, it was not observed for Gd-DTPA-DeA. Gd-DTPA-DeA may be used as a hepatobiliary contrast agent and shows different pharmacokinetics from Gd-EOB-DTPA. Copyright 2003 Wiley-Liss, Inc.

  20. Variants of hepatobiliary leakage: Biloma and aberrant drainage paths - case report

    Energy Technology Data Exchange (ETDEWEB)

    Mack, J M; Peracha, H; Sziklas, J J; Rosenberg, R J; Spencer, R P

    1987-04-01

    Three variants of abnormal biliary drainage, on Tc-99m-DIPIDA studies, were illustrated, despite patency of the normal pathway. A 23-year-old man had gun shot fragments removed from the liver. An area originally negative for uptake of the hepatobiliary agent later demonstrated an increased content after the remainder of the liver had drained (a biloma). A 67-year-old woman showed passage of Tc-99m-DIPIDA simultaneously from 2 pathways. One was via a biliary-cutaneous fistula site along a prior T-tube tract, and the other was into the small intestine via a biliary stent. Following cholecystectomy, a hepatobiliary study in a 46-year-old man revealed a 'gallbladder'. This represented leakage into the prior gallbladder bed. The hepatobiliary agents can exit via traumatically or surgically created pathways, even when the 'usual' anatomic drainage is present.

  1. Biliary scintigraphy in children with sickle cell anemia and acute abdominal pain

    International Nuclear Information System (INIS)

    D'Alonzo, W.A. Jr.; Heyman, S.

    1985-01-01

    The patterns of radionuclide hepatobiliary scans in nine children with sickle cell disease and acute right upper quadrant abdominal pain were reviewed. The most common pattern observed was delayed gall bladder visualization, consistent with chronic cholecystitis. The value of hepatobiliary imaging in distinguishing acute cholecystitis from crisis is presented. (orig.)

  2. Hepatobiliary phase images using gadolinium-ethoxybenzyl-diethylenetriamine penta-acetic acid-enhanced MRI as an imaging surrogate for the albumin–bilirubin grading system

    Energy Technology Data Exchange (ETDEWEB)

    Takatsu, Yasuo, E-mail: pcblue2@yahoo.co.jp [Department of Radiology, Osaka Red Cross Hospital, 5-30 Fudegasaki, Tennouji-ku, Osaka, 543-8555 (Japan); Division of Health Sciences, Graduate School of Medical Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, 920-0942 (Japan); Kobayashi, Satoshi, E-mail: satoshik@staff.kanazawa-u.ac.jp [Division of Health Sciences, Graduate School of Medical Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, 920-0942 (Japan); Miyati, Tosiaki, E-mail: ramiyati@mhs.mp.kanazawa-u.ac.jp [Division of Health Sciences, Graduate School of Medical Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, 920-0942 (Japan); Shiozaki, Toshiki, E-mail: shiozaki.toshiki@gmail.com [Department of Radiology, Osaka Red Cross Hospital, 5-30 Fudegasaki, Tennouji-ku, Osaka, 543-8555 (Japan)

    2016-12-15

    Objectives: To clarify the correlation between hepatobiliary phase (HBP) images using gadolinium-ethoxybenzyl-diethylenetriamine penta-acetic acid (Gd-EOB-DTPA) and albumin–bilirubin (ALBI) grading system. Materials and methods: We evaluated 220 consecutive patients who underwent liver magnetic resonance imaging with Gd-EOB-DTPA. Quantitative liver–spleen contrast ratio (Q-LSC) was calculated in HBP images approximately 20 min after Gd-EOB-DTPA administration. To evaluate the degree of association between Q-LSC and ALBI grade, the Child–Pugh (C-P) score was used for comparison. Correlation coefficients were calculated, and median Q-LSC values were compared with the C-P scores and ALBI grades. The Steel–Dwass multiple comparison test was used for statistical analysis. Results: The correlation coefficient between Q-LSC and C-P score was −0.35, P < 0.0001, and the ALBI grade was −0.61, P < 0.0001. Q-LSC of overall median, C-P A, B, and C were 1.94, 1.91, 1.96, and 1.33, respectively. The differences between C-P A and C-P B, C-P B and C-P C, and C-P A and C-P C were P = 0.999, 0.126, and 0.149, respectively. Q-LSC of the overall median, ALBI grade 1, 2, and 3 were 1.94, 2.12, 1.69, and 1.30, respectively. The differences between ALBI grades 1 and 2, 2 and 3, and 1 and 3 were P < 0.0001, P = 0.0466, and P = 0.0035, respectively. Q-LSC was better correlated and discriminated by ALBI grade than C-P score. Conclusion: A strong correlation was observed between Q-LSC of an HBP image with Gd-EOB-DTPA and ALBI grade; HBP imaging could be a surrogate for the ALBI grade.

  3. Dynamic contrast-enhanced MR imaging of endometrial cancer. Optimizing the imaging delay for tumour-myometrium contrast

    International Nuclear Information System (INIS)

    Park, Sung Bin; Moon, Min Hoan; Sung, Chang Kyu; Oh, Sohee; Lee, Young Ho

    2014-01-01

    To investigate the optimal imaging delay time of dynamic contrast-enhanced magnetic resonance (MR) imaging in women with endometrial cancer. This prospective single-institution study was approved by the institutional review board, and informed consent was obtained from the participants. Thirty-five women (mean age, 54 years; age range, 29-66 years) underwent dynamic contrast-enhanced MR imaging with a temporal resolution of 25-40 seconds. The signal intensity difference ratios between the myometrium and endometrial cancer were analyzed to investigate the optimal imaging delay time using single change-point analysis. The optimal imaging delay time for appropriate tumour-myometrium contrast ranged from 31.7 to 268.1 seconds. The median optimal imaging delay time was 91.3 seconds, with an interquartile range of 46.2 to 119.5 seconds. The median signal intensity difference ratios between the myometrium and endometrial cancer were 0.03, with an interquartile range of -0.01 to 0.06, on the pre-contrast MR imaging and 0.20, with an interquartile range of 0.15 to 0.25, on the post-contrast MR imaging. An imaging delay of approximately 90 seconds after initiating contrast material injection may be optimal for obtaining appropriate tumour-myometrium contrast in women with endometrial cancer. (orig.)

  4. Diagnostic value of hepatobiliary sequence scintigraphy in patients with postcholecystectomy syndrome

    International Nuclear Information System (INIS)

    Frey, H.; Jorke, D.; Gottschild, D.; Langbein, T.; Zinner, G.; Kob, D.

    1992-01-01

    The autors report about the possibility of registration from functionally disturbances of gall fluid with the help of hepatobiliary sequence-scintigraphy in patients with postcholecystectomy-syndrome. The diagnostic importance of this methode and the meaning of other usually procedures is discussed. A selection of patients succeed in objective manner with hepatobiliary sequence-scintigraphy together with clinically dates of laboratory. In patients with postcholecystectomy-syndrome the procedure can show functionally disturbances in the area of extrahepatic gall ways. (orig.) [de

  5. Gastrointestinal and hepatobiliary radiology

    International Nuclear Information System (INIS)

    Graham, R.N.J.; Perriss, R.W.; Scarsbrook, A.F.

    2006-01-01

    This is the fifth in the series of short reviews of internet-based radiological learning resources and will focus on gastrointestinal (GI) and hepatobiliary radiology. Below are details of a few of the higher quality resources currently available. Most of the sites cater for medical students and trainee or non-specialist radiologists, but may be also be of interest to specialists, especially for use in teaching. Hyperlinks are available in the electronic version of this article and were all active at the time of going to press (May 2006)

  6. Hepatobiliary magnetic resonance imaging in patients with liver disease: correlation of liver enhancement with biochemical liver function tests

    Energy Technology Data Exchange (ETDEWEB)

    Kukuk, Guido M.; Schaefer, Stephanie G.; Hadizadeh, Dariusch R.; Schild, Hans H.; Willinek, Winfried A. [University of Bonn, Department of Radiology, Bonn (Germany); Fimmers, Rolf [University of Bonn, Department of Medical Biometry, Informatics and Epidemiology, Bonn (Germany); Ezziddin, Samer [Department of Nuclear Medicine, Bonn (Germany); Spengler, Ulrich [Department of Internal Medicine I, Bonn (Germany)

    2014-10-15

    To evaluate hepatobiliary magnetic resonance imaging (MRI) using Gd-EOB-DTPA in relation to various liver function tests in patients with liver disorders. Fifty-one patients with liver disease underwent Gd-EOB-DTPA-enhanced liver MRI. Based on region-of-interest (ROI) analysis, liver signal intensity was calculated using the spleen as reference tissue. Liver-spleen contrast ratio (LSCR) and relative liver enhancement (RLE) were calculated. Serum levels of total bilirubin, gamma glutamyl transpeptidase (GGT), aspartate aminotransferase (AST), alanine aminotransferase (ALT), glutamate dehydrogenase (GLDH), lactate dehydrogenase (LDH), serum albumin level (AL), prothrombin time (PT), creatinine (CR) as well as international normalised ratio (INR) and model for end-stage liver disease (MELD) score were tested for correlation with LSCR and RLE. Pre-contrast LSCR values correlated with total bilirubin (r = -0.39; p = 0.005), GGT (r = -0.37; p = 0.009), AST (r = -0.38; p = 0.013), ALT (r = -0.29; p = 0.046), PT (r = 0.52; p < 0.001), GLDH (r = -0.55; p = 0.044), INR (r = -0.42; p = 0.003), and MELD Score (r = -0.53; p < 0.001). After administration of Gd-EOB-DTPA bilirubin (r = -0.45; p = 0.001), GGT (r = -0.40; p = 0.004), PT (r = 0.54; p < 0.001), AST (r = -0.46; p = 0.002), ALT (r = -0.31; p = 0.030), INR (r = -0.45; p = 0.001) and MELD Score (r = -0.56; p < 0.001) significantly correlated with LSCR. RLE correlated with bilirubin (r = -0.40; p = 0.004), AST (r = -0.38; p = 0.013), PT (r = 0.42; p = 0.003), GGT (r = -0.33; p = 0.020), INR (r = -0.36; p = 0.011) and MELD Score (r = -0.43; p = 0.003). Liver-spleen contrast ratio and relative liver enhancement using Gd-EOB-DTPA correlate with a number of routinely used biochemical liver function tests, suggesting that hepatobiliary MRI may serve as a valuable biomarker for liver function. The strongest correlation with liver enhancement was found for the MELD Score. (orig.)

  7. Hepatobiliary Disorders in Celiac Disease: An Update

    Directory of Open Access Journals (Sweden)

    Kaushal K. Prasad

    2011-01-01

    Full Text Available This communication reviews recent literature and summarizes hepatobiliary abnormalities that may complicate the clinical course of celiac disease. A wide spectrum of hepatobiliary diseases has been described, including asymptomatic elevations of liver enzyme levels, nonspecific hepatitis, nonalcoholic fatty liver disease, and autoimmune and cholestatic liver disease. Moreover, in the majority of patients, liver enzyme levels will normalize on a gluten-free diet. In addition, celiac disease may be associated with rare hepatic complications, such as hepatic T-cell lymphoma. Because many celiac patients do not have overt gastrointestinal symptoms, a high index of suspicion is required. Simple methods of detecting celiac disease such as serum antibody tests help in the early identification of the disease, thus preventing serious complications of the disorder. The IgG DGP antibody test and IgA tTG antibody test used in combination are an excellent screening test for suspected cases of celiac disease.

  8. Prognosis of small hepatocellular nodules detected only at the hepatobiliary phase of Gd-EOB-DTPA-enhanced MR imaging as hypointensity in cirrhosis or chronic hepatitis

    Energy Technology Data Exchange (ETDEWEB)

    Higaki, Atsushi; Ito, Katsuyoshi; Tamada, Tsutomu; Sone, Teruki; Kanki, Akihiko; Noda, Yasufumi; Yasokawa, Kazuya; Yamamoto, Akira [Kawasaki Medical School, Department of Radiology, Kurashiki City, Okayama (Japan)

    2014-10-15

    To evaluate the prognosis of ''strict'' high-risk nodules (small hepatocellular nodules detected only in the hepatobiliary phase of initial Gd-EOB-DTPA-enhanced MR examination) in patients with cirrhosis or chronic hepatitis. The study included thirty-three patients with 60 ''strict'' high-risk nodules showing hypointensity at the hepatobiliary phase that was undetectable at the vascular phase and other conventional sequences of initial Gd-EOB-DTPA-enhanced MR imaging. These nodules were observed on follow-up MR examinations until hypervascularity was detected. The potential predictive factors for hypervascular transformation were compared between two groups (group A showing hypervascular transformation, group B not showing hypervascularization). Ten (16.7 %) of 60 ''strict'' high-risk nodules showed hypervascular transformation during follow-up periods (group A). The growth rates of the nodules in group A (6.3 ± 4.5 mm/year) were significantly higher than those in group B (3.4 ± 7.2 mm/year) (p = 0.003). Additionally, the median observation period in group A (177.5 ± 189.5 day) was significantly shorter than in group B (419 ± 372.2 day) (p = 0.045). The other predictive factors were not significantly correlated with hypervascularization. Subsets of ''strict'' high-risk nodules showed hypervascular transformation during follow-up periods in association with increased growth rates, indicating that nodule growth rate is an important predictive factor for hypervascularization. (orig.)

  9. Hepato-biliary scan using sup(99m)Tc-pyridoxylidene isoleucine (sup(99m)Tc-PI) and its clinical significance

    Energy Technology Data Exchange (ETDEWEB)

    Nakano, S; Watahiki, H; Takeda, I; Kitamura, K; Ichikawa, H [Ogaki Municipal Hospital, Gifu (Japan)

    1978-05-01

    The hepato-biliary scan with sup(99m)Tc-pyridoxylidene Isoleucine (sup(99m)Tc-PI) was able to demonstrate the biliary system much more clearly than that using usual radiopharmaceuticals such as /sup 131/I-BSP of /sup 131/I-Rose Bengal. The hepato-biliary scan with sup(99m)Tc-PI demonstrated the hepatobiliary system more clearly than DIC in 47.6% of all cases studied. Especially the demonstration of changes of intra-hepatic biliary tree in cases with intra-hepatic gall stone and cholangiocarcinoma was quite superior to DIC, although there was somewhat difficulty in getting information about the right hepatic duct. For the diagnosis of gall stone in the gall bladder, DIC was more suitable than sup(99m)Tc-PI hepatobiliary scan. The sup(99m)Tc-PI hepato-biliary scan was able to demonstrate the biliary system even in cases having moderate jaundice, in which cases DIC could not demonstrate the biliary system. This sup(99m)Tc-PI hepato-biliary scan was proved to be useful in determing a certain cause of defects shown on the conventional liver scan. No side effect was noticed in this series of the study.

  10. Hepatobiliary imaging: a comparison of 99Tcsup(m)-dihydro-thioctic acid and 99Tcsup(m)-pyridoxylidene glutamate in the non-jaundiced patient

    International Nuclear Information System (INIS)

    Jenner, R.E.; Howard, E.R.; Clarke, M.B.; Barrett, J.J.

    1978-01-01

    A comparison of two hepatobiliary imaging agents, 99 Tcsup(m)-dihydrothioctic acid ( 99 Tcsup(m)-DHT) and 99 Tcsup(m)-pyridoxylidene glutamate ( 99 Tcsup(m)-PG) has been carried out in 44 non-jaundiced patients. Thirty-one patients were admitted for investigation of upper abdominal pain and 13 patients were volunteers who were undergoing treatment for unrelated conditions. Satisfactory liver images were obtained with both agents in patients without liver disease, but they were inferior to those seen after 99 Tcsup(m)-sulphur colloid. 99 Tcsup(m)-PG produced clearer images of the gall-bladder and bile ducts than 99 Tcsup(m)-DHT. Non-visualization of the gall-bladder was interpreted as gall-bladder disease; in patients with inflammatory gall-bladder disease no gall-bladder image was seen (nine 99 Tcsup(m)-DHT, nine 99 Tcsup(m)-PG). The gall-bladder was also not demonstrated in two of the volunteers' group (one 99 Tcsup(m)-DHT, one 99 Tcsup(m)-PG), nor was a gall-bladder seen in five patients whose abdominal pain was not due to acute cholecystitis. Despite this, there was agreement between the results of imaging and oral cholecystography in 21 out of 22 subjects. 99 Tcsup(m)-PG is non-toxic, cheap and rapidly excreted by the liver into the bile. A 99 Tcsup(m)-PG scan would be useful when rapid diagnosis is required in suspected acute cholecystitis when conventional contrast radiology is unlikely to be of value. (author)

  11. The changes of bile dynamics in patients with gallstones by quantitative hepatobiliary scintigraphy

    International Nuclear Information System (INIS)

    Xu Wei'na; Yu Shupeng

    2004-01-01

    The gold standard of diagnosing SOD is endoscopic sphincter of Oddi manometry, but it is not widely used because it is invasive, expensive and there are more complicateds after examination. Hepatobiliary scintigraphy can give us quantitative parameters of bile emptying and it is a noninvasive, sensitive and accurate method in diagnosing SOD. The bile dynamics after cholecystectomy was seldom studied, the aim of this study is to obtain the normal changes of bile emptying after cholecystectomy by hepatobiliary scintigraphy and provide basis for diagnosing SOD. Objective: Quantitative hepatobiliary scintigraphy, a noninvasive method used to diagnose dysfunction of bile duct, can show bile secretion and outflow in bile duct. The goal of this study was to examine the dynamics of bile secretion and outflow by quantitative hepatobiliary scintigraphy in patients with gallstones, postcholecystectomy and normal groups, got the parameters of normal changes of bile emptying in postcholecystectomy patients and to help diagnosing SOD. Methods: 1 Patients. 31 patients with gallstones, demonstrated single or multiple gallstones by abdominal ultrasonography; 12 normal controls and 12 patients after cholecystectomy. They were all rulled out liver diseases and bile duct stones by liver function tests and US respectively, the diameter of common bile duct were normal, liver functions were normal and there were not symptoms of bile duct diseases. 2 Methods. All the patients were examined by fatty meal * hepatobiliary scintigraphy according to the same method. after fasting over 4 hours, 740 MBq 99m Tc-EHIDA was injected intravenously. Images were recorded continuously at one frame per minute for 100 minutes, at 60th minute two fry eggs were taken. Then the parameters of of bile emptying (Tmax in liver and common bile duct, T1/2 in liver and common bile duct, time of duodenal appeared (DAT), transit time from liver to duodenol(HDTT) and half-emptying time in common bile duct after fatty

  12. Gall blandder kinetics in diabetics. A hepatobiliary scintigraphy overview

    International Nuclear Information System (INIS)

    Shelley, S.; Indirani, M.; Gokhale, S.; Anirudhan, N.

    2004-01-01

    Introduction: Hepatobiliary scintigraphy is underutilized in the evaluation of Gall Bladder(GB) function in diabetics when compared to various other imaging modalities that are currently available.It establishes the function of GB in Diabetes mellitus noninvasively, with a quantified ejection fraction thereby helping to resolve the problem of diabetic cholecystopathy, in the evaluation of visceral neuropathy. Aim: To study Gall Bladder kinetics and emptying in diabetic patients. Materials and methods: One forty eight patients of both sexes in the age group of 30 to 70 were included in the study between 1997 to 1999 in our institution.A 90 minute dynamic post mebrofenin study was acquired. A fatty meal of 600 kcal was given to these patients once the Gall Bladder was visualized.Time activity curves were generated and the Gall Bladder contraction in these patients was evaluated.Patients were classified into 3 groups-Group 1 consists of established Diabetic patients. Group 2 consists of patients with impaired glucose tolerance. Group 3 consists of controls. Observation and result: In Group 1 (n=47) ,28 patients (60%) showed reduced ejection fraction and the mean EF% was 44.12 +/- 16.6. In Group 2 (n=48), 18 patients (38%) showed slightly reduced ejection fraction and the mean EF % was 51.56 +/- 15.67. In Group 3(n=53), 7 patients (13%) showed reduced ejection fraction and the meanEF % was 69.77 +/- 13.59. Test of significance was done using 'Z' test also called normal test in large samples. This study has shown that the average Ejection Fraction (in%) is maximum in normal group and least in diabetic group. Conclusion: Hepatobiliary scintigraphy is helpful in early identification of autonomic dysfunction of Gall Bladder in diabetic patients and in patients with impaired glucose tolerance. (authors)

  13. Hepatobiliary scintigraphy in patients with bile leaks

    International Nuclear Information System (INIS)

    Carichner, S.L.; Nagle, C.E.

    1987-01-01

    Hepatobiliary scintigraphy has been recognized as a useful tool in detecting the presence and sites of bile leaks. The clinical settings in which bile leaks are likely to occur, as well as some of the scintigraphic patterns seen in patients with bile leaks, are reviewed here. Tips for technologists are offered on interventions that might enhanced the quality of information available to the nuclear physician

  14. Morphological and functional criteria of hepatobiliary scintigraphy with IDA derivatives in patients with hepatocellular jaundice

    International Nuclear Information System (INIS)

    Biersack, H.J.; Breuel, H.P.; Altland, H.; Bell, E.

    1979-01-01

    In 31 Patients with histologically proven hepatocellular jaundice hepatobiliary scintigraphy with Tc-99m labelled IDA derivatives was performed. Results were classified under morphological (demonstration of liver parenchyma, ductus choledochus, bile ducts, gallbladder, kidney) and functional (Tsub(max), halftime of bile excretion, appearance of activity in ductus choledochus, gallbladder, and intestines) criteria. The liver parenchyma could be demonstrated in 90.3% of cases, ductus choledochus in 71% and the gallbladder in 72.4%. The type of tracer excretion into the intestines showed 9.5% activity accumulation in the gallbladder with late bile excretion into the intestines and 90.5% early activity excretion into the duodenum with late filling of the gallbladder. The intrahepatic bile ducts were demonstrated in 22.6% (left hepatic duct) and 6.5% (right hepatic duct). In 35.5% of cases the kidneys were still visible after 15 min p.i. All cases showed - sometimes delayed - bile excretion into the GI tract. The time of appearance of activity in ductus choledochus (18.4 min) and gallbladder (39.5 min) was delayed. The liver histogram showed likewise delayed values concerning Tsub(max) (14.3 min) and half life of tracer excretion (> 30 min) when compared to controls. The differentiation of hepatocellular jaundice from obstructive jaundice is possible by the demonstration of bile excretion into the intestines, normal width of the bile ducts, and filling of the gallbladder. (orig.) [de

  15. Technetium-99m biliary imaging in pediatric surgical problems

    International Nuclear Information System (INIS)

    Sty, J.R.; Glicklich, M.; Babbitt, D.P.; Starshak, R.J.

    1981-01-01

    The results of scintigraphic imaging of the hepatobiliary system with 99mTc-PIPIDA (IDA derivative p-isopropylacetanilidoiminodiacetic acid) in forty children are reported. 99mTc-PIPIDA imaging is a noninvasive, rapid, safe examination that provides both functional and anatomical information about the hepatobiliary system. Although interpretation is limited by elevated direct serum bilirubin, this agent allows diagnostic information to be obtained with direct serum bilirubin levels up to 8 mg/dl

  16. Basic studies on the hepatobiliary scintigraphy with 123I-rose bengal

    International Nuclear Information System (INIS)

    Narabayashi, Isamu; Ito, Yasuhiko; Otsuka, Nobuaki; Muranaka, Akira; Konno, Katsunobu.

    1979-01-01

    The purpose of this investigation is to evaluate the values of 123 I-rose bengal. sup(99m)Tc-labels for the hepatobiliary radiopharmaceutical are not fully satisfied because of greater urinary excretion, especially in cases of hyperbilirubinemia. 123 I is a lower gamma ray energy emitter more suitable for imaging and has a short half life with 13 hours. Commercially obtained rose bengal was purified using Sephadex G-25 column on gelfiltration. 123 I-rose bengal was prepared using iodine exchange reaction between nonradioactive rose bengal and Na 123 I. Radiochemical purity of 123 I-rose bengal was examined by paper chromatography. Biological distribution of 123 I-rose bengal in rabbits at 1 hours after intravenous injection indicated that the tracer was cleared from the blood to the liver, thereafter excreted into the small intestine through the common bile duct. Hepatic uptake and excretion of activity has been measured for 60 minutes using a scintillation camera in conjunction with a VTR system. There existed no significant relative to those of 131 I-rose bengal. Serial scintigraphic images showed satisfactorily better images even in a rabbit with complete obstructive jaundice. (author)

  17. Clinical significance of segmental parenchymal excretion delay on Tc-99m DISIDA hepatobiliary scan

    International Nuclear Information System (INIS)

    Kang, D. Y.; Ryu, J. S.; Moon, D. H.; Lee, S. K.; Kim, M. H.; Lee, H. K.

    1998-01-01

    Segmental parenchymal excretion delay on Tc-99m DISIDA scan in caused by intrahepatic bile duct obstruction. However, the diagnostic value for intrahepatic bile duct obstruction is unknown. We conducted this study to assess the positive predictive value of segmental excretion delay for the diagnosis of intrahepatic bile duct obstruction, and additional benefit over other noninvasive radiologic studies. The study population consisted of 43 patients (48 scans) who showed segmental parenchymal excretion delay on Tc-99m DISIDA scan. The results of abdominal CT or ultrasonography, which was done within 1 month of Tc-99m DISIDA scan, were compared with scintigraphic findings. The etiology of segmental parenchymal excretion delay was determined by ERC or PTC in 31 scans, and follow-up studies in 13 scans. No causes were identified in 4 scans. The positive predictive value of segmental parenchymal excretion delay for intrahepatic bile duct obstruction was 92% (44/48). On the other hand, 13% (5/38) of CT and 28% (5/18) of ultrasonography were normal. In 18% *7/38) of CT and 17% (3/18) of ultrasonography, only intrahepatic bile duct dilatation was noted without any diagnostic findings of intrahepatic bile duct obstruction. Segmental parenchymal excretion delay on Tc-99m DISIDA scan had a high positive predictive value for the diagnosis of intrahepatic bile duct obstruction. Tc-99m DISIDA scan may be useful for the diagnosis of intrahepatic bile duct obstruction, especially in patients with nondiagnostic CT or ultrasonography. The diagnostic usefulness need to be confirmed by further prospective studies

  18. Sonographic findings of hepatobiliary fascioliasis accompanied by extrahepatic expansion and ectopic lesions.

    Science.gov (United States)

    Teke, Memik; Önder, Hakan; Çiçek, Mutalip; Hamidi, Cihad; Göya, Cemil; Çetinçakmak, Mehmet Güli; Hattapoğlu, Salih; Ülger, Burak Veli

    2014-12-01

    The aim of the study was to describe the sonographic findings of hepatobiliary fascioliasis with extrahepatic expansion and ectopic lesions. The study included 45 patients with fascioliasis. All diagnoses were confirmed via serologic enzyme-linked immunosorbent assays. Sonographic findings in the hepatobiliary system, extrahepatic expansion, and ectopic lesions were defined. The most common hepatic lesions were subcapsular localized, small, confluent, multiple hypoechoic nodules with poorly defined borders. We also detected ectopic lesion in 5 patients (11.1%) and live parasites in the gallbladder and bile duct in 11 (24.4%). The large spectrum of entities in the differential diagnosis of hepatobiliary fascioliasis may lead to misdiagnosis and incorrect treatment. However, the diagnosis can be made when the characteristic sonographic features are seen, such as heterogeneity of the liver with multiple poorly defined hypoechoic-isoechoic lesions and multiple echogenic nonshadowing particles in the gallbladder or common bile ducts. Nonetheless, the differential diagnosis of fascioliasis versus other hepatic lesions may still be difficult. In these situations, pathologic confirmation should be performed to exclude the possibility of malignancy. © 2013 by the American Institute of Ultrasound in Medicine.

  19. A study on hepato-biliary and alimentary scintigram by means of triple tracer method

    International Nuclear Information System (INIS)

    Aibata, Hirofumi; Torizumi, Kazutami; Okada, Takashi; Kiji, Shigeyuki; Yamada, Ryusaku; Shimada, Kosuke; Taniguchi, Katsutoshi; Aoki, Yozo

    1987-01-01

    In order to evaluate the gastric emptying and postprandial mixing of bile with food, the scintigraphies of hepatobiliary and gastrointestinal tracts by using three different kinds of radioisotopes were performed simultaneously ( 99m Tc-E · HIDA for hepatobiliary scintigraphy, 111 In-DTPA containing orange juice and 131 I-albumin containing scrambled egg for gastrointestinal scintigraphy). This method was available for observation of gastric emptying of liquid and solid foods and also examination of the mixing effect of bile and food quantitatively. (author)

  20. Double-Stage Delay Multiply and Sum Beamforming Algorithm: Application to Linear-Array Photoacoustic Imaging

    OpenAIRE

    Mozaffarzadeh, Moein; Mahloojifar, Ali; Orooji, Mahdi; Adabi, Saba; Nasiriavanaki, Mohammadreza

    2018-01-01

    Photoacoustic imaging (PAI) is an emerging medical imaging modality capable of providing high spatial resolution of Ultrasound (US) imaging and high contrast of optical imaging. Delay-and-Sum (DAS) is the most common beamforming algorithm in PAI. However, using DAS beamformer leads to low resolution images and considerable contribution of off-axis signals. A new paradigm namely Delay-Multiply-and-Sum (DMAS), which was originally used as a reconstruction algorithm in confocal microwave imaging...

  1. Robotic resections in hepatobiliary oncology - initial experience with Xi da Vinci system in India.

    Science.gov (United States)

    Chandarana, M; Patkar, S; Tamhankar, A; Garg, S; Bhandare, M; Goel, M

    2017-01-01

    Minimal invasive surgery has proven its advantages over open surgeries in the perioperative period. Food and Drug Administration approved da Vinci robot in 2000. The latest version, da Vinci Xi system has a mobile tower-based robot with several modifications to improve the functionality, versatility, and operative ease. None of the centers have reported exclusively on hepatobiliary oncology using the da Vinci Xi system. We report our initial experience. To study the feasibility, advantages, and discuss the operative technique of da Vinci Xi system in hepatobiliary oncology. Data were analyzed retrospectively from a prospectively maintained database from June 2015 to October 2016. Twenty-five patients with suspected or proven hepatobiliary malignancies were operated. Total robotic technique using da Vinci Xi system was used. Demographic details and perioperative outcomes were noted. Of the 25 surgeries, 14 patients had a suspected gallbladder malignancy, 11 patients had primary or metastatic liver tumor. Median age was 53 years. The average duration of surgery was 225 min with a median blood loss 150 ml. The median postoperative stay was 4 days. The median nodal yield for radical cholecystectomy was seven. Five patients required conversion. Two of these developed postoperative morbidity. Robotic surgery for hepatobiliary oncology is feasible and can be performed safely in experienced hands. Increasing experience in this field may equal or even prove advantageous over conventional or laparoscopic approach in future. A cautious approach with judicious patient selection is the key to establishing robotic surgery as a standard surgical approach.

  2. Structure-activity studies on 99mTc phenolic aminocarboxyllic acid hepatobiliary agente

    International Nuclear Information System (INIS)

    Maddalena, D.J.; Wilson, J.G.; Snowdon, G.M.

    1987-01-01

    Biodistributions of a series of eight 99m Tc hydroxybenzylsarcosine (HBS) complexes were carried out in rats and their urinary and hepatobiliary excretion compared with their lipophilicities, the influence of substituent on the phenyl ring and plasma protein binding ability. The charge on the complexes was determined by electrophoresis at varying pH values. The HBS derivatives formed anionic complexes with 99m Tc that excreted mainly via the urinary route. An increase in the lipophilicity of the complexes by substitution of halogens onto the phenyl ring led to an increase in serum protein binding and a decrease in the urinary output but hat no direct effect on hepatobiliary output. (Author) [es

  3. Hsp90 and hepatobiliary transformation during sea lamprey metamorphosis.

    Science.gov (United States)

    Chung-Davidson, Yu-Wen; Yeh, Chu-Yin; Bussy, Ugo; Li, Ke; Davidson, Peter J; Nanlohy, Kaben G; Brown, C Titus; Whyard, Steven; Li, Weiming

    2015-12-01

    Biliary atresia (BA) is a human infant disease with inflammatory fibrous obstructions in the bile ducts and is the most common cause for pediatric liver transplantation. In contrast, the sea lamprey undergoes developmental BA with transient cholestasis and fibrosis during metamorphosis, but emerges as a fecund adult. Therefore, sea lamprey liver metamorphosis may serve as an etiological model for human BA and provide pivotal information for hepatobiliary transformation and possible therapeutics. We hypothesized that liver metamorphosis in sea lamprey is due to transcriptional reprogramming that dictates cellular remodeling during metamorphosis. We determined global gene expressions in liver at several metamorphic landmark stages by integrating mRNA-Seq and gene ontology analyses, and validated the results with real-time quantitative PCR, histological and immunohistochemical staining. These analyses revealed that gene expressions of protein folding chaperones, membrane transporters and extracellular matrices were altered and shifted during liver metamorphosis. HSP90, important in protein folding and invertebrate metamorphosis, was identified as a candidate key factor during liver metamorphosis in sea lamprey. Blocking HSP90 with geldanamycin facilitated liver metamorphosis and decreased the gene expressions of the rate limiting enzyme for cholesterol biosynthesis, HMGCoA reductase (hmgcr), and bile acid biosynthesis, cyp7a1. Injection of hsp90 siRNA for 4 days altered gene expressions of met, hmgcr, cyp27a1, and slc10a1. Bile acid concentrations were increased while bile duct and gall bladder degeneration was facilitated and synchronized after hsp90 siRNA injection. HSP90 appears to play crucial roles in hepatobiliary transformation during sea lamprey metamorphosis. Sea lamprey is a useful animal model to study postembryonic development and mechanisms for hsp90-induced hepatobiliary transformation.

  4. Image encryption based on a delayed fractional-order chaotic logistic system

    Science.gov (United States)

    Wang, Zhen; Huang, Xia; Li, Ning; Song, Xiao-Na

    2012-05-01

    A new image encryption scheme is proposed based on a delayed fractional-order chaotic logistic system. In the process of generating a key stream, the time-varying delay and fractional derivative are embedded in the proposed scheme to improve the security. Such a scheme is described in detail with security analyses including correlation analysis, information entropy analysis, run statistic analysis, mean-variance gray value analysis, and key sensitivity analysis. Experimental results show that the newly proposed image encryption scheme possesses high security.

  5. Image encryption based on a delayed fractional-order chaotic logistic system

    International Nuclear Information System (INIS)

    Wang Zhen; Li Ning; Huang Xia; Song Xiao-Na

    2012-01-01

    A new image encryption scheme is proposed based on a delayed fractional-order chaotic logistic system. In the process of generating a key stream, the time-varying delay and fractional derivative are embedded in the proposed scheme to improve the security. Such a scheme is described in detail with security analyses including correlation analysis, information entropy analysis, run statistic analysis, mean-variance gray value analysis, and key sensitivity analysis. Experimental results show that the newly proposed image encryption scheme possesses high security. (general)

  6. [Discussion on relationship between hepatobiliary pathological changes under B-ultrasound and Clonorchis sinensis infection].

    Science.gov (United States)

    Liang, Zhi-cheng; Qiu, Shou-zhong; Luo, Li-xuan

    2015-12-01

    To explore the relationship between the hepatobiliary pathological changes under B-ultrasound examinations and Clonorchis sinensis infection, so as to provide the evidence for further prevention and control. The stool test and ELISA were applied to test the pathogeny and antibody to C. sinensis of the suspicious patients who had the hepatobiliary pathological changes under B-ultrasound examinations in People's Hospital of Wuxuan County from Jan. 2010 to Dec. 2013. Totally 113 suspicious patients of C. sinensis infection were investigated, and the positive rates of egg and serum antibody were 64.60% (73 cases) and 66.37% (75 cases) respectively. The positive rates of the male and those aged ≥ 50 years were significantly higher than those of the female and the cases younger than 50 years respectively (χ² = 3.554, 6.267, both P sinensis infected patients, the degree of pathological changes of hepatobiliary was positively correlated with the infectiosity of C. sinensis (χ² = 64.952, P sinensis, and the patients with the changes should be further investigated for the pathogen and antibody to C. sinensis.

  7. Acquiring additional delayed PET images improves sensitivity and specificity in oncology cases

    International Nuclear Information System (INIS)

    Lamki, L.M.; Barron, B.J.; Mullani, N.; Joseph, U.; Ehert, E.

    2002-01-01

    Aim: This study looked into utility of acquiring PET images at 2-3 hours in addition to the standard whole body PET done at 1-hour after FDG injection in certain oncology cases. The objective is to evaluate whether the delayed additional images can decipher equivocal foci of FDG accumulation commonly seen in oncology patients. Typical example is the bowel activity that moves with time. Materials and Methods: PET protocol at our Institution in patients with colon Cancer, Pancreas Ca, Ovarian Ca and Breast Ca include a whole body PET (6-7 bed positions) done at 1-hour after 15 mCi F-18-FDG followed by select limited area PET scan (typically 2 bed stops over the area of interest) at 2-3 hours. Acquisition was undertaken on Siemens ECAT-EXACT Camera - 2-D acquisition and 8 mins. per bed position (5 mins. Emission and 3 mins. Transmission), 16.3 cm FOV and then Iterative Reconstruction. Results: Analysis of the first 115 patients who had additional delayed images resulted in 80% of patients where delayed images helped in interpretation. In 70% of these, delayed images helped in identifying physiological structures, e.g., ureters, bowel, blood vessels and muscles versus pathology. In 25%, they actually helped in identifying malignancy, e.g. more definite FDG accumulation. Almost all helped to boost the confidence of the reader. The contribution was mainly in differentiating bowel and ureter activity from cancer in the abdomen, as these change position with time. In case of pancreas and breast cancer, delayed images contributed in clarifying tumor metabolic activity as well. Inflammation and motion artifacts could also be better defined and so was muscle uptake. Conclusion: (1) Additional delayed PET imaging is very helpful in certain cancers in identifying more lesions and avoiding pitfalls. (2) They can yield higher sensitivity and specificity for colon, ovarian, breast and pancreas cancers. (3) Identification of physiologic structures and differentiation of these from

  8. Recent advances in 3D computed tomography techniques for simulation and navigation in hepatobiliary pancreatic surgery.

    Science.gov (United States)

    Uchida, Masafumi

    2014-04-01

    A few years ago it could take several hours to complete a 3D image using a 3D workstation. Thanks to advances in computer science, obtaining results of interest now requires only a few minutes. Many recent 3D workstations or multimedia computers are equipped with onboard 3D virtual patient modeling software, which enables patient-specific preoperative assessment and virtual planning, navigation, and tool positioning. Although medical 3D imaging can now be conducted using various modalities, including computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET), and ultrasonography (US) among others, the highest quality images are obtained using CT data, and CT images are now the most commonly used source of data for 3D simulation and navigation image. If the 2D source image is bad, no amount of 3D image manipulation in software will provide a quality 3D image. In this exhibition, the recent advances in CT imaging technique and 3D visualization of the hepatobiliary and pancreatic abnormalities are featured, including scan and image reconstruction technique, contrast-enhanced techniques, new application of advanced CT scan techniques, and new virtual reality simulation and navigation imaging. © 2014 Japanese Society of Hepato-Biliary-Pancreatic Surgery.

  9. Detection of active bile leak with Gd-EOB-DTPA enhanced MR cholangiography: Comparison of 20–25 min delayed and 60–180 min delayed images

    International Nuclear Information System (INIS)

    Cieszanowski, Andrzej; Stadnik, Anna; Lezak, Aleksandra; Maj, Edyta; Zieniewicz, Krzysztof; Rowinska-Berman, Katarzyna; Grudzinski, Ireneusz P.; Krawczyk, Marek; Rowiński, Olgierd

    2013-01-01

    Objectives: The purpose of this study was to assess the value of contrast-enhanced magnetic resonance cholangiography (MRC) performed in different time delays after injection of gadoxetic acid disodium (Gd-EOB-DTPA) for the diagnosis of active bile leak. Methods: This retrospective analysis included Gd-EOB-DTPA enhanced MR images of 34 patients suspected of bile leak. Images were acquired 20–25 min after Gd-EOB-DTPA injection. If there was inadequate contrast in the bile ducts then delayed images after 60–90 min and 150–180 min were obtained. Results were correlated with intraoperative findings, ERCP results, clinical data, laboratory tests, and follow-up examinations. Results: Gd-EOB-DTPA enhanced MRC yielded an overall sensitivity of 96.4%, specificity of 100% and accuracy of 97.1% for the diagnosis of an active bile leak. The sensitivity of 20–25 min delayed MR images was 42.9%, of combined 20–25 min and 60–90 min delayed images was 92.9% and of combined 20–25 min, 60–90 min and 150–180 min delayed images was 96.4%. Conclusions: Gd-EOB-DTPA enhanced MRC utilizing delayed phase images was effective for detecting the presence and location of active bile leaks. The images acquired 60–180 min post-injection enabled identification of bile leaks even in patients with a dilated biliary system or moderate liver dysfunction

  10. Delayed enhancement of peripheral zone of neurofibromas at magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Kurosaki, Y. [Dept. of Radiology, Inst. of Clinical Medicine, Univ. of Tsukuba (Japan); Kuramoto, K. [Dept. of Radiology, Inst. of Clinical Medicine, Univ. of Tsukuba (Japan); Itai, Y. [Dept. of Radiology, Inst. of Clinical Medicine, Univ. of Tsukuba (Japan)

    1996-02-01

    It is well known that bizonal histologic appearance characteristic of neurofibromas are reflected on magnetic resonance (MR) images. We report a case in which a delayed enhanced MR image showed that the entire mass enhanced homogeneously resulting in loss of zonal distinction on early enhanced MR image. (orig.)

  11. The diagnostic value of adding dynamic scintigraphy to standard delayed planar imaging for sentinel node identification in melanoma patients

    DEFF Research Database (Denmark)

    Nielsen, Marie Kristina Rue; Chakera, Annette H; Hesse, Birger

    2011-01-01

    The aim of this study was to compare early dynamic imaging combined with delayed static imaging and single photon emission computed tomography (SPECT)/CT with delayed, planar, static imaging alone for sentinel node (SN) identification in melanoma patients.......The aim of this study was to compare early dynamic imaging combined with delayed static imaging and single photon emission computed tomography (SPECT)/CT with delayed, planar, static imaging alone for sentinel node (SN) identification in melanoma patients....

  12. Magnetic Resonance Imaging (MRI) Evaluation of Developmental Delay in Pediatric Patients

    OpenAIRE

    Ali, Althaf S.; Syed, Naziya P.; Murthy, G.S.N.; Nori, Madhavi; Abkari, Anand; Pooja, B.K.; Venkateswarlu, J.

    2015-01-01

    Introduction: Developmental delay is defined as significant delay in one or more developmental domains. Magnetic Resonance Imaging (MRI) is the best modality to investigate such patients. Evaluation of a child with developmental delay is important not only because it allows early diagnosis and treatment but also helpful for parental counseling regarding the outcome of their child and to identify any possible risk of recurrence in the siblings. Thus this study was undertaken to evaluate the de...

  13. Brain MR imaging in children with psychomotor developmental delay

    Energy Technology Data Exchange (ETDEWEB)

    Hirai, Toshinori; Korogi, Yukunori; Sakamoto, Yuji; Furusawa, Mitsuhiro; Hamatake, Satoshi; Takahashi, Mutsumasa [Kumamoto Univ. (Japan). School of Medicine

    1994-06-01

    Fifty-two patients with developmental delay of unknown cause underwent MR imaging of the brain. Their ages ranged from 5 months to 22 years, with a mean of 2.2 years. Thirty-seven (71%) had positive MR findings, including nine with congenital malformation, nine with atrophy, six with white matter lesion, five with delayed myelination, five with atrophy and delayed myelination, two with acquired injury of corpus callosum, and one with ulegyria. Congenital malformations obtained included holoprosencephaly, polymicrogyria, dysgenesis of corpus callosum, hypoplasia of cerebellum, and tuberous sclerosis. Abnormal MR findings were frequently observed both in the children with neurologic physical findings and in generally retarded children, while in the children with suspected autism, MR imaging did not demonstrate any abnormalities. Of 24 patients with epilepsy, abnormal MR findings were obtained in 17 patients (71%). The frequency of white matter lesion and atrophy was slightly higher in the patients with epilepsy. However, no significant correlations were found between MR findings and the presence of epilepsy. Also, no significant correlations were obtained between MR findings and the degree of developmental quotient (DQ). Severely injured cases did not necessarily show abnormal findings on MRI. (author).

  14. Brain MR imaging in children with psychomotor developmental delay

    International Nuclear Information System (INIS)

    Hirai, Toshinori; Korogi, Yukunori; Sakamoto, Yuji; Furusawa, Mitsuhiro; Hamatake, Satoshi; Takahashi, Mutsumasa

    1994-01-01

    Fifty-two patients with developmental delay of unknown cause underwent MR imaging of the brain. Their ages ranged from 5 months to 22 years, with a mean of 2.2 years. Thirty-seven (71%) had positive MR findings, including nine with congenital malformation, nine with atrophy, six with white matter lesion, five with delayed myelination, five with atrophy and delayed myelination, two with acquired injury of corpus callosum, and one with ulegyria. Congenital malformations obtained included holoprosencephaly, polymicrogyria, dysgenesis of corpus callosum, hypoplasia of cerebellum, and tuberous sclerosis. Abnormal MR findings were frequently observed both in the children with neurologic physical findings and in generally retarded children, while in the children with suspected autism, MR imaging did not demonstrate any abnormalities. Of 24 patients with epilepsy, abnormal MR findings were obtained in 17 patients (71%). The frequency of white matter lesion and atrophy was slightly higher in the patients with epilepsy. However, no significant correlations were found between MR findings and the presence of epilepsy. Also, no significant correlations were obtained between MR findings and the degree of developmental quotient (DQ). Severely injured cases did not necessarily show abnormal findings on MRI. (author)

  15. {sup 68}Ga-PSMA I and T PET/CT for assessment of prostate cancer: evaluation of image quality after forced diuresis and delayed imaging

    Energy Technology Data Exchange (ETDEWEB)

    Derlin, Thorsten; Weiberg, Desiree; Ross, Tobias L.; Bengel, Frank M. [Hannover Medical School, Department of Nuclear Medicine, Hannover (Germany); Klot, Christoph von [Hannover Medical School, Department of Urology and Urologic Oncology, Hannover (Germany); Wester, Hans-Juergen [Technische Universitaet Muenchen, Pharmaceutical Radiochemistry, Garching (Germany); Henkenberens, Christoph; Christiansen, Hans [Hannover Medical School, Department of Radiation Oncology, Hannover (Germany); Merseburger, Axel S. [University Hospital Schleswig-Holstein, Department of Urology, Campus Luebeck, Luebeck (Germany)

    2016-12-15

    Urinary radiotracer excretion of {sup 68}Ga-Labelled prostate-specific membrane antigen (PSMA) ligands may complicate the assessment of the prostate region and differentiation of lymph nodes from ureteral activity. The aim of this study was to assess the value of delayed imaging after forced diuresis. Sixty-six patients underwent {sup 68}Ga-PSMA I and T PET/CT for evaluation of prostate cancer at 60 min post-injection. In subgroups of patients, this was amended by delayed imaging after 180 min post-injection, preceded by furosemide and oral hydration early, at the time of tracer injection, or delayed, at 100 min post-injection. Urinary tracer activity within the bladder and focal ureteral activity was analyzed. After forced diuresis, linear and focal visualization of ureters was significantly reduced. After delayed furosemide, mean and peak bladder activity decreased (p < 0.001), and image quality of the prostate region improved on delayed images (p < 0.001). Early furosemide co-injection with tracer resulted in increased mean and peak bladder activity (p < 0.001) and in deteriorated image quality of the prostate region on delayed images (p = 0.008). Ga-PSMA I and T PET/CT delayed imaging after forced diuresis can improve the assessment of prostate region and pelvic lymph nodes by removing excreted tracer from the lower urinary tract. (orig.)

  16. The role of surgical clips in the evaluation of interfractional uncertainty for treatment of hepatobiliary and pancreatic cancer with postoperative radiotherapy

    International Nuclear Information System (INIS)

    Bae, Jin Suk; Kim, Dong Hyun; Kim, Won Taek; Kim, Yong Ho; Park, Dahl; Ki, Yong Kan

    2017-01-01

    To evaluate the utility of implanted surgical clips for detecting interfractional errors in the treatment of hepatobiliary and pancreatic cancer with postoperative radiotherapy (PORT). Twenty patients had been treated with PORT for locally advanced hepatobiliary or pancreatic cancer, from November 2014 to April 2016. Patients underwent computed tomography simulation and were treated in expiratory breathing phase. During treatment, orthogonal kilovoltage (kV) imaging was taken twice a week, and isocenter shifts were made to match bony anatomy. The difference in position of clips between kV images and digitally reconstructed radiographs was determined. Clips were consist of 3 proximal clips (clip_p, ≤2 cm) and 3 distal clips (clip_d, >2 cm), which were classified according to distance from treatment center. The interfractional displacements of clips were measured in the superior-inferior (SI), anterior-posterior (AP), and right-left (RL) directions. The translocation of clip was well correlated with diaphragm movement in 90.4% (190/210) of all images. The clip position errors greater than 5 mm were observed in 26.0% in SI, 1.8% in AP, and 5.4% in RL directions, respectively. Moreover, the clip position errors greater than 10 mm were observed in 1.9% in SI, 0.2% in AP, and 0.2% in RL directions, despite respiratory control. Quantitative analysis of surgical clip displacement reflect respiratory motion, setup errors and postoperative change of intraabdominal organ position. Furthermore, position of clips is distinguished easily in verification images. The identification of the surgical clip position may lead to a significant improvement in the accuracy of upper abdominal radiation therapy

  17. The role of surgical clips in the evaluation of interfractional uncertainty for treatment of hepatobiliary and pancreatic cancer with postoperative radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Bae, Jin Suk; Kim, Dong Hyun; Kim, Won Taek; Kim, Yong Ho; Park, Dahl; Ki, Yong Kan [Pusan National University Hospital, Pusan National University School of Medicine, Busan (Korea, Republic of)

    2017-03-15

    To evaluate the utility of implanted surgical clips for detecting interfractional errors in the treatment of hepatobiliary and pancreatic cancer with postoperative radiotherapy (PORT). Twenty patients had been treated with PORT for locally advanced hepatobiliary or pancreatic cancer, from November 2014 to April 2016. Patients underwent computed tomography simulation and were treated in expiratory breathing phase. During treatment, orthogonal kilovoltage (kV) imaging was taken twice a week, and isocenter shifts were made to match bony anatomy. The difference in position of clips between kV images and digitally reconstructed radiographs was determined. Clips were consist of 3 proximal clips (clip{sub p}, ≤2 cm) and 3 distal clips (clip{sub d}, >2 cm), which were classified according to distance from treatment center. The interfractional displacements of clips were measured in the superior-inferior (SI), anterior-posterior (AP), and right-left (RL) directions. The translocation of clip was well correlated with diaphragm movement in 90.4% (190/210) of all images. The clip position errors greater than 5 mm were observed in 26.0% in SI, 1.8% in AP, and 5.4% in RL directions, respectively. Moreover, the clip position errors greater than 10 mm were observed in 1.9% in SI, 0.2% in AP, and 0.2% in RL directions, despite respiratory control. Quantitative analysis of surgical clip displacement reflect respiratory motion, setup errors and postoperative change of intraabdominal organ position. Furthermore, position of clips is distinguished easily in verification images. The identification of the surgical clip position may lead to a significant improvement in the accuracy of upper abdominal radiation therapy.

  18. Hepato-biliary scintigraphy and hepatography with Tc-99m diethyl-acetanilido-iminodiacetate in obstructive jaundice

    International Nuclear Information System (INIS)

    Nielsen, S.P.; Trap-Jensen, J.; Lindenberg, J.; Nielsen, M.L.

    1978-01-01

    Tc-99m diethyl-IDA was used for combined serial hepato-biliary scintigraphy and processing of hepatographic curves, using a scintillation camera and an image-processing system. Patients with obstruction of the common bile duct, proven by operation, were investigated. Hepatograms from an area of interest corresponding to the periphery of the right liver lobe varied predictably with changes in the serum levels of alkaline phosphatase and bilirubin. Both anatomical and functional information was obtained. The investigation could be carried out even under reduced liver function. Hepatic uptake of the agent was noted at serum alkaline phosphatase levels up to 1000 U/l and serum bilirubin levels up to 170 μmol/l

  19. The transport, hepatobiliary distribution and clearance of sup(99m)Tc-Sn-lidocaine iminodiacetic acid, sup(99m)Tc-Sn-Lida

    International Nuclear Information System (INIS)

    Noronha, O.P.D.; Sewatkar, A.B.; Ganatra, R.D.; Subramanian, G.

    1977-01-01

    Details are given of the preparation of stable sterile solutions of the radiopharmaceutical sup(99m)Tc-Sn-LIDA for use as a hepatobiliary scanning agent. Toxicity and survival studies in mice showed no untoward response even at a concentration of up to 210 mg/kg mouse, and the usual human dose is very much less than this. Tissue distribution studies in rats and mice showed a rapid decrease in liver activity with concomitant increase in gut activity. Scintiscans of a rabbit injected (i.v.) with 2.0 mCi of sup(99m)Tc-Sn-LIDA also showed extremely rapid excretion of the radiopharmaceutical. Sequential gamma camera images obtained 2 to 60 min after administration to overnight fasting normal human subjects revealed rapid liver uptake and gall bladder localization in about 20 min, followed by a gradual decrease in liver activity and increase in the activity in the intestinal tract. After about 40 min the liver has been washed-out of activity, leaving the gall bladder visible. sup(99m)Tc-Sn-LIDA is therefore an excellent hepatobiliary scanning agent. (U.K.)

  20. Hypervascular hepatocellular carcinomas: detection with gadoxetate disodium-enhanced MR imaging and multiphasic multidetector CT

    Energy Technology Data Exchange (ETDEWEB)

    Onishi, Hiromitsu; Kim, Tonsok; Hori, Masatoshi; Nakaya, Yasuhiro; Tsuboyama, Takahiro; Nakamoto, Atsushi; Tatsumi, Mitsuaki; Tomiyama, Noriyuki [Osaka University Graduate School of Medicine, Department of Radiology, Suita, Osaka (Japan); Imai, Yasuharu [Ikeda Municipal Hospital, Department of Gastroenterology, Ikeda, Osaka (Japan); Nagano, Hiroaki [Osaka University Graduate School of Medicine, Department of Surgery, Suita, Osaka (Japan); Kumano, Seishi; Okada, Masahiro; Murakami, Takamichi [Kinki University School of Medicine, Department of Radiology, Osakasayama, Osaka (Japan); Takamura, Manabu [Ikeda Municipal Hospital, Department of Radiology, Ikeda, Osaka (Japan); Wakasa, Kenichi [Osaka City University Graduate School of Medicine, Department of Diagnostic Pathology, Osaka, Osaka (Japan)

    2012-04-15

    To retrospectively compare the accuracy of detection of hypervascular hepatocellular carcinoma (HCC) by multiphasic multidetector CT and by gadoxetate disodium-enhanced MR imaging. After ethical approval, we analysed a total of 73 hypervascular HCC lesions from 31 patients suspected of having HCC, who underwent both gadoxetate disodium-enhanced MR imaging and multiphasic multidetector CT. Five blinded observers independently reviewed CT images, as well as dynamic MR images alone and combined with hepatobiliary phase MR images. Diagnostic accuracy (Az values), sensitivities and positive predictive values were compared by using the Scheffe post hoc test. The mean Az value for dynamic and hepatobiliary phase MR combined (0.81) or dynamic MR images alone (0.78) was significantly higher than that for CT images (0.67, P < 0.001, 0.005, respectively). The mean sensitivity of the combined MR images (0.67) was significantly higher than that of dynamic MR alone (0.52, P < 0.05) or CT images (0.44, P < 0.05). The mean positive predictive values were 0.96, 0.95 and 0.94, for CT, dynamic MR alone and combined MR images, respectively. Compared with multiphasic multidetector CT, gadoxetate disodium-enhanced MR imaging combining dynamic and hepatobiliary phase images results in significantly improved sensitivity and diagnostic accuracy for detection of hypervascular HCC. (orig.)

  1. Efficient Sample Delay Calculation for 2-D and 3-D Ultrasound Imaging.

    Science.gov (United States)

    Ibrahim, Aya; Hager, Pascal A; Bartolini, Andrea; Angiolini, Federico; Arditi, Marcel; Thiran, Jean-Philippe; Benini, Luca; De Micheli, Giovanni

    2017-08-01

    Ultrasound imaging is a reference medical diagnostic technique, thanks to its blend of versatility, effectiveness, and moderate cost. The core computation of all ultrasound imaging methods is based on simple formulae, except for those required to calculate acoustic propagation delays with high precision and throughput. Unfortunately, advanced three-dimensional (3-D) systems require the calculation or storage of billions of such delay values per frame, which is a challenge. In 2-D systems, this requirement can be four orders of magnitude lower, but efficient computation is still crucial in view of low-power implementations that can be battery-operated, enabling usage in numerous additional scenarios. In this paper, we explore two smart designs of the delay generation function. To quantify their hardware cost, we implement them on FPGA and study their footprint and performance. We evaluate how these architectures scale to different ultrasound applications, from a low-power 2-D system to a next-generation 3-D machine. When using numerical approximations, we demonstrate the ability to generate delay values with sufficient throughput to support 10 000-channel 3-D imaging at up to 30 fps while using 63% of a Virtex 7 FPGA, requiring 24 MB of external memory accessed at about 32 GB/s bandwidth. Alternatively, with similar FPGA occupation, we show an exact calculation method that reaches 24 fps on 1225-channel 3-D imaging and does not require external memory at all. Both designs can be scaled to use a negligible amount of resources for 2-D imaging in low-power applications and for ultrafast 2-D imaging at hundreds of frames per second.

  2. The use of MR imaging and spectroscopy of the brain in children investigated for developmental delay: What is the most appropriate imaging strategy?

    Energy Technology Data Exchange (ETDEWEB)

    Griffiths, Paul D. [University of Sheffield, Academic Unit of Radiology, Sheffield (United Kingdom); Royal Hallamshire Hospital, Academic Unit of Radiology, Sheffield (United Kingdom); Batty, Ruth; Raghavan, Ashok; Connolly, Daniel J.A. [Sheffield Children' s Hospital Trust, Department of Radiology, Sheffield (United Kingdom); Warren, Daniel; Hart, Anthony [University of Sheffield, Academic Unit of Radiology, Sheffield (United Kingdom); Sharrard, Mark [Sheffield Children' s Hospital Trust, Department of Paediatrics, Sheffield (United Kingdom); Mordekar, Santosh R. [Sheffield Children' s Hospital Trust, Department of Paediatric Neurology, Sheffield (United Kingdom)

    2011-09-15

    Developmental delay is a common problem in paediatric practice and many children with developmental delay are referred for MR imaging. Our study was performed as part of a continuing audit process to optimise our MR protocol and case selection. We performed MR imaging and spectroscopy protocol on 157 children with developmental delay. We analysed the effect of these interventions by looking at the overall detection rate of relevant pathology and in particular subgroups of the children. 71% of the children had normal MR imaging, 10% had non-specific findings and 19% had specific abnormalities on MR imaging. The overall risk of having a specific structural abnormality with isolated developmental was 7.5% but if other neurological symptoms/signs were present the risk was 28%. Two children had abnormal spectroscopic findings, one with tuberous sclerosis and the other with absent brain creatine. Case selection for MR imaging is important in children with developmental delay. The best strategies for selecting children for MR are either; not performing MR with developmental delay in one domain only or performing MR with developmental delay in three or four domains or if there are other neurological features. (orig.)

  3. The use of MR imaging and spectroscopy of the brain in children investigated for developmental delay: What is the most appropriate imaging strategy?

    International Nuclear Information System (INIS)

    Griffiths, Paul D.; Batty, Ruth; Raghavan, Ashok; Connolly, Daniel J.A.; Warren, Daniel; Hart, Anthony; Sharrard, Mark; Mordekar, Santosh R.

    2011-01-01

    Developmental delay is a common problem in paediatric practice and many children with developmental delay are referred for MR imaging. Our study was performed as part of a continuing audit process to optimise our MR protocol and case selection. We performed MR imaging and spectroscopy protocol on 157 children with developmental delay. We analysed the effect of these interventions by looking at the overall detection rate of relevant pathology and in particular subgroups of the children. 71% of the children had normal MR imaging, 10% had non-specific findings and 19% had specific abnormalities on MR imaging. The overall risk of having a specific structural abnormality with isolated developmental was 7.5% but if other neurological symptoms/signs were present the risk was 28%. Two children had abnormal spectroscopic findings, one with tuberous sclerosis and the other with absent brain creatine. Case selection for MR imaging is important in children with developmental delay. The best strategies for selecting children for MR are either; not performing MR with developmental delay in one domain only or performing MR with developmental delay in three or four domains or if there are other neurological features. (orig.)

  4. Cumulative phase delay imaging for contrast-enhanced ultrasound tomography

    International Nuclear Information System (INIS)

    Demi, Libertario; Van Sloun, Ruud J G; Wijkstra, Hessel; Mischi, Massimo

    2015-01-01

    Standard dynamic-contrast enhanced ultrasound (DCE-US) imaging detects and estimates ultrasound-contrast-agent (UCA) concentration based on the amplitude of the nonlinear (harmonic) components generated during ultrasound (US) propagation through UCAs. However, harmonic components generation is not specific to UCAs, as it also occurs for US propagating through tissue. Moreover, nonlinear artifacts affect standard DCE-US imaging, causing contrast to tissue ratio reduction, and resulting in possible misclassification of tissue and misinterpretation of UCA concentration. Furthermore, no contrast-specific modality exists for DCE-US tomography; in particular speed-of-sound changes due to UCAs are well within those caused by different tissue types. Recently, a new marker for UCAs has been introduced. A cumulative phase delay (CPD) between the second harmonic and fundamental component is in fact observable for US propagating through UCAs, and is absent in tissue. In this paper, tomographic US images based on CPD are for the first time presented and compared to speed-of-sound US tomography. Results show the applicability of this marker for contrast specific US imaging, with cumulative phase delay imaging (CPDI) showing superior capabilities in detecting and localizing UCA, as compared to speed-of-sound US tomography. Cavities (filled with UCA) which were down to 1 mm in diameter were clearly detectable. Moreover, CPDI is free of the above mentioned nonlinear artifacts. These results open important possibilities to DCE-US tomography, with potential applications to breast imaging for cancer localization. (fast track communication)

  5. 99m-Tc-IDA scintigraphic demonstrability of biliary elements and liver function tests in hepatobiliary diseases

    International Nuclear Information System (INIS)

    Kim, C.Y.; Bahk, Y.W.

    1982-01-01

    In the present communication, the results will be reported on a clinical study of how well scintigraphic visualization of the hepatobiliary elements and several commonly used clinical liver function tests correlate each other in various diseases of the hepatobiliary system. The demonstrability of the biliary tract, gallblader (GB) and duodenum was rather closely paralleled to serum bilirubin level and less closely to alkaline phosphatase and rather poorly to SGOT and SGPT. The biliary tree could not be visualized scintigraphically when bilirubin exceeded 10 mg/dl

  6. Increased biliary excretion of glutathione is generated by the glutathione-dependent hepatobiliary transport of antimony and bismuth.

    Science.gov (United States)

    Gyurasics, A; Koszorús, L; Varga, F; Gregus, Z

    1992-10-06

    We have recently demonstrated that the hepatobiliary transport of arsenic is glutathione-dependent and is associated with a profound increase in biliary excretion of glutathione (GSH), hepatic GSH depletion and diminished GSH conjugation (Gyurasics A, Varga F and Gregus Z, Biochem Pharmacol 41: 937-944 and Gyurasics A, Varga F and Gregus Z, Biochem Pharmacol 42: 465-468, 1991). The present studies in rats aimed to determine whether antimony and bismuth, other metalloids in group Va of the periodic table, also possess similar properties. Antimony potassium tartrate (25-100 mumol/kg, i.v.) and bismuth ammonium citrate (50-200 mumol/kg, i.v.) increased up to 50- and 4-fold, respectively, the biliary excretion of non-protein thiols (NPSH). This resulted mainly from increased hepatobiliary transport of GSH as suggested by a close parallelism in the biliary excretion of NPSH and GSH after antimony or bismuth administration. Within 2 hr, rats excreted into bile 55 and 3% of the dose of antimony (50 mumol/kg, i.v.) and bismuth (150 mumol/kg, i.v.), respectively. The time courses of the biliary excretion of these metalloids and NPSH or GSH were strikingly similar suggesting co-ordinate hepatobiliary transport of the metalloids and GSH. However, at the peak of their excretion, each molecule of antimony or bismuth resulted in a co-transport of approximately three molecules of GSH. Diethyl maleate, indocyanine green and sulfobromophthalein (BSP), which decreased biliary excretion of GSH, significantly diminished excretion of antimony and bismuth into bile indicating that hepatobiliary transport of these metalloids is GSH-dependent. Administration of antimony, but not bismuth, decreased hepatic GSH level by 30% and reduced the GSH conjugation and biliary excretion of BSP. These studies demonstrate that the hepatobiliary transport of trivalent antimony and bismuth is GSH-dependent similarly to the hepatobiliary transport of trivalent arsenic. Proportionally to their biliary

  7. The rates and time-delay distribution of multiply imaged supernovae behind lensing clusters

    Science.gov (United States)

    Li, Xue; Hjorth, Jens; Richard, Johan

    2012-11-01

    Time delays of gravitationally lensed sources can be used to constrain the mass model of a deflector and determine cosmological parameters. We here present an analysis of the time-delay distribution of multiply imaged sources behind 17 strong lensing galaxy clusters with well-calibrated mass models. We find that for time delays less than 1000 days, at z = 3.0, their logarithmic probability distribution functions are well represented by P(log Δt) = 5.3 × 10-4Δttilde beta/M2502tilde beta, with tilde beta = 0.77, where M250 is the projected cluster mass inside 250 kpc (in 1014M⊙), and tilde beta is the power-law slope of the distribution. The resultant probability distribution function enables us to estimate the time-delay distribution in a lensing cluster of known mass. For a cluster with M250 = 2 × 1014M⊙, the fraction of time delays less than 1000 days is approximately 3%. Taking Abell 1689 as an example, its dark halo and brightest galaxies, with central velocity dispersions σ>=500kms-1, mainly produce large time delays, while galaxy-scale mass clumps are responsible for generating smaller time delays. We estimate the probability of observing multiple images of a supernova in the known images of Abell 1689. A two-component model of estimating the supernova rate is applied in this work. For a magnitude threshold of mAB = 26.5, the yearly rate of Type Ia (core-collapse) supernovae with time delays less than 1000 days is 0.004±0.002 (0.029±0.001). If the magnitude threshold is lowered to mAB ~ 27.0, the rate of core-collapse supernovae suitable for time delay observation is 0.044±0.015 per year.

  8. Limited value of delayed radiothallium image in the diagnosis of nodular goiter

    International Nuclear Information System (INIS)

    Misaki, Takashi; Yagi, Kanji; Dokoh, Shigeharu; Koh, Toshikiyo; Shimbo, Shin-ichiro

    1991-01-01

    To test whether delayed thallium image can improve the diagnostic accuracy of thyroid tumor, we have reviewed 35 patients with cold nodules of proven histopathology. Early and delayed images were taken 10-20 min and 3-4 hr postinjection, respectively. In this study, a thyroid nodule was interpreted as malignant if it had normal or increased uptake on early scan and more residual radioactivity than paranodular tissue on delayed scan. In the eighteen patients who had carcinoma, a disappointing 44% false negative rate was observed. No significant difference was seen between retention-positive and negative cases in tumor size or histological type of cancer. Nor could any demographic bias explain the low sensitivity. Of the six false negatives, macroscopic cystic degeneration was seen in two cases, but tumors in the other four were grossly solid. Considering the histological heterogeneity often seen within a thyroid tumor, the portion with increased retention of radiothallium may be too small to be detected in the false negative cases. Furthermore, 3 false positive readings were obtained in 17 patients with benign conditions. We conclude that the contribution of the delayed thallium image was quite limited in predicting or ruling out malignancy in nodular goiters. (author)

  9. Radiology imaging delays as independent predictors of length of hospital stay for emergency medical admissions

    International Nuclear Information System (INIS)

    Cournane, S.; Conway, R.; Creagh, D.; Byrne, D.G.; Sheehy, N.; Silke, B.

    2016-01-01

    Aim: To investigate the extent to which the time to completion for computed tomography (CT), magnetic resonance imaging (MRI), and ultrasound could be shown to influence the length of stay and costs incurred while in hospital, while accounting for patient acuity. Materials and methods: All emergency admissions, totalling 25,326 imaging investigations between 2010–2014 were evaluated. The 50"t"h, 75"t"h, and 90"t"h centiles of completion times for each imaging type was entered into a multivariable truncated Poisson regression model predicting the length of hospital stay. Estimates of risk (odds or incidence rate ratios [IRRs]) of the regressors were adjusted for acute illness severity, Charlson comorbidity index, chronic disabling disease score, and sepsis status. Quantile regression analysis was used to examine the impact of imaging on total hospital costs. Results: For all imaging examinations, longer hospital lengths of stay were shown to be related to delays in imaging time. Increased delays in CT and MRI were shown to be associated with increased hospital episode costs, while ultrasound did not independently predict increased hospital costs. The magnitude of the effect of imaging delays on episode costs were equivalent to some measures of illness severity. Conclusion: CT, MRI, and ultrasound are undertaken in patients with differing clinical complexity; however, even with adjustment for complexity, the time delay in a more expeditious radiological service could potentially shorten the hospital episode and reduce costs. - Highlights: • There are differing clinical complexities for patients depending on the modality. • A predictive risk model, incorporating advanced imaging, was devised. • Inpatients delays in radiology imaging associated with longer LOS. • Inpatients who underwent radiology imaging associated with increased hospital costs.

  10. Morbidity and mortality after liver resection for benign and malignant hepatobiliary lesions

    NARCIS (Netherlands)

    Erdogan, Deha; Busch, Olivier R. C.; Gouma, Dirk J.; van Gulik, Thomas M.

    2009-01-01

    Aim: Although most partial liver resections are performed for malignant lesions, an increasing contingent of benign lesions is also considered for surgery. The aim was to assess post-operative morbidity and mortality after liver resection for benign hepatobiliary lesions in comparison with outcome

  11. Dual-time-point Imaging and Delayed-time-point Fluorodeoxyglucose-PET/Computed Tomography Imaging in Various Clinical Settings

    DEFF Research Database (Denmark)

    Houshmand, Sina; Salavati, Ali; Antonsen Segtnan, Eivind

    2016-01-01

    The techniques of dual-time-point imaging (DTPI) and delayed-time-point imaging, which are mostly being used for distinction between inflammatory and malignant diseases, has increased the specificity of fluorodeoxyglucose (FDG)-PET for diagnosis and prognosis of certain diseases. A gradually incr...

  12. Hepatobiliary delivery of polyaminopolycarboxylate chelates: Synthesis and characterization of a cholic acid conjugate of EDTA and biodistribution and imaging studies with its indium-111 chelate

    Energy Technology Data Exchange (ETDEWEB)

    Betebenner, D.A.; Carney, P.L.; Zimmer, A.M.; Kazikiewicz, J.M.; Bruecher, E.S.; Sherry, A.D.; Johnson, D.K. (Abbott Laboratories, Abbott Park, Illinois (USA))

    1991-03-01

    A conjugate in which the steroid nucleus of cholic acid was linked to EDTA via an 11-atom spacer was obtained by reacting the succinimidyl ester of cholic acid with the amine formed by reaction of a benzyl isothiocyanate derivative of EDTA with N-(tert-butoxycarbonyl)ethylenediamine and subsequent deprotection. Potentiometric titration studies with model complexes showed that the EDTA moiety retained the ability to form 1:1 chelates of high thermodynamic stability, although formation constants were some 3-4 log K units lower for complexes of the conjugate than for the analogous chelates with underivatized EDTA. A complex formed between the cholic acid-EDTA conjugate and 111InIII was clearly rapidly into the liver when injected iv into mice, with subsequent excretion from the liver into the gastrointestinal tract being complete within 1 h of injection. Radioscintigraphic imaging studies conducted in a rabbit given the 111In-labeled conjugate also showed early liver uptake followed by rapid clearance from the liver into the intestine, with good visualization of the gallbladder in images obtained at 20-25 min postinjection. It is concluded that conjugation to cholic acid provides a useful means for the hepatobiliary delivery of EDTA chelates that otherwise exhibit predominantly extracellular distribution and renal clearance.

  13. Hepatobiliary delivery of polyaminopolycarboxylate chelates: Synthesis and characterization of a cholic acid conjugate of EDTA and biodistribution and imaging studies with its indium-111 chelate

    International Nuclear Information System (INIS)

    Betebenner, D.A.; Carney, P.L.; Zimmer, A.M.; Kazikiewicz, J.M.; Bruecher, E.S.; Sherry, A.D.; Johnson, D.K.

    1991-01-01

    A conjugate in which the steroid nucleus of cholic acid was linked to EDTA via an 11-atom spacer was obtained by reacting the succinimidyl ester of cholic acid with the amine formed by reaction of a benzyl isothiocyanate derivative of EDTA with N-(tert-butoxycarbonyl)ethylenediamine and subsequent deprotection. Potentiometric titration studies with model complexes showed that the EDTA moiety retained the ability to form 1:1 chelates of high thermodynamic stability, although formation constants were some 3-4 log K units lower for complexes of the conjugate than for the analogous chelates with underivatized EDTA. A complex formed between the cholic acid-EDTA conjugate and 111InIII was clearly rapidly into the liver when injected iv into mice, with subsequent excretion from the liver into the gastrointestinal tract being complete within 1 h of injection. Radioscintigraphic imaging studies conducted in a rabbit given the 111In-labeled conjugate also showed early liver uptake followed by rapid clearance from the liver into the intestine, with good visualization of the gallbladder in images obtained at 20-25 min postinjection. It is concluded that conjugation to cholic acid provides a useful means for the hepatobiliary delivery of EDTA chelates that otherwise exhibit predominantly extracellular distribution and renal clearance

  14. The diagnostic value of adding dynamic scintigraphy to standard delayed planar imaging for sentinel node identification in melanoma patients

    International Nuclear Information System (INIS)

    Nielsen, Kristina Rue; Nielsen, Michael B.; Chakera, Annette H.; Hesse, Birger; Oturai, Peter S.; Scolyer, Richard A.; Stretch, Jonathan F.; Thompson, John F.; Uren, Roger F.

    2011-01-01

    The aim of this study was to compare early dynamic imaging combined with delayed static imaging and single photon emission computed tomography (SPECT)/CT with delayed, planar, static imaging alone for sentinel node (SN) identification in melanoma patients. Three hundred and seven consecutive melanoma patients referred for SN biopsy (SNB) were examined using combined imaging. Secondary interpretation of only the delayed static images was subsequently performed. In 220 patients (72%), complete surgical and pathological information relating to the SNB was available. The number of SNs identified and number of patients with positive SNs were compared between the two interpretations of the imaging studies and, when available, related to pathology data. A slightly higher number of SNs (mean 0.12/patient) was identified when interpreting only delayed static images compared to combined imaging. In a direct patient-to-patient comparison, the number of SN(s) identified on the combined vs static images only showed moderate agreement (kappa value 0.56). In 38 patients (17%), positive SNs were identified by the combined procedure compared to 35 (16%) by static imaging only. Thus by static imaging only, tumour-positive SNs were not identified in 3 of 38 patients (8%). For SN identification in melanoma patients, dynamic imaging combined with delayed static imaging and SPECT/CT is superior to delayed static imaging only because the latter is more likely to fail to identify SNs containing metastases. (orig.)

  15. Sporadic incidence of Fascioliasis detected during hepatobiliary procedures: a study of 18 patients from Sulaimaniyah governorate.

    Science.gov (United States)

    Hawramy, Tahir Abdullah Hussein; Saeed, Kamal Ahmed; Qaradaghy, Seerwan Hama Sharif; Karboli, Taha Ahmed; Nore, Beston Faiek; Bayati, Noora Hisham Abood

    2012-12-21

    Fascioliasis is an often-neglected zoonotic disease and currently is an emerging infection in Iraq. Fascioliasis has two distinct phases, an acute phase, exhibiting the hepatic migratory stage of the fluke's life cycle, and a chronic biliary phase manifested with the presence of the parasite in the bile ducts through hepatic tissue. The incidence of Fascioliasis in Sulaimaniyah governorate was unexpected observation. We believe that shedding light on this disease in our locality will increase our physician awareness and experience in early detection, treatment in order to avoid unnecessary surgeries. We retrospectively evaluated this disease in terms of the demographic features, clinical presentations, and managements by reviewing the medical records of 18 patients, who were admitted to the Sulaimani Teaching Hospital and Kurdistan Centre for Gastroenterology and Hepatology. Patients were complained from hepatobiliary and/or upper gastrointestinal symptoms and diagnosed accidentally with Fascioliasis during hepatobiliary surgeries and ERCP by direct visualization of the flukes and stone analysis. Elevated liver enzymes, white blood cells count and eosinophilia were notable laboratory indices. The dilated CBD, gallstones, liver cysts and abscess were found common in radiological images. Fascioliasis diagnosed during conventional surgical CBD exploration and choledochodoudenostomy, open cholecystectomy, surgical drainage of liver abscess, ERCP and during gallstone analysis. Fascioliasis is indeed an emerging disease in our locality, but it is often underestimated and ignored. We recommend the differential diagnosis of patients suffering from Rt. Hypochondrial pain, fever and eosinophilia. The watercress ingestion was a common factor in patient's history.

  16. Noninvasive imaging of hepatocellular carcinoma: From diagnosis to prognosis

    Science.gov (United States)

    Jiang, Han-Yu; Chen, Jie; Xia, Chun-Chao; Cao, Li-Kun; Duan, Ting; Song, Bin

    2018-01-01

    Hepatocellular carcinoma (HCC) is the most common primary liver cancer and a major public health problem worldwide. Hepatocarcinogenesis is a complex multistep process at molecular, cellular, and histologic levels with key alterations that can be revealed by noninvasive imaging modalities. Therefore, imaging techniques play pivotal roles in the detection, characterization, staging, surveillance, and prognosis evaluation of HCC. Currently, ultrasound is the first-line imaging modality for screening and surveillance purposes. While based on conclusive enhancement patterns comprising arterial phase hyperenhancement and portal venous and/or delayed phase wash-out, contrast enhanced dynamic computed tomography and magnetic resonance imaging (MRI) are the diagnostic tools for HCC without requirements for histopathologic confirmation. Functional MRI techniques, including diffusion-weighted imaging, MRI with hepatobiliary contrast agents, perfusion imaging, and magnetic resonance elastography, show promise in providing further important information regarding tumor biological behaviors. In addition, evaluation of tumor imaging characteristics, including nodule size, margin, number, vascular invasion, and growth patterns, allows preoperative prediction of tumor microvascular invasion and patient prognosis. Therefore, the aim of this article is to review the current state-of-the-art and recent advances in the comprehensive noninvasive imaging evaluation of HCC. We also provide the basic key concepts of HCC development and an overview of the current practice guidelines. PMID:29904242

  17. Radionuclide study of the hepatobiliary system function in patients with diabetes mellitus

    International Nuclear Information System (INIS)

    Slavnov, V.M.; Savich, O.A.; Markov, V.V.

    2002-01-01

    The functional state of the liver parenchyma, concentration and motor functions of the gallbladder in patients with diabetes mellitus (DM) was studied. To analyze hepatobiliary system disorders depending on the type of DM, presence of complications, duration of the disease and the age of the patients

  18. Delayed sodium (18)F-fluoride PET/CT imaging does not improve quantification of vascular calcification metabolism

    DEFF Research Database (Denmark)

    Blomberg, Björn Alexander; Thomassen, Anders; Takx, Richard A P

    2014-01-01

    This study aimed to determine if delayed sodium (18)F-fluoride (Na(18)F) PET/CT imaging improves quantification of vascular calcification metabolism. Blood-pool activity can disturb the arterial Na(18)F signal. With time, blood-pool activity declines. Therefore, delayed imaging can potentially...

  19. Study of a new hepatobiliary radiotracer: sup(99m)Tc diethyl IDA. Its value in the diagnosis of cholestasis

    International Nuclear Information System (INIS)

    Roques, J.F.

    1979-01-01

    This work examines a new means of investigation: Technetium 99 (2,6 diethyl acetanilido) imino-diacetic acid, or HEPATOBIDA, hepatobiliary scintigraphy. A survey of different scintigraphic techniques is necessary. At first the kinetic study of hepatobiliary radiotracers was carried out with multiprobe systems giving quantitative information on the various organs or pools concerned. With the appearance of the scintillation camera it became possible to obtain not only quantitative data but also topographical and morphological information. Since 1976 the derivatives of iminodiacetic acid have been widely adopted, possessing features most closely resembling those of the ideal hepatobiliatropic molecules. Examinations have been performed at the Angers Radioisotopes Service with the diethyl derivative or HEPATOBIDA (Nuclear Solca Lab.) The results recorded in a group of cholestasis patients are studied, with normal data supplied by a set of 8 reference subjects free from hepatobiliary diseases [fr

  20. Basic and clinical studies on hepatobiliary function test with sup(99m)Tc-PI

    International Nuclear Information System (INIS)

    Narabayashi, Isamu; Shigemoto, Hirosada; Ito, Yasuhiko; Muranaka, Akira; Ohtsuka, Nobuaki

    1979-01-01

    In these basic and clinical studies, the usefulness of sup(99m)Tc-pyridoxilideneisoleucine, a new hepatobiliary agent, was evaluated for a hepatobiliary function test in comparison with sup(99m)Tc-N-[N-(2,6 dimethylphenyl)carbamoylmethyl] iminodiacetic acid (HIDA) and 131 I-rose bengal (RB). The experiments were performed with 2.5 - 5 kg rabbits. Hepatic uptake and the excretion of sup(99m)Tc-pyridoxylidene isoleucine (PI) were earlier than those of 131 I-RB. However, biliary excretions of sup(99m)Tc-PI and sup(99m)Tc-HIDA were less than that of 131 I-RB, because urinary excretions of sup(99m)Tc-labeled compounds were greater. During the first 2.5 - 5 min, sup(99m)Tc-labeled agents had lower blood levels than 131 I-RB. At 6 days after the choledochal ligation, no hepatic uptake of sup(99m)Tc-PI was noted, although 131 I-RB concentrated to the liver. Blood retention of sup(99m)Tc-PI might not always reflect hepatobiliary function, especially in the hyperbilirubinemia. On the other hand, hepatograms from a region of interest corresponding to the liver varied with changes in the serum bilirubin level, although no hepatic uptake was detected in the complete obstructive jaundice and severe parenchymal liver disease being over 7 mg/dl in the serum bilirubin level. (author)

  1. Histology atlas of the developing mouse hepatobiliary hemolymphatic vascular system with emphasis on embryonic days 11.5-18.5 and early postnatal development

    Science.gov (United States)

    A critical event in fetal development is the proper formation of the vascular system, of which the hepatobiliary system plays a pivotal role. This has lead pathologists and scientists to utilize transgenic mice to identify developmental disorders associated with the hepatobiliary vascular system. Va...

  2. Radiology imaging delays as independent predictors of length of hospital stay for emergency medical admissions.

    Science.gov (United States)

    Cournane, S; Conway, R; Creagh, D; Byrne, D G; Sheehy, N; Silke, B

    2016-09-01

    To investigate the extent to which the time to completion for computed tomography (CT), magnetic resonance imaging (MRI), and ultrasound could be shown to influence the length of stay and costs incurred while in hospital, while accounting for patient acuity. All emergency admissions, totalling 25,326 imaging investigations between 2010-2014 were evaluated. The 50(th), 75(th), and 90(th) centiles of completion times for each imaging type was entered into a multivariable truncated Poisson regression model predicting the length of hospital stay. Estimates of risk (odds or incidence rate ratios [IRRs]) of the regressors were adjusted for acute illness severity, Charlson comorbidity index, chronic disabling disease score, and sepsis status. Quantile regression analysis was used to examine the impact of imaging on total hospital costs. For all imaging examinations, longer hospital lengths of stay were shown to be related to delays in imaging time. Increased delays in CT and MRI were shown to be associated with increased hospital episode costs, while ultrasound did not independently predict increased hospital costs. The magnitude of the effect of imaging delays on episode costs were equivalent to some measures of illness severity. CT, MRI, and ultrasound are undertaken in patients with differing clinical complexity; however, even with adjustment for complexity, the time delay in a more expeditious radiological service could potentially shorten the hospital episode and reduce costs. Copyright © 2016 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  3. Clinical evaluation of sup(99m)Tc-N-pyridoxyl-5-methyltryptophan hepatobiliary scintigraphy in hepatocellular carcinoma

    International Nuclear Information System (INIS)

    Kashiwagi, Toru; Azuma, Masayoshi; Matsuda, Hiroyuki; Yoshioka, Hiroaki; Ishizu, Hiroshi; Mitsutani, Natsuki; Koizumi, Takeo; Kobayashi, Yasushi

    1985-01-01

    We have assessed the diagnostic value of sup(99m)Tc-N-pyridoxyl-5-methyltryptophan (sup(99m)Tc-PMT) hepatobiliary scintigraphy in 28 patients with hepatocellular carcinoma (HCC) who had obvious filling defects on sup(99m)Tc-phytate liver scintigram. Uptake of sup(99m)Tc-PMT in obvious defects on sup(99m)Tc-phytate liver scintigram was observed in 16 out of 28 patients (57.1 %). Most of HCC with sup(99m)Tc-PMT uptake were histologically well-differenciated. However, well-differenciated HCC did not always take up sup(99m)Tc-PMT. No correlation was observed between sup(99m)Tc-PMT uptake in the tumor and levels of serum alpha-fetoprotein. Patients with high alpha-fetoprotein level (>3000 ng/ml) were only 9 patients (32.1 %) in our study. By the combined results of sup(99m)Tc-PMT hepatobiliary scintigraphy and alpha-fetoprotein level (>3000 ng/ml), diagnostic rate for HCC was markedly elevated up to 75 %. Therefore, it is considered that sup(99m)Tc-PMT hepatobiliary scintigraphy is clinically useful for specific diagnosis of HCC. Furthermore, it provides the information for invasion of HCC into the bile duct. (author)

  4. Clinical evaluation of sup(99m)Tc-N-pyridoxyl-5-methyltryptophan hepatobiliary scintigraphy in hepatocellular carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Kashiwagi, Toru; Azuma, Masayoshi; Matsuda, Hiroyuki; Yoshioka, Hiroaki; Ishizu, Hiroshi; Mitsutani, Natsuki; Koizumi, Takeo; Kobayashi, Yasushi

    1985-09-01

    We have assessed the diagnostic value of sup(99m)Tc-N-pyridoxyl-5-methyltryptophan (sup(99m)Tc-PMT) hepatobiliary scintigraphy in 28 patients with hepatocellular carcinoma (HCC) who had obvious filling defects on sup(99m)Tc-phytate liver scintigram. Uptake of sup(99m)Tc-PMT in obvious defects on sup(99m)Tc-phytate liver scintigram was observed in 16 out of 28 patients (57.1 %). Most of HCC with sup(99m)Tc-PMT uptake were histologically well-differenciated. However, well-differenciated HCC did not always take up sup(99m)Tc-PMT. No correlation was observed between sup(99m)Tc-PMT uptake in the tumor and levels of serum alpha-fetoprotein. Patients with high alpha-fetoprotein level (>3000 ng/ml) were only 9 patients (32.1 %) in our study. By the combined results of sup(99m)Tc-PMT hepatobiliary scintigraphy and alpha-fetoprotein level (>3000 ng/ml), diagnostic rate for HCC was markedly elevated up to 75 %. Therefore, it is considered that sup(99m)Tc-PMT hepatobiliary scintigraphy is clinically useful for specific diagnosis of HCC. Furthermore, it provides the information for invasion of HCC into the bile duct.

  5. The significance of 123I-BMIPP delayed scintigraphic imaging in cardiac patients.

    Science.gov (United States)

    Akashi, Yoshihiro J; Kida, Keisuke; Suzuki, Kae; Inoue, Koji; Kawasaki, Kensuke; Yamauchi, Masahiro; Musha, Haruki; Anker, Stefan D

    2007-04-25

    Earlier studies have not fully investigated the significance of radionuclide planar imaging in cardiac patients using the fatty acid analogue 123I-beta-methyl-iodophenylpentadecanoic acid (123I-BMIPP). This study was to clarify the effectiveness of 123I-BMIPP in assessing the heart-to-mediastinum ratio (H/M) and myocardial washout rate (WR) in patients with heart disease. Myocardial 123I-BMIPP imaging was performed in 33 patients (20 with chronic heart failure [CHF] and 13 with stable angina pectoris [AP]) and 11 control subjects. Myocardial 123I-BMIPP planner images were obtained 30 min (early image) and 4 h (delayed image) after tracer injection. The left ventricular ejection fraction (LVEF) was measured by quantitative gated single photon emission computed tomography. The concentration of plasma brain natriuretic peptide (BNP) was measured before the scintigraphic study. (1) Delayed H/M was much lower in CHF than in AP (1.93 +/- 0.37 vs. 2.21 +/- 0.38, p acid metabolism disorders in patients with heart disease in both masked and unmasked conditions.

  6. Delayed complications of radiotherapy treatment for nasopharyngeal carcinoma: imaging findings

    International Nuclear Information System (INIS)

    King, A.D.; Ahuja, A.T.; Yeung, D.K.; Wong, J.K.T.; Lee, Y.Y.P.; Lam, W.W.M.; Ho, S.S.M.; Yu, S.C.H.; Leung, S.-F.

    2007-01-01

    Radiotherapy is used to treat a wide variety of head and neck tumours that arise in and around the skull base. The delayed effects of radiation damages a range of structures, including the nervous system, bone, major vessels, mucus membranes, pituitary and salivary glands, as well as increasing the risk of radiation-induced neoplasms. In this review the complications resulting from radiation treatment for nasopharyngeal carcinoma (NPC), a cancer treated with a high dose of radiation to a fairly large region, are illustrated. Many patients with NPC have a long-term survival, so are at risk of developing delayed radiation effects, and hence may demonstrate a wide range of complications on imaging. Other tumours around the skull base treated with radiotherapy include meningiomas, chordomas, chondrosarcomas, pituitary adenomas, paranasal sinus and nasal cavity tumours. In these cases similar complications may be encountered on imaging, although the severity, incidence and location will vary

  7. Transport mechanisms of hepatic uptake and bile excretion in clinical hepatobiliary scintigraphy with 99mTc-N-pyridoxyl-5-methyltryptophan

    International Nuclear Information System (INIS)

    Kobayashi, Masato; Nakanishi, Takeo; Nishi, Kodai; Higaki, Yusuke; Okudaira, Hiroyuki; Ono, Masahiro; Tsujiuchi, Takafumi; Mizutani, Asuka; Nishii, Ryuichi; Tamai, Ikumi; Arano, Yasushi; Kawai, Keiichi

    2014-01-01

    Introduction: In clinical hepatobiliary scintigraphy, 99m Tc-N-pyridoxyl-5-methyltryptophan ( 99m Tc-PMT) is an effective radiotracer among the 99m Tc-pyridoxylaminates. However, the mechanisms of human hepatic uptake and bile excretion transport of 99m Tc-PMT have not been determined. We thus investigated the transport mechanisms of human hepatic uptake and bile excretion in hepatobiliary scintigraphy with 99m Tc-PMT. Methods: Four solute carrier (SLC) transporters involved in hepatic uptake were evaluated using human embryonic kidney (HEK) and HeLa cells with high expression of SLC transporters (organic anion transporting polypeptide (OATP)1B1, OATP1B3, OATP2B1, organic anion transporters (OAT)2 and organic cation transporters (OCT)1) after 5 min of 99m Tc-PMT incubation. Metabolic analysis of 99m Tc-PMT was performed using pooled human liver S9. Adenosine triphosphate (ATP)-binding cassette (ABC) transporters for bile excretion were examined using hepatic ABC transporter vesicles human expressing multiple drug resistance 1 (MDR1), multidrug resistance-associated protein 2 (MRP2), breast cancer resistance protein or bile salt export pump. 99m Tc-PMT was incubated for 1, 3 and 5 min with ATP or adenosine monophosphate and these vesicles. SPECT scans were performed in normal and Eisai hyperbilirubinemic (EHBR) model rats, deficient in Mrp2 transporters, without and with verapamil (rat Mdr1 and human MDR1 inhibitor) after intravenous injection of 99m Tc-PMT. Results: Uptake of 99m Tc-PMT in HEK293/OATP1B1 and HeLa/OATP1B3 was significantly higher than that in HEK293- and HeLa-mock cells. 99m Tc-PMT was not metabolized in the human liver S9. In vesicles with high expression of ABC transporters, uptake of MDR1 or MRP2 was significantly higher at all incubation times. Bile excretion of 99m Tc-PMT was also identified by comparison between normal and EHBR rats with and without verapamil on in-vivo imaging. Conclusions: Human hepatic uptake of 99m Tc-PMT was transferred

  8. Correlation between hepatobiliary scintigraphy and surgery or postmortem examination findings in dogs and cats with extrahepatic biliary obstruction, partial obstruction, or patency of the biliary system: 18 cases (1995-2004).

    Science.gov (United States)

    Head, Laurie L; Daniel, Gregory B

    2005-11-15

    To evaluate the usefulness of serum biochemical variables and scintigraphic study results for differentiating between dogs and cats with complete extrahepatic biliary obstruction (EHO) and those with partial EHO or patent bile ducts. Retrospective case series. 17 dogs and 1 cat. Animals that underwent hepatobiliary scintigraphy and had either surgical or postmortem confirmation of the degree of bile duct patency were included. Scintigraphic images were evaluated and biliary tracts were classified as patent, partially obstructed but patent, or obstructed. Surgery or postmortem examination was considered the gold standard for diagnosis, and compared with those findings, sensitivity and specificity of scintigraphy were calculated. With absence of radioactivity in the intestinal tract as the diagnostic criterion for EHO, the sensitivity and specificity of scintigraphic diagnosis were both 83% when final images were acquired at 19 to 24 hours, compared with 100% and 33%, respectively, when 180 minutes was used as the cutoff time. Animals with partial biliary obstruction had less intestinal radioactivity that arrived later than that observed in animals with patent biliary tracts. Animals in which intestinal radioactivity has not been observed after the standard 3 to 4 hours should undergo additional scintigraphic imaging. Findings in animals with partial biliary obstruction include delayed arrival of radioactivity and less radioactivity in the intestine. Distinguishing between complete and partial biliary tract obstruction is important because animals with partial obstruction may respond favorably to medical management and should not be given an erroneous diagnosis of complete obstruction.

  9. Hepatobiliary Clearance Prediction: Species Scaling From Monkey, Dog, and Rat, and In Vitro-In Vivo Extrapolation of Sandwich-Cultured Human Hepatocytes Using 17 Drugs.

    Science.gov (United States)

    Kimoto, Emi; Bi, Yi-An; Kosa, Rachel E; Tremaine, Larry M; Varma, Manthena V S

    2017-09-01

    Hepatobiliary elimination can be a major clearance pathway dictating the pharmacokinetics of drugs. Here, we first compared the dose eliminated in bile in preclinical species (monkey, dog, and rat) with that in human and further evaluated single-species scaling (SSS) to predict human hepatobiliary clearance. Six compounds dosed in bile duct-cannulated (BDC) monkeys showed biliary excretion comparable to human; and the SSS of hepatobiliary clearance with plasma fraction unbound correction yielded reasonable predictions (within 3-fold). Although dog SSS also showed reasonable predictions, rat overpredicted hepatobiliary clearance for 13 of 24 compounds. Second, we evaluated the translatability of in vitro sandwich-cultured human hepatocytes (SCHHs) to predict human hepatobiliary clearance for 17 drugs. For drugs with no significant active uptake in SCHH studies (i.e., with or without rifamycin SV), measured intrinsic biliary clearance was directly scalable with good predictability (absolute average fold error [AAFE] = 1.6). Drugs showing significant active uptake in SCHH, however, showed improved predictability when scaled based on extended clearance term (AAFE = 2.0), which incorporated sinusoidal uptake along with a global scaling factor for active uptake and the canalicular efflux clearance. In conclusion, SCHH is a useful tool to predict human hepatobiliary clearance, whereas BDC monkey model may provide further confidence in the prospective predictions. Copyright © 2017 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

  10. sup(99m)Tc-pyridoxylidene glutamate - a radiopharmaceutical for the hepatobiliary system

    International Nuclear Information System (INIS)

    Noronha, O.P.D.; Sewatkar, A.B.; Ganatra, R.D.; Subramanian, G.

    1976-01-01

    sup(99m)Tc-pyridoxylidene glutamate is a good agent to visualize the hepatobiliary system. The method of preparation and quality control, and preliminary data on its behaviour in human controls is presented. In humans the gall bladder could be well seen in about 15-20 minutes after intravenous injection. (orig.) [de

  11. When should we recommend use of dual time-point and delayed time-point imaging techniques in FDG PET?

    Energy Technology Data Exchange (ETDEWEB)

    Cheng, Gang [Philadelphia VA Medical Center, Department of Radiology, Philadelphia, PA (United States); Hospital of the University of Pennsylvania, Department of Radiology, Philadelphia, PA (United States); Torigian, Drew A.; Alavi, Abass [Hospital of the University of Pennsylvania, Department of Radiology, Philadelphia, PA (United States); Zhuang, Hongming [Children' s Hospital of Philadelphia, Department of Radiology, Philadelphia, PA (United States)

    2013-05-15

    FDG PET and PET/CT are now widely used in oncological imaging for tumor characterization, staging, restaging, and response evaluation. However, numerous benign etiologies may cause increased FDG uptake indistinguishable from that of malignancy. Multiple studies have shown that dual time-point imaging (DTPI) of FDG PET may be helpful in differentiating malignancy from benign processes. However, exceptions exist, and some studies have demonstrated significant overlap of FDG uptake patterns between benign and malignant lesions on delayed time-point images. In this review, we summarize our experience and opinions on the value of DTPI and delayed time-point imaging in oncology, with a review of the relevant literature. We believe that the major value of DTPI and delayed time-point imaging is the increased sensitivity due to continued clearance of background activity and continued FDG accumulation in malignant lesions, if the same diagnostic criteria (as in the initial standard single time-point imaging) are used. The specificity of DTPI and delayed time-point imaging depends on multiple factors, including the prevalence of malignancies, the patient population, and the cut-off values (either SUV or retention index) used to define a malignancy. Thus, DTPI and delayed time-point imaging would be more useful if performed for evaluation of lesions in regions with significant background activity clearance over time (such as the liver, the spleen, the mediastinum), and if used in the evaluation of the extent of tumor involvement rather than in the characterization of the nature of any specific lesion. Acute infectious and non-infectious inflammatory lesions remain as the major culprit for diminished diagnostic performance of these approaches (especially in tuberculosis-endemic regions). Tumor heterogeneity may also contribute to inconsistent performance of DTPI. The authors believe that selective use of DTPI and delayed time-point imaging will improve diagnostic accuracy and

  12. Sporadic incidence of Fascioliasis detected during Hepatobiliary procedures: A study of 18 patients from Sulaimaniyah governorate

    Science.gov (United States)

    2012-01-01

    Background Fascioliasis is an often-neglected zoonotic disease and currently is an emerging infection in Iraq. Fascioliasis has two distinct phases, an acute phase, exhibiting the hepatic migratory stage of the fluke’s life cycle, and a chronic biliary phase manifested with the presence of the parasite in the bile ducts through hepatic tissue. The incidence of Fascioliasis in Sulaimaniyah governorate was unexpected observation. We believe that shedding light on this disease in our locality will increase our physician awareness and experience in early detection, treatment in order to avoid unnecessary surgeries. Findings We retrospectively evaluated this disease in terms of the demographic features, clinical presentations, and managements by reviewing the medical records of 18 patients, who were admitted to the Sulaimani Teaching Hospital and Kurdistan Centre for Gastroenterology and Hepatology. Patients were complained from hepatobiliary and/or upper gastrointestinal symptoms and diagnosed accidentally with Fascioliasis during hepatobiliary surgeries and ERCP by direct visualization of the flukes and stone analysis. Elevated liver enzymes, white blood cells count and eosinophilia were notable laboratory indices. The dilated CBD, gallstones, liver cysts and abscess were found common in radiological images. Fascioliasis diagnosed during conventional surgical CBD exploration and choledochodoudenostomy, open cholecystectomy, surgical drainage of liver abscess, ERCP and during gallstone analysis. Conclusion Fascioliasis is indeed an emerging disease in our locality, but it is often underestimated and ignored. We recommend the differential diagnosis of patients suffering from Rt. Hypochondrial pain, fever and eosinophilia. The watercress ingestion was a common factor in patient’s history. PMID:23259859

  13. Sporadic incidence of Fascioliasis detected during Hepatobiliary procedures: A study of 18 patients from Sulaimaniyah governorate

    Directory of Open Access Journals (Sweden)

    Hawramy Tahir Abdullah Hussein

    2012-12-01

    Full Text Available Abstract Background Fascioliasis is an often-neglected zoonotic disease and currently is an emerging infection in Iraq. Fascioliasis has two distinct phases, an acute phase, exhibiting the hepatic migratory stage of the fluke’s life cycle, and a chronic biliary phase manifested with the presence of the parasite in the bile ducts through hepatic tissue. The incidence of Fascioliasis in Sulaimaniyah governorate was unexpected observation. We believe that shedding light on this disease in our locality will increase our physician awareness and experience in early detection, treatment in order to avoid unnecessary surgeries. Findings We retrospectively evaluated this disease in terms of the demographic features, clinical presentations, and managements by reviewing the medical records of 18 patients, who were admitted to the Sulaimani Teaching Hospital and Kurdistan Centre for Gastroenterology and Hepatology. Patients were complained from hepatobiliary and/or upper gastrointestinal symptoms and diagnosed accidentally with Fascioliasis during hepatobiliary surgeries and ERCP by direct visualization of the flukes and stone analysis. Elevated liver enzymes, white blood cells count and eosinophilia were notable laboratory indices. The dilated CBD, gallstones, liver cysts and abscess were found common in radiological images. Fascioliasis diagnosed during conventional surgical CBD exploration and choledochodoudenostomy, open cholecystectomy, surgical drainage of liver abscess, ERCP and during gallstone analysis. Conclusion Fascioliasis is indeed an emerging disease in our locality, but it is often underestimated and ignored. We recommend the differential diagnosis of patients suffering from Rt. Hypochondrial pain, fever and eosinophilia. The watercress ingestion was a common factor in patient’s history.

  14. Gadobenate dimeglumine-enhanced MR of VX2 carcinoma in rabbit liver: usefulness of the delayed phase imaging and optimal pulse sequence

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Seung Il; Lee, Jeong Min; Kim, Young Kon; Kim, Chong Soo [College of Medicine, Chonbuk National Univ., Chonju (Korea, Republic of)

    2002-07-01

    To assess the diagnostic value of delayed imaging using gadobenate dimeglumine (MultiHance) and to determine the optimal pulse sequence for the detection of VX2 carcinoma lesions in the rabbit. Twelve VX2 carcinomas implanted in the livers of eleven New Zealand rabbits were studied. All patients underwent an MR protocal consisting of precontrast T2-and T1-weighted sequences, followed by repetition of the T1-weighted sequence at 0 to 30 (arterial phase). 31-60 (portal phase), and 40 minutes (delayed phase) after the intravenous administration of 0.1 mmol/kg of gadobenate dimeglumine. The signal-to-noise ratio (SNR) of the liver and VX2 tumor, and the lesion-to-liver contrast-to-noise ratio (CNR) of precontrast and postcontrast MR images were quantitatively analyzed, and two experienced radiologists evaluated image quality in terms of lesion conspicuity, artifact, mass delineation, and vascular anatomy. Liver SNR was significantly higher at delayed imaging than at precontrast, arterial, and portal imaging (p<0.05), while lesion SNR was significantly higher at delayed imaging than at precontrast imaging (p<0.05). Lesion CNR was higher at delayed imaging than at precontrast and portal phase imaging (p<0.05), but there was no difference between arterial and delayed imaging. The latter provided better mass delineation than precontrast, arterial and portal phase imaging (p<0.05). While in terms of lesion conspicuity and vascular anatomy, the delayed phase was better than the arterial phase (p<0.05) but similar to the precontrast and portal phase. During the delayed phase, the gradient-echo sequence showed better results than the spin-echo in terms of liver SNR, and lesion SNR and CNR (p<0.05). Because it provides better lesion conspicuity and mass delineation by improving liver SNR and lesion-to-liver CNR, the addition of the delayed phase to a dynamic MRI sequence after gadobenate dimeglumine adminstration facilitates lesion detection. For delayed-phase imaging, the

  15. Gadobenate dimeglumine-enhanced MR of VX2 carcinoma in rabbit liver: usefulness of the delayed phase imaging and optimal pulse sequence

    International Nuclear Information System (INIS)

    Cho, Seung Il; Lee, Jeong Min; Kim, Young Kon; Kim, Chong Soo

    2002-01-01

    To assess the diagnostic value of delayed imaging using gadobenate dimeglumine (MultiHance) and to determine the optimal pulse sequence for the detection of VX2 carcinoma lesions in the rabbit. Twelve VX2 carcinomas implanted in the livers of eleven New Zealand rabbits were studied. All patients underwent an MR protocal consisting of precontrast T2-and T1-weighted sequences, followed by repetition of the T1-weighted sequence at 0 to 30 (arterial phase). 31-60 (portal phase), and 40 minutes (delayed phase) after the intravenous administration of 0.1 mmol/kg of gadobenate dimeglumine. The signal-to-noise ratio (SNR) of the liver and VX2 tumor, and the lesion-to-liver contrast-to-noise ratio (CNR) of precontrast and postcontrast MR images were quantitatively analyzed, and two experienced radiologists evaluated image quality in terms of lesion conspicuity, artifact, mass delineation, and vascular anatomy. Liver SNR was significantly higher at delayed imaging than at precontrast, arterial, and portal imaging (p<0.05), while lesion SNR was significantly higher at delayed imaging than at precontrast imaging (p<0.05). Lesion CNR was higher at delayed imaging than at precontrast and portal phase imaging (p<0.05), but there was no difference between arterial and delayed imaging. The latter provided better mass delineation than precontrast, arterial and portal phase imaging (p<0.05). While in terms of lesion conspicuity and vascular anatomy, the delayed phase was better than the arterial phase (p<0.05) but similar to the precontrast and portal phase. During the delayed phase, the gradient-echo sequence showed better results than the spin-echo in terms of liver SNR, and lesion SNR and CNR (p<0.05). Because it provides better lesion conspicuity and mass delineation by improving liver SNR and lesion-to-liver CNR, the addition of the delayed phase to a dynamic MRI sequence after gadobenate dimeglumine adminstration facilitates lesion detection. For delayed-phase imaging, the

  16. Hepatobiliary transporter expression and post-operative jaundice in patients undergoing partial hepatectomy.

    Science.gov (United States)

    Bernhardt, Gerwin A; Zollner, Gernot; Cerwenka, Herwig; Kornprat, Peter; Fickert, Peter; Bacher, Heinz; Werkgartner, Georg; Müller, Gabriele; Zatloukal, Kurt; Mischinger, Hans-Jörg; Trauner, Michael

    2012-01-01

    Post-operative hyperbilirubinaemia in patients undergoing liver resections is associated with high morbidity and mortality. Apart from different known factors responsible for the development of post-operative jaundice, little is known about the role of hepatobiliary transport systems in the pathogenesis of post-operative jaundice in humans after liver resection. Two liver tissue samples were taken from 14 patients undergoing liver resection before and after Pringle manoeuvre. Patients were retrospectively divided into two groups according to post-operative bilirubin serum levels. The two groups were analysed comparing the results of hepatobiliary transporter [Na-taurocholate cotransporter (NTCP); multidrug resistance gene/phospholipid export pump(MDR3); bile salt export pump (BSEP); canalicular bile salt export pump (MRP2)], heat shock protein 70 (HSP70) expression as well as the results of routinely taken post-operative liver chemistry tests. Patients with low post-operative bilirubin had lower levels of NTCP, MDR3 and BSEP mRNA compared to those with high bilirubin after Pringle manoeuvre. HSP70 levels were significantly higher after ischaemia-reperfusion (IR) injury in both groups resulting in 4.5-fold median increase. Baseline median mRNA expression of all four transporters prior to Pringle manoeuvre tended to be lower in the low bilirubin group whereas expression of HSP70 was higher in the low bilirubin group compared to the high bilirubin group. Higher mRNA levels of HSP70 in the low bilirubin group could indicate a possible protective effect of high HSP70 levels against IR injury. Although the exact role of hepatobiliary transport systems in the development of post-operative hyper bilirubinemia is not yet completely understood, this study provides new insights into the molecular aspects of post-operative jaundice after liver surgery. © 2011 John Wiley & Sons A/S.

  17. Effect of ketamine, pentobarbital, and morphine on Tc-99m-DISIDA hepatobiliary kinetics

    International Nuclear Information System (INIS)

    Durakovic, A.; Dubois, A.

    1985-01-01

    The purpose of this study was to evaluate hapatobiliary kinetics of Tc-99m-DISIDA in dogs after administration of anesthetic sedative or narcotic agents. Four groups of six male Beagle dogs were studied as a non-treated control group and after parenteral administration of ketamine (30 mg/kg IM), pentobarbital (25 mg/kg IV) or morphine (1 mg/kg IV). Each animal was injected with 4 mCi Tc-99m-DISIDA and hepatobiliary scintigraphic studies were obtained using a gamma camera with parallel hole multipurpose collimator and an A/sup 3/ MDS computer. The authors determined; peak activity of Tc-99m-DISIDA in the liver, visualization and peak activity of gallbladder, and intestinal visualization of Tc-99m-DISIDA. Total bilirubin, LDH, SGOT and SGPT were not modified significantly after any drug compared to control. The results showed that two commonly used anesthetics and sedatives (ketamine and pentobarbital) have dramatic and opposite effects on extrahepatic biliary kinetics. Furthermore, ketamine, but not pentobarbital, significantly accelerates intrahepatic biliary kinetics. Finally, as expected, morphine delayed extrahepatic biliary kinetics. Thus, studies of biliary kinetics should be interpreted with caution when measurements are made after administration of anesthetic, sedative or narcotic agents

  18. 123I-BMIPP delayed scintigraphic imaging in patients with chronic heart failure.

    Science.gov (United States)

    Kida, Keisuke; Akashi, Yoshihiro J; Yoneyama, Kihei; Shimokawa, Mitsuhiro; Musha, Haruki

    2008-11-01

    The objective of the present study was to clarify the ability of 123I-beta-methyl-iodophenylpentadecanoic acid (123I-BMIPP) to evaluate the heart-to-mediastinum (H/M) ratio and myocardial global washout rate (WR) in patients with chronic heart failure (CHF). The severity of CHF was evaluated on the basis of the New York Heart Association (NYHA) classification. Twenty patients with CHF (13 with idiopathic dilated cardiomyopathy and 7 with ischemic cardiomyopathy) and 11 age-matched controls underwent myocardial radionuclide imaging. Scintigraphic images were obtained from each participant at the early (30 min following radio-isotope injection) and late (4 h) phases using 123I-BMIPP. The H/M ratio and WR were calculated from planar images. Concentrations of plasma brain natriuretic peptide (BNP) were measured prior to the scintigraphic study. The 123I-BMIPP uptake of early H/M and global WR did not significantly differ among groups, but uptake of delayed H/M was significantly lower in patients with NYHA class III than in controls (control 2.47 +/- 0.39; class III 1.78 +/- 0.28, P < 0.05). The uptake of delayed H/M and global WR correlated with plasma log BNP in all participants (r = -0.38, P < 0.05; 0.43, P < 0.05, respectively). These data suggest that 123I-BMIPP uptake of delayed H/M enhances the image of CHF severity. The myocardial WR of 123I-BMIPP also effectively depicted the severity of CHF.

  19. Imaging-based evaluation of liver function: comparison of {sup 99m}Tc-mebrofenin hepatobiliary scintigraphy and Gd-EOB-DTPA-enhanced MRI

    Energy Technology Data Exchange (ETDEWEB)

    Geisel, Dominik; Gebauer, Bernhard [Charite Campus Virchow-Klinikum, Department of Diagnostic and Interventional Radiology, Berlin (Germany); Luedemann, Lutz [Essen University Hospital, Department of Medical Physics, Essen (Germany); Froeling, Vera; Denecke, Timm [Charite Campus Virchow-Klinikum, Department of Diagnostic and Interventional Radiology, Berlin (Germany); Charite Campus Virchow-Klinikum, Department of Nuclear Medicine, Berlin (Germany); Malinowski, Maciej; Stockmann, Martin; Baron, Annekathrin; Seehofer, Daniel [Charite Campus Virchow-Klinikum, Department of General, Visceral and Thoracic Surgery, Berlin (Germany); Prasad, Vikas [Charite Campus Virchow-Klinikum, Department of Nuclear Medicine, Berlin (Germany)

    2015-05-01

    To compare Gd-EOB-enhanced MRI and {sup 99m}Tc-mebrofenin hepatobiliary scintigraphy (HBS) as imaging-based liver function tests for separate evaluation of right (RLL) and left liver lobe (LLL) function. Fourteen patients underwent Gd-EOB-enhanced MRI and {sup 99m}Tc-mebrofenin HBS after portal vein embolization within 24 h. Relative enhancement (RE) and hepatic uptake index (HUI) were determined from MRI; and T{sub max}, T{sub 1/2} and mebrofenin uptake were determined from HBS, all values separately for RLL and LLL. Mebrofenin uptake correlated significantly with HUI and RE for both liver lobes. There was strong correlation of mebrofenin uptake with HUI for RLL (r{sup 2} = 0.802, p = 0.001) and RE for LLL (r{sup 2} = 0.704, p = 0.005) and moderate correlation with HUI for LLL (r{sup 2} = 0.560, p = 0.037) and RE for RLL (r{sup 2} = 0.620, p = 0.018). Correlating the percentage share of RLL function derived from MRI (with HUI) with the percentage of RLL function derived from mebrofenin uptake revealed a strong correlation (r{sup 2} = 0.775, p = 0.002). Both RE and HUI correlate with mebrofenin uptake in HBS. The results suggest that Gd-EOB-enhanced MRI and {sup 99m}Tc-mebrofenin HBS may equally be used to separately determine right and left liver lobe function. (orig.)

  20. Comparison between immediate and delayed imaging after gadolinium chelate injection for detecting enhanced lesions in multiple sclerosis

    International Nuclear Information System (INIS)

    Alizadeh, A.; Roudbari, A.; Heidarzadeh, A.; Kouhsari, M.

    2010-01-01

    Magnetic resonance imaging is a noninvasive and valuable method in the diagnosis of Multiple Sclerosis. Compared with other modalities, the sensitivity of Magnetic resonance imaging for detection of the lesion increases using magnetization transfer and delayed imaging. Our aim was to compare the two methods in detecting Multiple Sclerosis lesions. Patients and Methods: In this double-blind clinical trial, twenty-one patients with the definite diagnosis of Multiple Sclerosis referred to Poursina Hospital, Rasht were included. Two radiologists evaluated all the images. First, images without contrast were conducted, then 0.1 mmol/kg contrast material (Dotarem, single dose) was injected and after 30 minutes, T1W and magnetization transfer images were obtained. Seventy-two hours later, T1W images were obtained immediately after injection of 0.2 mmol/kg contrast material (double dose). The data were analyzed using Fisher's and McNemar tests by SPSS for Windows. Results: Delayed magnetization transfer showed 44 enhanced lesions using magnetization transfer (69.84%) and 29 lesions using T1 (46.03%). In addition, the number of enhanced lesions in the delayed method were significantly more than those in the immediate method (p value=0.003). Conclusion: The use of single dose in combination with magnetization transfer and delayed images after 20-30 minutes enables us to detect more enhanced lesions.

  1. Postoperative follow-up studies in congenital dilatation of the common bile duct using hepatobiliary scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Hirobe, Seiichi; Ishida, Haruo; Hayashi, Akira; Kamagata, Shoichiro; Fuchimoto, Yasufumi; Mizuno, Dai; Yano, Tsunehiro [Tokyo Metropolitan Kiyose Children`s Hospital (Japan); Ishii, Katsumi

    1995-03-01

    Follow-up studies in congenital dilatation of the common bile duct were done in 20 cases ranging 3 to 20 years after operation. Operative cholangiography had shown dilatation of the intrahepatic bile ducts in 15 patients (75%), of these, 7 patients had cystic dilatation. Five cases of these 7 patients showed prolonged stasis of the nuclide in the cystic dilated intrahepatic bile ducts by {sup 99m}Tc-PMT hepatobiliary scintigraphy in the follow-up studies even at 10 years after operation. But none of 20 cases had complication such as intrahepatic lithiasis, cholangitis, and liver dysfunction. Hepatobiliary scintigraphy could provide moderate anatomic and excellent functional information which were useful for these follow-up studies and careful follow-up should be done in the case of cystic dilatation of the intrahepatic bile ducts. (author).

  2. Decrease in the ability to detect elevated lung thallium due to delay in commencing imaging after exercise

    International Nuclear Information System (INIS)

    Rothendler, J.A.; Boucher, C.A.; Strauss, H.W.; Pohost, G.M.; Okada, R.D.

    1985-01-01

    Post-exercise elevation of the lung/myocardial thallium ratio and a high lung clearance rate between initial and delayed images have been reported to be markers for exercise-induced left ventricular (LV) dysfunction associated with coronary artery disease (CAD). The authors performed thallium exercise tests on 60 patients, 42 with CAD, in order to determine the effect of delaying initial imaging on detection of elevated lung thallium. In addition to images obtained at 2 minutes and at 2 hours after exercise, 18-minute images were also obtained to simulate such a delay. Because of rapid isotope clearance in those with initially elevated lung activity, there was decreased sensitivity of both the initial lung/myocardial ratio and lung thallium clearance for detecting CAD, using the 18-minute image as the initial post exercise study. They conclude that initial imaging should be done in the anterior view early after exercise to optimize detection of elevated lung thallium

  3. New Approaches For Asteroid Spin State and Shape Modeling From Delay-Doppler Radar Images

    Science.gov (United States)

    Raissi, Chedy; Lamee, Mehdi; Mosiane, Olorato; Vassallo, Corinne; Busch, Michael W.; Greenberg, Adam; Benner, Lance A. M.; Naidu, Shantanu P.; Duong, Nicholas

    2016-10-01

    Delay-Doppler radar imaging is a powerful technique to characterize the trajectories, shapes, and spin states of near-Earth asteroids; and has yielded detailed models of dozens of objects. Reconstructing objects' shapes and spins from delay-Doppler data is a computationally intensive inversion problem. Since the 1990s, delay-Doppler data has been analyzed using the SHAPE software. SHAPE performs sequential single-parameter fitting, and requires considerable computer runtime and human intervention (Hudson 1993, Magri et al. 2007). Recently, multiple-parameter fitting algorithms have been shown to more efficiently invert delay-Doppler datasets (Greenberg & Margot 2015) - decreasing runtime while improving accuracy. However, extensive human oversight of the shape modeling process is still required. We have explored two new techniques to better automate delay-Doppler shape modeling: Bayesian optimization and a machine-learning neural network.One of the most time-intensive steps of the shape modeling process is to perform a grid search to constrain the target's spin state. We have implemented a Bayesian optimization routine that uses SHAPE to autonomously search the space of spin-state parameters. To test the efficacy of this technique, we compared it to results with human-guided SHAPE for asteroids 1992 UY4, 2000 RS11, and 2008 EV5. Bayesian optimization yielded similar spin state constraints within a factor of 3 less computer runtime.The shape modeling process could be further accelerated using a deep neural network to replace iterative fitting. We have implemented a neural network with a variational autoencoder (VAE), using a subset of known asteroid shapes and a large set of synthetic radar images as inputs to train the network. Conditioning the VAE in this manner allows the user to give the network a set of radar images and get a 3D shape model as an output. Additional development will be required to train a network to reliably render shapes from delay

  4. Biological evaluation of 99m Tc-N-(3-bromo-trimethyl-acetanilide)-iminodiacetic acid (99mTc mebrofenin) as hepatobiliary radiopharmaceutical

    International Nuclear Information System (INIS)

    Hamada, E.S.

    1994-01-01

    Technetium-99 m-N-(3-bromo-2,4,6-trimethyl acetanilide) iminodiacetic acid ( 99m Tc-Mebrofenin) has been described as having optimal properties as hepatobiliary radiopharmaceutical. This paper describes the synthesis, radiopharmaceutical preparation and biological distribution of new labeled compound. The biodistribution study of 99m Tc-Mebrofenin- was carried out in normal mice. The specificity for hepatobiliary excretion blood clearance and cumulative biliary excretion were evaluated in normal and cirrhotic rats. (author). 5 refs, 3 figs, 3 tabs

  5. Portal vein stenting for delayed jejunal varix bleeding associated with portal venous occlusion after hepatoiliary and pancreatic surgery

    Energy Technology Data Exchange (ETDEWEB)

    Hyun, Dong Ho; Park, Kwang Bo; Cho, Sung Ki; Park, Hong Suk; Shin, Sung Wook; Choo, Sung Wook; Do, Young Soo; Choo, In Wook; Choi, Dong Wook [Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2017-09-15

    The study aimed to describe portal stenting for postoperative portal occlusion with delayed (≥ 3 months) variceal bleeding in the afferent jejunal loop. Eleven consecutive patients (age range, 2–79 years; eight men and three women) who underwent portal stenting between April 2009 and December 2015 were included in the study. Preoperative medical history and the postoperative clinical course were reviewed. Characteristics of portal occlusion and details of procedures were also investigated. Technical success, treatment efficacy (defined as disappearance of jejunal varix on follow-up CT), and clinical success were analyzed. Primary stent patency rate was plotted using the Kaplan-Meier method. All patients underwent hepatobiliary-pancreatic cancer surgery except two children with liver transplantation for biliary atresia. Portal occlusion was caused by benign postoperative change (n = 6) and local tumor recurrence (n = 5). Variceal bleeding occurred at 27 months (4 to 72 months) and portal stenting was performed at 37 months (4 to 121 months), on average, postoperatively. Technical success, treatment efficacy, and clinical success rates were 90.9, 100, and 81.8%, respectively. The primary patency rate of portal stent was 88.9% during the mean follow-up period of 9 months. Neither procedure-related complication nor mortality occurred. Interventional portal stenting is an effective treatment for delayed jejunal variceal bleeding due to portal occlusion after hepatobiliary-pancreatic surgery.

  6. Portal vein stenting for delayed jejunal varix bleeding associated with portal venous occlusion after hepatoiliary and pancreatic surgery

    International Nuclear Information System (INIS)

    Hyun, Dong Ho; Park, Kwang Bo; Cho, Sung Ki; Park, Hong Suk; Shin, Sung Wook; Choo, Sung Wook; Do, Young Soo; Choo, In Wook; Choi, Dong Wook

    2017-01-01

    The study aimed to describe portal stenting for postoperative portal occlusion with delayed (≥ 3 months) variceal bleeding in the afferent jejunal loop. Eleven consecutive patients (age range, 2–79 years; eight men and three women) who underwent portal stenting between April 2009 and December 2015 were included in the study. Preoperative medical history and the postoperative clinical course were reviewed. Characteristics of portal occlusion and details of procedures were also investigated. Technical success, treatment efficacy (defined as disappearance of jejunal varix on follow-up CT), and clinical success were analyzed. Primary stent patency rate was plotted using the Kaplan-Meier method. All patients underwent hepatobiliary-pancreatic cancer surgery except two children with liver transplantation for biliary atresia. Portal occlusion was caused by benign postoperative change (n = 6) and local tumor recurrence (n = 5). Variceal bleeding occurred at 27 months (4 to 72 months) and portal stenting was performed at 37 months (4 to 121 months), on average, postoperatively. Technical success, treatment efficacy, and clinical success rates were 90.9, 100, and 81.8%, respectively. The primary patency rate of portal stent was 88.9% during the mean follow-up period of 9 months. Neither procedure-related complication nor mortality occurred. Interventional portal stenting is an effective treatment for delayed jejunal variceal bleeding due to portal occlusion after hepatobiliary-pancreatic surgery

  7. Value of Gd-EOB-DTPA-enhanced MRI in diagnosis of hepatocellular carcinoma

    Directory of Open Access Journals (Sweden)

    SUN Yu

    2018-01-01

    Full Text Available Objective To investigate the value of Gd-EOB-DTPA-enhanced MRI in the diagnosis of hepatocellular carcinoma (HCC. Methods A total of 40 patients with liver cirrhosis or suspected HCC who visited General Hospital of Shenyang Military Area Command from October 2016 to April 2017 were enrolled, and the data on three dynamic phases of Gd-EOB-DTPA-enhanced MRI (arterial phase, portal venous phase, and delayed phase, hepatobiliary phase (delayed for 20 minutes, and diffusion-weighted imaging (DWI (b=50,400, and 1000 s/mm2 were collected. Two radiologists made a diagnosis and gave diagnostic confidence scores based on the presence or absence of hepatobiliary phase images. Postoperative pathology or clinical diagnosis was used as the criteria for assessing the diagnostic accuracy of HCC. The t-test was used for comparison of continuous data, and the chi-square test was used for comparison of categorical data. Results A total of 42 HCC lesions and 37 cirrhotic nodules were detected. There were significant differences between HCC lesions and cirrhotic nodules in signal intensity on hepatobiliary phase and DWI (χ2=64.503 and 67.855, both P<0.001,as well as the apparent diffusion coefficient when the b-values of DWI were 400 s/mm2 and 1000 s/mm2 (t=62.75 and 75.36, both P<0.001. There was a significant difference in diagnostic confidence score given by the radiologists between the images of three dynamic phases of Gd-EOB-DTPA-enhanced MRI and those of four dynamic phases (including hepatobiliary phase (3.260±0.521 vs 4.620±0.661, t=10.67, P<0.001. With postoperative pathology and clinical diagnosis as criteria, the images of three dynamic phases of Gd-EOB-DTPA-enhanced MRI had a significantly higher diagnostic accuracy for HCC than those of four dynamic phases (including hepatobiliary phase [76.19% (32/42 vs 95.24% (40/42, χ2=6.222, P=0.013]. Conclusion Gd-EOB-DTPA-enhanced MRI may improve diagnostic accuracy and confidence for HCC and has

  8. Effect of delay in hospital presentation on clinical and imaging findings in acute pulmonary thromboembolism.

    Science.gov (United States)

    Jenab, Yaser; Alemzadeh-Ansari, Mohammad Javad; Fehri, Seyedeh Arezoo; Ghaffari-Marandi, Neda; Jalali, Arash

    2014-04-01

    There is limited information on the extent and clinical importance of the delay in hospital presentation of acute pulmonary thromboembolism (PTE). The aim of this study was to investigate the delay in hospital presentation of PTE and its association with clinical and imaging findings in PTE. This prospective study was conducted on patients admitted to our hospital with a diagnosis of acute PTE between September 2007 and September 2011. Relationships between delay in hospital presentation and clinical findings, risk factors, imaging findings, and in-hospital mortality were analyzed. Of the 195 patients enrolled, 84 (43.1%) patients presented 3 days after the onset of symptoms. Patients with chest pain, history of immobility for more than 3 days, recent surgery, and estrogen use had significantly less delayed presentation. Right ventricular dysfunction was significantly more frequent in patients with delayed presentation (odds ratio [OR] = 2.38; 95% confidence interval [CI] 1.27-4.44; p = 0.006); however, no relationship was found between delay in presentation and pulmonary computed tomographic angiography or color Doppler sonography findings. Patients with delayed presentation were at higher risk of in-hospital mortality (OR = 4.32; 95% CI 1.12-16.49; p = 0.021). Our study showed that a significant portion of patients with acute PTE had delayed presentation. Also, patients with delayed presentation had worse echocardiographic findings and higher in-hospital mortality. Copyright © 2014 Elsevier Inc. All rights reserved.

  9. Diagnostic value of ultrasonography, infusion tomography of the gall-bladder and sup(99m)Tc-DIDA hepatobiliary scanning in cases of suspected acute cholecystitis

    Energy Technology Data Exchange (ETDEWEB)

    Holst Pedersen, J.; Hancke, S.; Christensen, B.; Gammelgaard, J.; Haubek, A.; Ingemann Jensen, L.; Munck, O.; Wied, U. (Koebenhavns amts sygehus i Herlev, kirurgisk gastroenterologisk afd., Herlev, Denmark)

    1982-01-01

    Ultrasonography, infusion tomography of the gall-bladder and sup(99m)Tc-diethyl acetanilide iminodiacetic acid (DIDA) hepatobiliary scanning were compared in a prospective investigation of 45 consecutive patients in whom acute cholecystitis was suspected clinically. The definitive diagosis of acute cholecystitis was established or excluded at operation in 35 patients, by oral cholecystography in five and by intravenous cholangiography in five. The predictive values of positive and negative results of investigation were 100% and 83%. respectively, with ultrasonography and 98% and 88%, respectively, in hepatobiliary scanning. The corresponding values for infusion tomography were 87% and 33%, respectively. It is concluded from these results that ultrasonography and sup(99m)Tc-DIDA hepatobiliary scanning are capable of establishing the diagnosis rapidly and with certainty in cases of suspected acute cholecystitis. A preliminary account of the results of routine employment of sup(99m)Tc-DIDA hepatobiliary scanning in 29 consecutive patients revealed no erroneous diagnoses. In the majority of patients with acute cholecystitis, operation proved possible within 48 hours of admission.

  10. Delay and Standard Deviation Beamforming to Enhance Specular Reflections in Ultrasound Imaging.

    Science.gov (United States)

    Bandaru, Raja Sekhar; Sornes, Anders Rasmus; Hermans, Jeroen; Samset, Eigil; D'hooge, Jan

    2016-12-01

    Although interventional devices, such as needles, guide wires, and catheters, are best visualized by X-ray, real-time volumetric echography could offer an attractive alternative as it avoids ionizing radiation; it provides good soft tissue contrast, and it is mobile and relatively cheap. Unfortunately, as echography is traditionally used to image soft tissue and blood flow, the appearance of interventional devices in conventional ultrasound images remains relatively poor, which is a major obstacle toward ultrasound-guided interventions. The objective of this paper was therefore to enhance the appearance of interventional devices in ultrasound images. Thereto, a modified ultrasound beamforming process using conventional-focused transmit beams is proposed that exploits the properties of received signals containing specular reflections (as arising from these devices). This new beamforming approach referred to as delay and standard deviation beamforming (DASD) was quantitatively tested using simulated as well as experimental data using a linear array transducer. Furthermore, the influence of different imaging settings (i.e., transmit focus, imaging depth, and scan angle) on the obtained image contrast was evaluated. The study showed that the image contrast of specular regions improved by 5-30 dB using DASD beamforming compared with traditional delay and sum (DAS) beamforming. The highest gain in contrast was observed when the interventional device was tilted away from being orthogonal to the transmit beam, which is a major limitation in standard DAS imaging. As such, the proposed beamforming methodology can offer an improved visualization of interventional devices in the ultrasound image with potential implications for ultrasound-guided interventions.

  11. The usefulness of hepatobiliary scintigraphy in the diagnosis of complications after adult-to-adult living donor liver transplantation

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jae Seung; Moon, Dae Hyuk; Lee, Hee Kyung [Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea); Lee, Sung Gyu; Lee, Young Joo; Park, Kwang Min; Hwang, Shin [Department of General Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea)

    2002-04-01

    Living donor liver transplantation has become an accepted procedure to overcome the shortage of adult donor organs. The aim of this study was to evaluate the usefulness of hepatobiliary scintigraphy in the diagnosis of complications after adult-to-adult living donor liver transplantation. We analysed 82 hepatobiliary scintigraphy studies performed using technetium-99m DISIDA in 60 adult patients (44 males, 16 females) who had been transplanted with a living donor's hepatic lobe (right lobe, 32; left lobe, 28). Indications for hepatobiliary scintigraphy were abnormal symptoms and/or liver function tests (n=54) or suspected bile leak or biloma (n=28). Median interval between transplantation and scintigraphy was 69 days (9 days to 23 months). Scintigraphic findings were classified into hepatic parenchymal dysfunction, total biliary obstruction, segmental biliary obstruction, bile leak and normal graft. Scintigraphic findings were confirmed by liver biopsy in 17 cases, and by radiological and clinical follow-up in 65 cases. There were 29 events relating to biliary complications (six total biliary obstructions, eight segmental biliary obstructions and 15 bile leaks) and 19 relating to non-biliary complications (15 cases of rejection, two of infection and two of vascular compromise) in 38 patients. Hepatobiliary scintigraphy provided the correct diagnosis in all eight segmental and five of six total biliary obstructions, and in all 15 cases of bile leak. Of the 19 non-biliary complications, 16 showed parenchymal dysfunction regardless of the aetiology and three showed total biliary obstruction on scintigraphy. All but three of 34 normally functioning grafts were normal on scintigraphy. The diagnostic sensitivity and specificity of scintigraphy for biliary obstruction in the 54 patients with abnormal symptoms or liver function tests were 93% (100% for segmental, 83% for total) and 88% (35/40), respectively. The sensitivity and specificity were each 100% (15/15, 13

  12. Hypovascular hypointense nodules on hepatobiliary phase without T2 hyperintensity on gadoxetic acid-enhanced MR images in patients with chronic liver disease: long-term outcomes and risk factors for hypervascular transformation

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Yong Seek [Chonbuk National University Medical School and Hospital, Department of Radiology, Jeonju-si, Chonbuk (Korea, Republic of); Song, Ji Soo; Lee, Hyun Kyung; Han, Young Min [Chonbuk National University Medical School and Hospital, Department of Radiology, Jeonju-si, Chonbuk (Korea, Republic of); Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Research Institute of Clinical Medicine, Chonbuk (Korea, Republic of)

    2016-10-15

    To evaluate the long-term outcomes and imaging features associated with hypervascularization of hypovascular nodules that show T2 iso-/hypointensity and hypointensity on hepatobiliary phase (HBP) of gadoxetic acid-enhanced magnetic resonance (MR) images in patients with chronic liver disease. Sixty patients and 114 nodules, which were hypovascular and iso-/hypointense on T2-weighted images and hypointense on HBP of gadoxetic acid-enhanced MRI, were included. We evaluated the effect of baseline clinical features, baseline MR features and growth rate on subsequent hypervascularization. Twenty-seven nodules in 21 patients transformed to hypervascular hepatocellular carcinoma (HCC). Using multivariate Cox analysis, T1 hyperintensity (hazard ratio [HR] = 2.69, P = 0.021), previous history of HCC (HR = 2.64, P = 0.021), and initial nodule size (HR = 1.09, P = 0.046) were identified to be associated with hypervascularization. The growth rate of nodules was a more powerful determinant of subsequent hypervascularization than baseline clinical and MR features. At long-term follow-up after >3 years, only one nodule with T1 isointensity showed hypervascularization. Careful follow-up or diagnostic procedures, such as biopsy, should be considered for up to 3 years after detection of hypointense nodules on HBP with T1 hyperintensity or a higher growth rate. (orig.)

  13. Differentiation of infantile jaundice with 99mTc-EHIDA hepatobiliary scintigraphy and determination of bilixanthine from duodenal drainage

    International Nuclear Information System (INIS)

    Zhao Ming; Wu Hua; Huang Zhihua

    1996-01-01

    The purpose of this study was to develop an effective diagnostic method for infantile jaundice. 99m Tc-EHIDA hepatobiliary scintigraphy and determination of bilixanthine from duodenal drainage were carried out in 33 infants with persistent jaundice. The final diagnosis was confirmed by surgical operation, pathology or clinical follow-up. For diagnosing biliary atresia, the sensitivity and specificity of scintigraphy were 100% and 72.7% respectively and those of bilixanthine measurement were 100% and 95.5%. Hepatobiliary scintigraphy may be a sensitive, simple, safe and noninvasive method for differentiating infantile jaundice. Duodenal bilixanthine determination may improve the specificity in the case without intestinal radioactivity in scintigram

  14. Enhancing contrast of magnetic resonance imaging in patients with ...

    African Journals Online (AJOL)

    DTPA), a recent magnetic resonance imaging (MRI) contrast agent, in hepatobiliary system of patients with liver cirrhosis. Methods: Liver cirrhosis patients that underwent contrast MRI examination at Renai Hospital, Taipei City, Taiwan were ...

  15. Natural orifice translumenal endoscopic surgery (NOTES) for innovation in hepatobiliary and pancreatic surgery: preface.

    Science.gov (United States)

    Sugimoto, Maki

    2009-01-01

    Natural orifice translumenal endoscopic surgery (NOTES) has captured the interest of interventional endoscopists and may represent the next stage of evolution of minimally invasive surgery. It provides the potential for performance of incisionless operations. It is gaining momentum both in the animal laboratory and in human case reports. Developments in the field of NOTES have led to the formation of the Natural Orifice Surgery Consortium for Assessment and Research (NOSCAR) in 2006. In this special issue, the current trends in NOTES in the field of hepatobiliary and pancreatic surgery are featured, including NOTES cholecystectomy, hepatectomy splenectomy, pancreatic necrosectomy, and the future of NOTES. In this issue, we discuss the potential benefits of these procedures in hepatobiliary and pancreatic surgery. We have just started the evaluation process for this new technology. The concept of NOTES is becoming established and is enormously advantageous for the patient. Both the surgeon and gastroenterologist should contribute to developing NOTES in making use of their specialties.

  16. Value of hepatobiliary scanning in complex liver trauma

    International Nuclear Information System (INIS)

    Gartman, D.M.; Zeman, R.K.; Cahow, C.E.; Baker, C.C.

    1985-01-01

    To evaluate the use of biliary scintigraphy with /sup 99m/Tc-dimethyl analogs (HIDA) in traumatic liver injuries, a group of 26 patients with penetrating and blunt liver injuries were studied. The results indicate that HIDA scanning is an effective noninvasive method of evaluating the hepatobiliary tree in the post-traumatic setting. The HIDA scan is a sensitive tool for studying the hepatic parenchyma and the presence or absence of bile leaks. Its evaluation of the extrahepatic biliary ductal system is not specific and should be assessed with further studies. Gallbladder nonvisualization by HIDA scans in this setting cannot be presumed to be secondary to acute cholecystitis and should be interpreted with extreme caution

  17. Magnetic Resonance Imaging of Liver Metastasis.

    Science.gov (United States)

    Karaosmanoglu, Ali Devrim; Onur, Mehmet Ruhi; Ozmen, Mustafa Nasuh; Akata, Deniz; Karcaaltincaba, Musturay

    2016-12-01

    Liver magnetic resonance imaging (MRI) is becoming the gold standard in liver metastasis detection and treatment response assessment. The most sensitive magnetic resonance sequences are diffusion-weighted images and hepatobiliary phase images after Gd-EOB-DTPA. Peripheral ring enhancement, diffusion restriction, and hypointensity on hepatobiliary phase images are hallmarks of liver metastases. In patients with normal ultrasonography, computed tomography (CT), and positron emission tomography (PET)-CT findings and high clinical suspicion of metastasis, MRI should be performed for diagnosis of unseen metastasis. In melanoma, colon cancer, and neuroendocrine tumor metastases, MRI allows confident diagnosis of treatment-related changes in liver and enables differential diagnosis from primary liver tumors. Focal nodular hyperplasia-like nodules in patients who received platinum-based chemotherapy, hypersteatosis, and focal fat can mimic metastasis. In cancer patients with fatty liver, MRI should be preferred to CT. Although the first-line imaging for metastases is CT, MRI can be used as a problem-solving method. MRI may be used as the first-line method in patients who would undergo curative surgery or metastatectomy. Current limitation of MRI is low sensitivity for metastasis smaller than 3mm. MRI fingerprinting, glucoCEST MRI, and PET-MRI may allow simpler and more sensitive diagnosis of liver metastasis. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Sequential hepatobiliary scintigraphy of the patients with constitutional jaundice, ICG excretory defect disease and hepatocellular carcinoma with 99mTc-PI, 99mTc-HIDA and 99mTc-EHIDA

    International Nuclear Information System (INIS)

    Mitani, Tsuyoshi

    1987-01-01

    Sequential 2 min scintiphotos were obtained with a scintilation camera after intravenous injection of 3 mCi of 99m Tc-HIDA or 99m Tc-PI. Digital matrix images were simultaneously recorded with computer. Sequential samples for the blood clearance of 99m Tc-HIDA or 99m Tc-PI were obtained for 120 min following injection to the patient of constitutional hyperbilirubinemia and ICG excretory defect disease. In Dubin-Johnson syndrome, the hepatic uptake of 99m Tc-HIDA was faster or normal but the excretion was extremely slower than in normal cases. Both hepatic uptake and excretion of 99m Tc-PI were almost normal. In Rotor's disease, hepatic uptake of 99m Tc-HIDA or 99m Tc-PI was very poor, showing almost no hepatic images in all time. In Gilbert's disease and ICG excretory defect disease, hepatic uptake and excretion of 99m Tc-HIDA or 99m Tc-PI were within normal limit. From these results, Dubin-Johnson syndrome, Rotor's disease and Gilbert's disease show the different patterns between hepatic uptake and excretion of 99m Tc-HIDA and 99m Tc-PI hepatobiliary scintigraphy and these patterns contribute to the differential diagnosis of constitutional jaundice. The usefulness of hepatobiliary imaging with 99m Tc-EHIDA in diagnosis of hepatocellular carcinoma was studied in 15 patients with histologically verified HCC. In 15 patients, 3 patients (20 %) showed increased radioactivity with 99m Tc-EHIDA image, where liver scan with 99m Tc-Sn colloid showed filling defect. These results indicate that use of 99m Tc-EHIDA scan and 67 Ga-citrate imaging is useful for positive visualization of HCC. (author)

  19. Traumatic injuries: imaging and intervention in post-traumatic complications (delayed intervention)

    Energy Technology Data Exchange (ETDEWEB)

    Goffette, Pierre P. [Department of Medical Imaging, Saint-Luc University Hospital-Louvain Medical School, Brussels (Belgium); Laterre, Pierre-Francois [Department of Emergency and Critical Care, Saint-Luc University Hospital-Louvain Medical School, Brussels (Belgium)

    2002-05-01

    The nonoperative management (NOM) of abdominal trauma has gained increasing acceptance over the past decade. This approach has been extended to severe trauma patients previously considered as candidates for surgery. Consequently, the incidence of delayed and uncommonly encountered complications has increased. Causes of delayed complications are multiple and include: (a) abnormal or insufficient injury healing process; (b) retention of necrotic tissue; (c) secondary infection of initially sterile collections; and (d) underestimation of injury severity. The purpose of this review article is to explain the role of various imaging modalities in detecting post-traumatic delayed complications and to highlight the usefulness of minimally invasive techniques, including laparoscopy, biliary endoscopy, therapeutic angiography and image-guided drainage. Subsequent complications, which do not necessarily negatively influence the final outcome, are often predictable, virtually obligatory consequences of the successful NOM of high-grade or complex abdominal injuries. Between 50 and 60% of those patients with grade-IV or grade-V liver or splenic lacerations require some type of interventional treatment; therefore, indiscriminate discharge of patients with solid organ injury managed conservatively may be potentially harmful. As the incidence of complications is higher for more severe grade-IV or grade-V liver, spleen, or kidney injuries, scheduled follow-up CT scans may be rational in this subset of patients to identify potential complications amenable to early application of interventional techniques. Follow-up CT scans are unnecessary in stable adults or children with low-grade injury. Delayed splenic or hepatic rupture is one of the major concerns because this type of complication remains difficult to predict and historically often requires emergent surgery. (orig.) (orig.)

  20. Double-Stage Delay Multiply and Sum Beamforming Algorithm Applied to Ultrasound Medical Imaging.

    Science.gov (United States)

    Mozaffarzadeh, Moein; Sadeghi, Masume; Mahloojifar, Ali; Orooji, Mahdi

    2018-03-01

    In ultrasound (US) imaging, delay and sum (DAS) is the most common beamformer, but it leads to low-quality images. Delay multiply and sum (DMAS) was introduced to address this problem. However, the reconstructed images using DMAS still suffer from the level of side lobes and low noise suppression. Here, a novel beamforming algorithm is introduced based on expansion of the DMAS formula. We found that there is a DAS algebra inside the expansion, and we proposed use of the DMAS instead of the DAS algebra. The introduced method, namely double-stage DMAS (DS-DMAS), is evaluated numerically and experimentally. The quantitative results indicate that DS-DMAS results in an approximately 25% lower level of side lobes compared with DMAS. Moreover, the introduced method leads to 23%, 22% and 43% improvement in signal-to-noise ratio, full width at half-maximum and contrast ratio, respectively, compared with the DMAS beamformer. Copyright © 2018. Published by Elsevier Inc.

  1. 123I-BMIPP delayed scintigraphic imaging in patients with chronic heart failure

    International Nuclear Information System (INIS)

    Kida, Keisuke; Akashi, Yoshihiro J.; Yoneyama, Kihei; Shimokawa, Mitsuhiro; Musha, Haruki

    2008-01-01

    The objective of the present study was to clarify the ability of 123 I-beta-methyl-iodophenylpentadecanoic acid ( 123 I-BMIPP) to evaluate the heart-to-mediastinum (H/M) ratio and myocardial global washout rate (WR) in patients with chronic heart failure (CHF). The severity of CHF was evaluated on the basis of the New York Heart Association (NYHA) classification. Twenty patients with CHF (13 with idiopathic dilated cardiomyopathy and 7 with ischemic cardiomyopathy) and 11 age-matched controls underwent myocardial radionuclide imaging. Scintigraphic images were obtained from each participant at the early (30 min following radio-isotope injection) and late (4 h) phases using 123 I-BMIPP. The H/M ratio and WR were calculated from planar images. Concentrations of plasma brain natriuretic peptide (BNP) were measured prior to the scintigraphic study. The 123 I-BMIPP uptake of early H/M and global WR did not significantly differ among groups, but uptake of delayed H/M was significantly lower in patients with NYHA class III than in controls (control 2.47±0.39; class III 1.78±0.28 P 123 I-BMIPP uptake of delayed H/M enhances the image of CHF severity. The myocardial WR of 123 I-BMIPP also effectively depicted the severity of CHF. (author)

  2. Prediction of therapy response to interferon-alpha in chronic viral hepatitis-B by liver and hepatobiliary scintigraphy

    International Nuclear Information System (INIS)

    Caglar, M.; Sari, O.; Akcan, Y.

    2002-01-01

    Interferon (IFN) provides effective treatment in some patients with chronic hepatitis. The clarification of factors predictive of therapy response would be helpful in identifying patients who would benefit from treatment. In this study, we evaluated the potential utility of Tc-99m sulfur colloid liver/spleen and Tc-99m-disofenin hepatobiliary scintigraphy to predict therapy response to IFN in patients with chronic active hepatitis. The study group consisted of ten patients with chronic viral hepatitis B who were treated with 4.5 units of interferon alpha for 12 months. Prior to the start of the therapy, sulfur colloid scintigraphy was obtained by which the liver/spleen ratios were derived. Hepatobiliary scintigraphy was performed on a separate day and time-activity curves were generated from regions of interest drawn over the liver, heart and gall-bladder. The index of blood and liver clearance time was calculated. Histological grading and laboratory values were obtained for clinical correlation. Responders (n=6) to IFN were defined as those who improved clinically with normalized transaminase levels and had hepatitis B envelope antigen (HBeAg) seroconversion. On sulfur colloid (SC) scintigraphy, the liver/spleen ratio of non-responders was significantly lower than responders (median values: 0.69 vs. 1.16, p=0.01) but on hepatobiliary scintigraphy no statistically significant parameters were found to predict response to interferon therapy. (author)

  3. Hepatobiliary imaging

    International Nuclear Information System (INIS)

    Klingensmith, W.C.

    1988-01-01

    If the gallbladder is not being evaluated, no patient preparation is necessary. However, if the gallbladder is being evaluated, the patient must have fasted for approximately 2-14 hr prior to injection of the radiopharmaceutical. If the patient has fasted for less than 2 hr. the gallbladder may still be contracting and, thus, prevent the inflow of radioactive bile. On the other hand, if the patient has fasted for more than 14 hr. the gallbladder may have concentrated its contents to the point where the osmotic gradient prevents further reabsorption of water. The author discusses how, in this situation, an analog of cholecystokinin-pancreazymin such as sincalide can be given intravenously approximately 20 min before injection of the radiopharmaceutical. This agent will cause the gallbladder to empty so that reabsorption of water and filling of the gallbladder can begin again

  4. Gadoxetic acid-enhanced 3.0 T MRI for the evaluation of hepatic metastasis from colorectal cancer: Metastasis is not always seen as a “defect” on the hepatobiliary phase

    International Nuclear Information System (INIS)

    Kim, Aram; Lee, Chang Hee; Kim, Baek Hui; Lee, Jongmee; Choi, Jae Woong; Park, Yang Shin; Kim, Kyeong Ah; Park, Cheol Min

    2012-01-01

    Purpose: To determine specific imaging features of hepatic metastasis from colorectal cancer, focusing on the hepatobiliary phase (HBP) of gadoxetic acid-enhanced MRI. Materials and methods: Over a 2-year period, 79 hepatic metastatic lesions were identified from 32 patients (22 men and 10 women) who proven colorectal cancer and underwent gadoxetic acid-enhanced 3.0 T MRI. Hepatic metastases were proven pathologically in 16 patients: by surgical liver resection (n = 14) and by US-guided biopsy (n = 2). The remaining 16 patients were considered to have hepatic metastasis based on imaging studies and clinical information. Two radiologists evaluated the imaging features of each MRI sequence, including high resolution T2WI, dynamic contrast enhancement study with hepatobiliary phase, and diffusion weighted image. We also compared SI of the lesions on T2WI and HBP. Results: T2WI showed homogeneous high SI (n = 25; 31.7%), target appearance (n = 3; 3.8%), reversed target appearance (n = 2; 2.6%), and heterogeneously high SI (n = 49; 62%). On HBP, homogeneous defect were seen in 22 lesions (27.9%), target appearance in five lesions (6.4%), reversed target appearance in two lesions (2.5%), and heterogeneous defect in 50 lesions (63.3%); including reticular (70%), partially globular (26%), and diffuse GGO-like (4%) patterns. According to the imaging features on HBP, the homogeneous defect and heterogeneous defect groups had a mean ADC value of 0.99 × 10 −3 and 1.07 × 10 −3 mm 2 /s, respectively, without statistically significant difference. Conclusion: Hepatic metastasis from colorectal cancer usually showed as a heterogeneous defect on HBP and a heterogeneous high SI on T2WI. The generally accepted “true defect” was not a common finding in hepatic metastasis from colorectal cancer.

  5. Gadoxetic acid-enhanced 3.0 T MRI for the evaluation of hepatic metastasis from colorectal cancer: Metastasis is not always seen as a “defect” on the hepatobiliary phase

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Aram, E-mail: arkim.rad@gmail.com [Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, 80 Guro-dong, Guro-gu, Seoul 152-703 (Korea, Republic of); Lee, Chang Hee, E-mail: chlee86@hanmail.net [Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, 80 Guro-dong, Guro-gu, Seoul 152-703 (Korea, Republic of); Kim, Baek Hui, E-mail: maelstrom@naver.com [Department of Pathology, Korea University Guro Hospital, Korea University College of Medicine, 80 Guro-dong, Guro-gu, Seoul 152-703 (Korea, Republic of); Lee, Jongmee, E-mail: leejongmee@hanmail.net [Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, 80 Guro-dong, Guro-gu, Seoul 152-703 (Korea, Republic of); Choi, Jae Woong, E-mail: cooljay@korea.ac.kr [Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, 80 Guro-dong, Guro-gu, Seoul 152-703 (Korea, Republic of); Park, Yang Shin, E-mail: pys797979@naver.com [Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, 80 Guro-dong, Guro-gu, Seoul 152-703 (Korea, Republic of); Kim, Kyeong Ah, E-mail: kahkim@korea.ac.kr [Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, 80 Guro-dong, Guro-gu, Seoul 152-703 (Korea, Republic of); Park, Cheol Min, E-mail: chlee86@gmail.com [Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, 80 Guro-dong, Guro-gu, Seoul 152-703 (Korea, Republic of)

    2012-12-15

    Purpose: To determine specific imaging features of hepatic metastasis from colorectal cancer, focusing on the hepatobiliary phase (HBP) of gadoxetic acid-enhanced MRI. Materials and methods: Over a 2-year period, 79 hepatic metastatic lesions were identified from 32 patients (22 men and 10 women) who proven colorectal cancer and underwent gadoxetic acid-enhanced 3.0 T MRI. Hepatic metastases were proven pathologically in 16 patients: by surgical liver resection (n = 14) and by US-guided biopsy (n = 2). The remaining 16 patients were considered to have hepatic metastasis based on imaging studies and clinical information. Two radiologists evaluated the imaging features of each MRI sequence, including high resolution T2WI, dynamic contrast enhancement study with hepatobiliary phase, and diffusion weighted image. We also compared SI of the lesions on T2WI and HBP. Results: T2WI showed homogeneous high SI (n = 25; 31.7%), target appearance (n = 3; 3.8%), reversed target appearance (n = 2; 2.6%), and heterogeneously high SI (n = 49; 62%). On HBP, homogeneous defect were seen in 22 lesions (27.9%), target appearance in five lesions (6.4%), reversed target appearance in two lesions (2.5%), and heterogeneous defect in 50 lesions (63.3%); including reticular (70%), partially globular (26%), and diffuse GGO-like (4%) patterns. According to the imaging features on HBP, the homogeneous defect and heterogeneous defect groups had a mean ADC value of 0.99 × 10{sup −3} and 1.07 × 10{sup −3} mm{sup 2}/s, respectively, without statistically significant difference. Conclusion: Hepatic metastasis from colorectal cancer usually showed as a heterogeneous defect on HBP and a heterogeneous high SI on T2WI. The generally accepted “true defect” was not a common finding in hepatic metastasis from colorectal cancer.

  6. GROWTH HORMONE LEVEL EVOLUTION IN CHILDREN WITH HEPATOBILIARY DISEASES, UNDERGOING LIVER TRANSPLANTATION

    Directory of Open Access Journals (Sweden)

    O. P. Shevchenko

    2012-01-01

    Full Text Available End stage liver disease is often associated with growth retardation in children with congenital and hereditary diseases of hepatobiliary system. The aim was to investigate the serum growth hormone level before and after liver transplantation in 52 children with congenital and hereditary diseases of hepatobiliary system. Data of our research work revealed increased serum level of growth hormone in children with liver cirrhosis (3,32 ± 7,7 ng/ml vs. 1,16 ± 1,46 ng/ml in healthy children, p = 0,01, which correlates with PELD score (r = 0,62, p < 0,001. In a month after liver transplantation growth hormone concentration decreases (p < 0,001 and in a year after transplantation it doesn’t differ from healthy children. There wasn’t revealed any interaction between serum growth hormone level and anthropometric parameters before liver transplantation, but in a year after there was significant correlation between growth hormone concentration and height (r = 0,79, p = 0,01. Investigation of growth hormone level in children with liver cirrhosis and its evolution after liver transplantation is of interest as objective criterion of recovery of physical development regulation and as an additional parameter, which cor- relates with severity of end-stage liver disease. 

  7. Interactions between Bacteria and Bile Salts in the Gastrointestinal and Hepatobiliary Tracts

    Directory of Open Access Journals (Sweden)

    Verónica Urdaneta

    2017-10-01

    Full Text Available Bile salts and bacteria have intricate relationships. The composition of the intestinal pool of bile salts is shaped by bacterial metabolism. In turn, bile salts play a role in intestinal homeostasis by controlling the size and the composition of the intestinal microbiota. As a consequence, alteration of the microbiome–bile salt homeostasis can play a role in hepatic and gastrointestinal pathological conditions. Intestinal bacteria use bile salts as environmental signals and in certain cases as nutrients and electron acceptors. However, bile salts are antibacterial compounds that disrupt bacterial membranes, denature proteins, chelate iron and calcium, cause oxidative damage to DNA, and control the expression of eukaryotic genes involved in host defense and immunity. Bacterial species adapted to the mammalian gut are able to endure the antibacterial activities of bile salts by multiple physiological adjustments that include remodeling of the cell envelope and activation of efflux systems and stress responses. Resistance to bile salts permits that certain bile-resistant pathogens can colonize the hepatobiliary tract, and an outstanding example is the chronic infection of the gall bladder by Salmonella enterica. A better understanding of the interactions between bacteria and bile salts may inspire novel therapeutic strategies for gastrointestinal and hepatobiliary diseases that involve microbiome alteration, as well as novel schemes against bacterial infections.

  8. Hepatobiliary scintigraphy with 99mTc-PIPIDA in the evaluation of neonatal jaundice

    International Nuclear Information System (INIS)

    Majd, M.; Reba, R.C.; Altman, R.P.

    1981-01-01

    Hepatobiliary scintigraphy with technetium 99m-labeled p-isopropylacetanilido iminodiacetic acid (99mTc-PIPIDA) was used to evaluate 22 neonates with mixed jaundice. Ten patients were proved to have biliary atresia; ten others were diagnosed as having neonatal hepatitis. In the remaining two, jaundice was secondary to prolonged hyperalimentation. Initial studies in all ten patients with biliary atresia showed no evidence of excretion of the tracer into the intestinal tract. Following three to seven days of oral administration of phenobarbital, repeat studies were performed in six of the ten patients. None showed evidence of excretion. Initial studies of the 12 patients with intrahepatic cholestasis showed definite excretion in five, questionable evidence of excretion in two, and no demonstrable excretion in five. Studies after phenobarbital therapy in five of the seven patients with questionable or no excretion on the initial studies showed definite excretion in four. Only in one patient who had poor hepatic extraction did the phenobarbital therapy not change the scintigraphic pattern. The authors conclude that hepatobiliary scintigraphy with 99mTc-PIPIDA after three to seven days of phenobarbital therapy is a highly accurate test for differentiating biliary atresia from other causes of neonatal jaundice

  9. Rest delayed images on 99mTc-MIBI myocardial SPECT as a noninvasive screen for the diagnosis of vasospastic angina pectoris

    International Nuclear Information System (INIS)

    Ono, Soichi; Yamaguchi, Hiroyuki; Takayama, Shin; Kurabe, Atsushi; Heito, Takayuki

    2002-01-01

    Diagnostic usefulness of 99m Tc-hexakis-2-methoxy isobutyl isonitrile (MIBI) myocardial SPECT at rest was examined in 39 cases of coronary vasospastic angina pectoris who were diagnosed by a positive reaction to ergonovine provocation. SPECT was performed 45 minutes (early image) and 3 hours (delayed image) after the intravenous injection of approximately 600 MBq of MIBI. Decrease in accumulation was ranked by four defect scores (0: normal; 1: slight decrease; 2: moderate decrease; 3: severe decrease) and the total defect score was evaluated semiquantitatively. The washout rate between the normal area and the spasm area was also evaluated quantitatively using bull's eye. As a result, 15 cases (15/39; 38.4%) showed decreased accumulation in the early image and 27 cases (27/39; 69.2%) showed decreased accumulation in the delayed image. All of the cases which showed decreased accumulation in the early image had decreased accumulation in the delayed image as well. In 6 cases (6/34; 17.6%) showed ST wave changes during exercise ECG and 16 cases (16/34: 47%) showed decreased accumulation in the exercise myocardial SPECT. The washout rate of MIBI in the decreased accumulation area was significantly higher than that of the normal area. Of 32 ergonovine induced vasospastic area, 23 areas (72%) exhibited decreased accumulation in the delayed image for the same area. Decreased accumulation in the delayed image in MIBI was due to the enhanced washout, which, in turn, indicated declined retention of MIBI by mitochondrial membrane. In coronary vasospastic angina pectoris, spasm induced ischemia was thought to have an effect on the mitochondria. This study suggested that even with a normal exercise ECG and exercise myocardial SPECT, there's a strong possibility of coronary vasospastic angina pectoris if a decreased accumulation was found in the delayed image in the MIBI myocardial SPECT at rest. Hence, in diagnosing coronary vasospastic angina pectoris, the delayed image in the

  10. Delayed contrast enhancement imaging of a murine model for ischemia reperfusion with carbon nanotube micro-CT.

    Directory of Open Access Journals (Sweden)

    Laurel M Burk

    Full Text Available We aim to demonstrate the application of free-breathing prospectively gated carbon nanotube (CNT micro-CT by evaluating a myocardial infarction model with a delayed contrast enhancement technique. Evaluation of murine cardiac models using micro-CT imaging has historically been limited by extreme imaging requirements. Newly-developed CNT-based x-ray sources offer precise temporal resolution, allowing elimination of physiological motion through prospective gating. Using free-breathing, cardiac-gated CNT micro-CT, a myocardial infarction model can be studied non-invasively and with high resolution. Myocardial infarction was induced in eight male C57BL/6 mice aged 8-12 weeks. The ischemia reperfusion model was achieved by surgically occluding the LAD artery for 30 minutes followed by 24 hours of reperfusion. Tail vein catheters were placed for contrast administration. Iohexol 300 mgI/mL was administered followed by images obtained in diastole. Iodinated lipid blood pool contrast agent was then administered, followed with images at systole and diastole. Respiratory and cardiac signals were monitored externally and used to gate the scans of free-breathing subjects. Seven control animals were scanned using the same imaging protocol. After imaging, the heart was harvested, cut into 1mm slices and stained with TTC. Post-processing analysis was performed using ITK-Snap and MATLAB. All animals demonstrated obvious delayed contrast enhancement in the left ventricular wall following the Iohexol injection. The blood pool contrast agent revealed significant changes in cardiac function quantified by 3-D volume ejection fractions. All subjects demonstrated areas of myocardial infarct in the LAD distribution on both TTC staining and micro-CT imaging. The CNT micro-CT system aids straightforward, free-breathing, prospectively-gated 3-D murine cardiac imaging. Delayed contrast enhancement allows identification of infarcted myocardium after a myocardial ischemic

  11. Bit-level plane image encryption based on coupled map lattice with time-varying delay

    Science.gov (United States)

    Lv, Xiupin; Liao, Xiaofeng; Yang, Bo

    2018-04-01

    Most of the existing image encryption algorithms had two basic properties: confusion and diffusion in a pixel-level plane based on various chaotic systems. Actually, permutation in a pixel-level plane could not change the statistical characteristics of an image, and many of the existing color image encryption schemes utilized the same method to encrypt R, G and B components, which means that the three color components of a color image are processed three times independently. Additionally, dynamical performance of a single chaotic system degrades greatly with finite precisions in computer simulations. In this paper, a novel coupled map lattice with time-varying delay therefore is applied in color images bit-level plane encryption to solve the above issues. Spatiotemporal chaotic system with both much longer period in digitalization and much excellent performances in cryptography is recommended. Time-varying delay embedded in coupled map lattice enhances dynamical behaviors of the system. Bit-level plane image encryption algorithm has greatly reduced the statistical characteristics of an image through the scrambling processing. The R, G and B components cross and mix with one another, which reduces the correlation among the three components. Finally, simulations are carried out and all the experimental results illustrate that the proposed image encryption algorithm is highly secure, and at the same time, also demonstrates superior performance.

  12. Dynamic hepatobiliary scintigraphy using EHIDA and HIDA

    International Nuclear Information System (INIS)

    Radtke, J.

    1980-01-01

    Data of 9 healthy test persons studied on an empty stomach using EHIDA and HIDA were analyzed in order to determine the influence of a region of interest on the shape of heart and liver function curves. The kinetics of EHIDA and HIDA in these 9 test persons showed marked differences in the passage of the hepatobiliary system and in plasma kinetics but not in renal urinary excretion. Further, functional histograms of the heart, liver, gall bladder, and duodenum of 25 healthy patients were established after meals and administration of EHIDA or HIDA. The parameters derived from these functional histograms did not differ significantly from the data of the test persons examined on an empty stomach. Also, the time interval since the last meal was found to be negligible. In 3 healthy test persons, the injected concentration of the radiopharmaceutical was increased to 8 times the standard dose. There was no significant change in HIDA kinetics except for a more rapid excretion into the intestine. In 7 healthy test persons, a comparative study was carried out of HIDA kinetics with and without decholine premedication. The normal collectives were compared with 118 patients with different morphological and functional findings. However, this method was not superior to sequential scintiscanning. Differential diagnosis of parenchymal and obstructive jaundice using the liver function curve is possible only in the acute stage in consideration of the analogue scintiscanning images. The data of the 9 healthy test persons were also used to assess the usefulness of EDP in eliminating statistical variations of the functional curves and in determining descriptive parameters. Curve smoothing by data bounding resulted in reproducible values, and the systematic error introduced by estination was avoided. (orig./MG) [de

  13. Exercising the hepatobiliary-gut axis. The impact of physical activity performance.

    Science.gov (United States)

    Molina-Molina, Emilio; Lunardi Baccetto, Raquel; Wang, David Q-H; de Bari, Ornella; Krawczyk, Marcin; Portincasa, Piero

    2018-05-24

    Physical inactivity puts the populations at risk of several health problems, while regular physical activity brings beneficial effects on cardiovascular disease, mortality and other health outcomes, including obesity, glycaemic control and insulin resistance. The hepatobiliary tract is greatly involved in several metabolic aspects which include digestion and absorption of nutrients in concert with intestinal motility, bile acid secretion and flow across the enterohepatic circulation and intestinal microbiota. Several metabolic abnormalities, including nonalcoholic fatty liver as well as cholesterol cholelithiasis, represent two conditions explained by changes of the aforementioned pathways. This review defines different training modalities and discusses the effects of physical activity in two metabolic disorders, that is nonalcoholic fatty liver disease (NAFLD) and cholelithiasis. Emphasis is given to pathogenic mechanisms involving intestinal bile acids, microbiota and inflammatory status. A full definition of physical activity includes the knowledge of aerobic and endurance exercise, metabolic equivalent tasks, duration, frequency and intensity, beneficial and harmful effects. Physical activity influences the hepatobiliary-gut axis at different levels and brings benefits to fat distribution, liver fat and gallbladder disease while interacting with bile acids as signalling molecules, intestinal microbiota and inflammatory changes in the body. Several beneficial effects of physical activity are anticipated on metabolic disorders linking liver steatosis, gallstone disease, gut motility, enterohepatic circulation of signalling bile acids in relation to intestinal microbiota and inflammatory changes. © 2018 Stichting European Society for Clinical Investigation Journal Foundation.

  14. Hepatobiliary scanning in cardiac transplant patients maintained on cyclosporine

    International Nuclear Information System (INIS)

    Dhekne, R.D.; Long, S.E.; Moore, W.H.; Frazier, O.H.

    1987-01-01

    Many patients receiving cyclosporine (CSA) develop hepatic dysfunction or pancreatitis. The authors reviewed 106 records of cardiac transplant patients maintained on CSA. Eleven patients underwent 16 hepatobiliary scans (HBSs) for abdominal pain and/or abnormal liver function. Of 16 HBSs, ten demonstrated normal gallbladder visualization. Follow-up in all cases confirmed scan findings. Five patients had no gallbladder visualization; confirmation of acute cholecystitis was obtained by surgery in two and by autopsy in three. One patient had previous cholecystectomy. The authors found HPS useful for evaluating acute cholecystitis in patients receiving CSA with or without associated drug-related pancreatitis and hepatic insufficiency and suggest that HBS can assist in the selection of patients for CSA dose adjustment

  15. 99m Tc-DISIDA hepatobiliary scintigram in evaluation of clonorchis sinensis infestation in endemic region

    International Nuclear Information System (INIS)

    Yum, Ha Yong

    1985-01-01

    This study was performed to evaluate clinical utilization of 99 mTc-DISIDA scintigraphy in detection of Cs-infestation and its complication as well as combined disease in liver, in comparison with detection rate of Cs-stool ova and to describe unique pattern of hepatobiliary bile flow found on the study. (Author)

  16. Magnetic resonance imaging (MRI) evaluation of developmental delay in pediatric patients.

    Science.gov (United States)

    Ali, Althaf S; Syed, Naziya P; Murthy, G S N; Nori, Madhavi; Abkari, Anand; Pooja, B K; Venkateswarlu, J

    2015-01-01

    Developmental delay is defined as significant delay in one or more developmental domains. Magnetic Resonance Imaging (MRI) is the best modality to investigate such patients. Evaluation of a child with developmental delay is important not only because it allows early diagnosis and treatment but also helpful for parental counseling regarding the outcome of their child and to identify any possible risk of recurrence in the siblings. Thus this study was undertaken to evaluate the developmental delay in Indian children which will help the clinicians in providing an estimation of the child's ultimate developmental potential and organize specific treatment requirement and also relieve parental apprehension. To study the prevalence of normal and abnormal MRI in pediatric patients presenting with developmental delay and further categorize the abnormal MRI based on its morphological features. It is a prospective, observational & descriptive study of MRI Brain in 81 paediatric patients (46 Males and 35 Females), aged between three months to 12 years; presenting with developmental delay in Deccan College of Medical Sciences, Hyderabad; over a period of three years (Sept 2011 to Sept 2014). MRI brain was done on 1.5T Siemens Magnetom Essenza & 0.35T Magnetom C with appropriate sequences and planes after making the child sleep/sedated/ anesthetized. Various anatomical structures like Ventricles, Corpus callosum, etc were systematically assessed. The MRI findings were divided into various aetiological subgroups. Normal MRI findings were seen in 32% cases and 68% had abnormal findings of which the proportion of Traumatic/ Neurovascular Diseases, Congenital & Developmental, Metabolic and Degenerative, neoplastic and non specific were 31%, 17%, 10%, 2.5% and 7.5% respectively. The ventricles and white matter mainly the corpus callosum were the most commonly affected anatomical structures. The diagnostic yield was found to be 68% and higher yield was seen in patients presenting with

  17. Precision cosmology with time delay lenses: high resolution imaging requirements

    Energy Technology Data Exchange (ETDEWEB)

    Meng, Xiao-Lei; Liao, Kai [Department of Astronomy, Beijing Normal University, 19 Xinjiekouwai Street, Beijing, 100875 (China); Treu, Tommaso; Agnello, Adriano [Department of Physics, University of California, Broida Hall, Santa Barbara, CA 93106 (United States); Auger, Matthew W. [Institute of Astronomy, University of Cambridge, Madingley Road, Cambridge CB3 0HA (United Kingdom); Marshall, Philip J., E-mail: xlmeng919@gmail.com, E-mail: tt@astro.ucla.edu, E-mail: aagnello@physics.ucsb.edu, E-mail: mauger@ast.cam.ac.uk, E-mail: liaokai@mail.bnu.edu.cn, E-mail: dr.phil.marshall@gmail.com [Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, 452 Lomita Mall, Stanford, CA 94305 (United States)

    2015-09-01

    Lens time delays are a powerful probe of cosmology, provided that the gravitational potential of the main deflector can be modeled with sufficient precision. Recent work has shown that this can be achieved by detailed modeling of the host galaxies of lensed quasars, which appear as ''Einstein Rings'' in high resolution images. The distortion of these arcs and counter-arcs, as measured over a large number of pixels, provides tight constraints on the difference between the gravitational potential between the quasar image positions, and thus on cosmology in combination with the measured time delay. We carry out a systematic exploration of the high resolution imaging required to exploit the thousands of lensed quasars that will be discovered by current and upcoming surveys with the next decade. Specifically, we simulate realistic lens systems as imaged by the Hubble Space Telescope (HST), James Webb Space Telescope (JWST), and ground based adaptive optics images taken with Keck or the Thirty Meter Telescope (TMT). We compare the performance of these pointed observations with that of images taken by the Euclid (VIS), Wide-Field Infrared Survey Telescope (WFIRST) and Large Synoptic Survey Telescope (LSST) surveys. We use as our metric the precision with which the slope γ' of the total mass density profile ρ{sub tot}∝ r{sup −γ'} for the main deflector can be measured. Ideally, we require that the statistical error on γ' be less than 0.02, such that it is subdominant to other sources of random and systematic uncertainties. We find that survey data will likely have sufficient depth and resolution to meet the target only for the brighter gravitational lens systems, comparable to those discovered by the SDSS survey. For fainter systems, that will be discovered by current and future surveys, targeted follow-up will be required. However, the exposure time required with upcoming facilitites such as JWST, the Keck Next Generation

  18. Precision cosmology with time delay lenses: High resolution imaging requirements

    Energy Technology Data Exchange (ETDEWEB)

    Meng, Xiao -Lei [Beijing Normal Univ., Beijing (China); Univ. of California, Santa Barbara, CA (United States); Treu, Tommaso [Univ. of California, Santa Barbara, CA (United States); Univ. of California, Los Angeles, CA (United States); Agnello, Adriano [Univ. of California, Santa Barbara, CA (United States); Univ. of California, Los Angeles, CA (United States); Auger, Matthew W. [Univ. of Cambridge, Cambridge (United Kingdom); Liao, Kai [Beijing Normal Univ., Beijing (China); Univ. of California, Santa Barbara, CA (United States); Univ. of California, Los Angeles, CA (United States); Marshall, Philip J. [Stanford Univ., Stanford, CA (United States)

    2015-09-28

    Lens time delays are a powerful probe of cosmology, provided that the gravitational potential of the main deflector can be modeled with sufficient precision. Recent work has shown that this can be achieved by detailed modeling of the host galaxies of lensed quasars, which appear as ``Einstein Rings'' in high resolution images. The distortion of these arcs and counter-arcs, as measured over a large number of pixels, provides tight constraints on the difference between the gravitational potential between the quasar image positions, and thus on cosmology in combination with the measured time delay. We carry out a systematic exploration of the high resolution imaging required to exploit the thousands of lensed quasars that will be discovered by current and upcoming surveys with the next decade. Specifically, we simulate realistic lens systems as imaged by the Hubble Space Telescope (HST), James Webb Space Telescope (JWST), and ground based adaptive optics images taken with Keck or the Thirty Meter Telescope (TMT). We compare the performance of these pointed observations with that of images taken by the Euclid (VIS), Wide-Field Infrared Survey Telescope (WFIRST) and Large Synoptic Survey Telescope (LSST) surveys. We use as our metric the precision with which the slope γ' of the total mass density profile ρtot∝ r–γ' for the main deflector can be measured. Ideally, we require that the statistical error on γ' be less than 0.02, such that it is subdominant to other sources of random and systematic uncertainties. We find that survey data will likely have sufficient depth and resolution to meet the target only for the brighter gravitational lens systems, comparable to those discovered by the SDSS survey. For fainter systems, that will be discovered by current and future surveys, targeted follow-up will be required. Furthermore, the exposure time required with upcoming facilitites such as JWST, the Keck Next Generation Adaptive

  19. New cholescintigraphic agent: ruthenium-97-DISIDA

    Energy Technology Data Exchange (ETDEWEB)

    Zanzi, I.; Srivastava, S.C.; Meinken, G,E.; Robeson, W.; Mausner, L.F.; Fairchild, R.G.; Margouleff, D.

    1986-06-01

    These studies demonstrate the first application of Ru-97-DISIDA in human subjects. High quality images were obtained. Scintigraphic findings in patients with hepatobiliary disorders were consistent with the biodistribution data obtained in experinmental animals and with other imaging procedures and clinical findings. Administration of Ru-97-DISIDA I.V. and of a solid test meal labeled with Tc-99m-Sulfur Colloid allowed simulateneous detection and quantification of deodenogastric reflux and determination of the gastric emptying rate. This represents an advantage as compared to the currently used techniques which necessitate two separate studies if a solid meal is used, or would mandate a liquid meal for a simultaneous study. The excellent nuclear decay characteristics of Ru-97 (tl/2 69.6 h, gamma 216 keV, 86%, no betas) permit delayed study of the hepatobiliary system with considerably less radiation exposure than I-131 Rose Bengal and with a marked improvement in image quality. 5 refs., 3 figs., 3 tabs.

  20. Relevance of I-BMIPP delayed scintigraphic imaging for patients with angina pectoris - a pilot study.

    Science.gov (United States)

    Koyama, Kohei; Akashi, Yoshihiro J; Kida, Keisuke; Suzuki, Kengo; Ishibashi, Yuki; Musha, Haruki; Banach, Maciej

    2011-06-01

    The study was designed to clarify the role of (123)I-β-methyl-iodophenylpentadecanoic acid ((123)I-BMIPP) in the evaluation of myocardial fatty acid metabolism in patients with stable angina pectoris (AP) before and after percutaneous coronary intervention (PCI). TEN CONTROLS (MEAN AGE: 70.4 ±10.5 years) and 12 patients with AP (mean age: 67.4 ±11.6 years) and single vessel coronary artery disease participated in the radionuclide cardiac study. Scintigraphic images were acquired at 30 min and at 4 h after (123)I-BMIPP injection to determine early and delayed BMIPP uptake, respectively. The heart-to-mediastinum (H/M) ratio and the washout rate (WR) were calculated from the planar images. All patients underwent scintigraphy one day before PCI and again 1 month after successful PCI. NO SIGNIFICANT DIFFERENCES IN THE EARLY OR DELAYED H/M RATIOS WERE OBSERVED BETWEEN THE PATIENTS AND THE CONTROLS BEFORE PCI (EARLY: 2.70 ±0.36 vs. 2.73 ±0.57; delayed: 2.26 ±0.33 vs. 2.40 ±0.43; p > 0.2 for both). The early and delayed H/M ratios remained unchanged with the comparison with before PCI (early: 2.72 ±0.27, delayed: 2.23 ±0.22; p > 0.2 for both). The global WR before PCI was significantly higher in the patients than in the control group (36.7 ±9.3%, vs. 28.1 ±8.2%, p = 0.02). However, the WR after PCI did not significantly differ between the patients and the controls (34.3 ±7.8% vs. 28.1 ±8.2%, p = 0.1). These data may suggest that the WR of (123)I-BMIPP determined from the planar images enhances the presence of myocardial ischaemia.

  1. Double-Stage Delay Multiply and Sum Beamforming Algorithm: Application to Linear-Array Photoacoustic Imaging.

    Science.gov (United States)

    Mozaffarzadeh, Moein; Mahloojifar, Ali; Orooji, Mahdi; Adabi, Saba; Nasiriavanaki, Mohammadreza

    2018-01-01

    Photoacoustic imaging (PAI) is an emerging medical imaging modality capable of providing high spatial resolution of Ultrasound (US) imaging and high contrast of optical imaging. Delay-and-Sum (DAS) is the most common beamforming algorithm in PAI. However, using DAS beamformer leads to low resolution images and considerable contribution of off-axis signals. A new paradigm namely delay-multiply-and-sum (DMAS), which was originally used as a reconstruction algorithm in confocal microwave imaging, was introduced to overcome the challenges in DAS. DMAS was used in PAI systems and it was shown that this algorithm results in resolution improvement and sidelobe degrading. However, DMAS is still sensitive to high levels of noise, and resolution improvement is not satisfying. Here, we propose a novel algorithm based on DAS algebra inside DMAS formula expansion, double stage DMAS (DS-DMAS), which improves the image resolution and levels of sidelobe, and is much less sensitive to high level of noise compared to DMAS. The performance of DS-DMAS algorithm is evaluated numerically and experimentally. The resulted images are evaluated qualitatively and quantitatively using established quality metrics including signal-to-noise ratio (SNR), full-width-half-maximum (FWHM) and contrast ratio (CR). It is shown that DS-DMAS outperforms DAS and DMAS at the expense of higher computational load. DS-DMAS reduces the lateral valley for about 15 dB and improves the SNR and FWHM better than 13% and 30%, respectively. Moreover, the levels of sidelobe are reduced for about 10 dB in comparison with those in DMAS.

  2. Linear-Array Photoacoustic Imaging Using Minimum Variance-Based Delay Multiply and Sum Adaptive Beamforming Algorithm

    OpenAIRE

    Mozaffarzadeh, Moein; Mahloojifar, Ali; Orooji, Mahdi; Kratkiewicz, Karl; Adabi, Saba; Nasiriavanaki, Mohammadreza

    2017-01-01

    In Photoacoustic imaging (PA), Delay-and-Sum (DAS) beamformer is a common beamforming algorithm having a simple implementation. However, it results in a poor resolution and high sidelobes. To address these challenges, a new algorithm namely Delay-Multiply-and-Sum (DMAS) was introduced having lower sidelobes compared to DAS. To improve the resolution of DMAS, a novel beamformer is introduced using Minimum Variance (MV) adaptive beamforming combined with DMAS, so-called Minimum Variance-Based D...

  3. Gadoxetic acid-enhanced magnetic resonance imaging characteristics of hepatocellular carcinoma occurring in liver transplants

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Mimi [Sungkyunkwan University School of Medicine, Department of Radiology and Center for Imaging Science, Samsung Medical Center, Seoul (Korea, Republic of); Hanyang University of Hospital, Department of Radiology, Seoul (Korea, Republic of); Kang, Tae Wook; Jeong, Woo Kyoung; Kim, Young Kon; Kim, Seong Hyun [Sungkyunkwan University School of Medicine, Department of Radiology and Center for Imaging Science, Samsung Medical Center, Seoul (Korea, Republic of); Kim, Jong Man [Sungkyunkwan University School of Medicine, Department of Surgery, Samsung Medical Center, Seoul (Korea, Republic of); Sinn, Dong Hyun [Sungkyunkwan University School of Medicine, Division of hepatology, Department of Medicine, Samsung Medical Center, Seoul (Korea, Republic of); Kim, Min-Ji; Jung, Sin-ho [Samsung Medical Center, Biostatics and Clinical Epidemiology Center, Seoul (Korea, Republic of)

    2017-08-15

    Characteristics of hepatocellular carcinoma (HCC) on magnetic resonance (MR) images were compared in patients who did or did not undergo liver transplantation (LT), and we evaluated the relationship of these findings with overall survival (OS) and time-to-tumour recurrence (TTR) after transplantation. The enhancement pattern of gadoxetic acid-enhanced MR images of 25 patients with recurrent HCCs (LT group) and 25 surgically confirmed HCC patients in the non-transplanted (control) group were compared. Typical enhancement was defined as 1) arterial enhancement and delayed wash-out and 2) absence of typical features of cholangiocarcinoma consisting of arterial rim enhancement and target appearance on hepatobiliary phase images. OS and TTR were analyzed in the LT group according to these patterns using the log-rank test. HCCs in the LT group significantly more often had an atypical enhancement pattern (16/25, 64.0%) than those in the control group (5/25, 20.0%; p = 0.004). However, OS and TTR did not differ significantly according to these enhancement patterns of recurrent HCC (p > 0.05). Although enhancement patterns of recurrent HCC in transplanted liver did not affect OS and TTR, these HCCs that arise after LT frequently revealed atypical enhancement on gadoxetic acid-enhanced MR imaging. (orig.)

  4. Gadoxetic acid-enhanced magnetic resonance imaging characteristics of hepatocellular carcinoma occurring in liver transplants

    International Nuclear Information System (INIS)

    Kim, Mimi; Kang, Tae Wook; Jeong, Woo Kyoung; Kim, Young Kon; Kim, Seong Hyun; Kim, Jong Man; Sinn, Dong Hyun; Kim, Min-Ji; Jung, Sin-ho

    2017-01-01

    Characteristics of hepatocellular carcinoma (HCC) on magnetic resonance (MR) images were compared in patients who did or did not undergo liver transplantation (LT), and we evaluated the relationship of these findings with overall survival (OS) and time-to-tumour recurrence (TTR) after transplantation. The enhancement pattern of gadoxetic acid-enhanced MR images of 25 patients with recurrent HCCs (LT group) and 25 surgically confirmed HCC patients in the non-transplanted (control) group were compared. Typical enhancement was defined as 1) arterial enhancement and delayed wash-out and 2) absence of typical features of cholangiocarcinoma consisting of arterial rim enhancement and target appearance on hepatobiliary phase images. OS and TTR were analyzed in the LT group according to these patterns using the log-rank test. HCCs in the LT group significantly more often had an atypical enhancement pattern (16/25, 64.0%) than those in the control group (5/25, 20.0%; p = 0.004). However, OS and TTR did not differ significantly according to these enhancement patterns of recurrent HCC (p > 0.05). Although enhancement patterns of recurrent HCC in transplanted liver did not affect OS and TTR, these HCCs that arise after LT frequently revealed atypical enhancement on gadoxetic acid-enhanced MR imaging. (orig.)

  5. Evaluating Hepatobiliary Transport with 18F-Labeled Bile Acids: The Effect of Radiolabel Position and Bile Acid Structure on Radiosynthesis and In Vitro and In Vivo Performance

    Directory of Open Access Journals (Sweden)

    Stef De Lombaerde

    2018-01-01

    Full Text Available Introduction. An in vivo determination of bile acid hepatobiliary transport efficiency can be of use in liver disease and preclinical drug development. Given the increased interest in bile acid Positron Emission Tomography- (PET- imaging, a further understanding of the impact of 18-fluorine substitution on bile acid handling in vitro and in vivo can be of significance. Methods. A number of bile acid analogues were conceived for nucleophilic substitution with [18F]fluoride: cholic acid analogues of which the 3-, 7-, or 12-OH function is substituted with a fluorine atom (3α-[18F]FCA; 7β-[18F]FCA; 12β-[18F]FCA; a glycocholic and chenodeoxycholic acid analogue, substituted on the 3-position (3β-[18F]FGCA and 3β-[18F]FCDCA, resp.. Uptake by the bile acid transporters NTCP and OATP1B1 was evaluated with competition assays in transfected CHO and HEK cell lines and efflux by BSEP in membrane vesicles. PET-scans with the tracers were performed in wild-type mice (n=3 per group: hepatobiliary transport was monitored and compared to a reference tracer, namely, 3β-[18F]FCA. Results. Compounds 3α-[18F]FCA, 3β-[18F]FGCA, and 3β-[18F]FCDCA were synthesized in moderate radiochemical yields (4–10% n.d.c. and high radiochemical purity (>99%; 7β-[18F]FCA and 12β-[18F]FCA could not be synthesized and included further in this study. In vitro evaluation showed that 3α-FCA, 3β-FGCA, and 3β-FCDCA all had a low micromolar Ki-value for NTCP, OATP1B1, and BSEP. In vivo, 3α-[18F]FCA, 3β-[18F]FGCA, and 3β-[18F]FCDCA displayed hepatobiliary transport with varying efficiency. A slight yet significant difference in uptake and efflux rate was noticed between the 3α-[18F]FCA and 3β-[18F]FCA epimers. Conjugation of 3β-[18F]FCA with glycine had no significant effect in vivo. Compound 3β-[18F]FCDCA showed a significantly slower hepatic uptake and efflux towards gallbladder and intestines. Conclusion. A set of 18F labeled bile acids was synthesized that are

  6. Update on radionuclide imaging in hepatobiliary disease

    International Nuclear Information System (INIS)

    Rosenthall, L.

    1981-01-01

    The recent introduction of technetium Tc 99m-labeled acetanilide iminodiacetic acid (/sup 99m/Tc-IDA) analogues has facilitated the clincal study of the bile flow pathways. A variety of /sup 99m/Tc-IDA derivaties are under investigation. Basically all are metabolized by the hepatocyte and immediately thereafter excreted unconjugated into the biliary tract. Of the various derivatives tested, e.g., dimethyl (lidofenin), diethyl, paraisopropyl (iprofenin), parabutyl (butilfenin), and diisopropyl (disofenin), the last named is the best universal agent at this time. By serial liver imaging the patency of the cystic duct and the integrity of altered cholangiointestinal anatomy can be assessed, leakage of bile and gastric reflux can be disclosed, and medical and surgical jaundice can be distinguished

  7. Evaluation of bile reflux in HIDA images based on fluid mechanics.

    Science.gov (United States)

    Lo, Rong-Chin; Huang, Wen-Lin; Fan, Yu-Ming

    2015-05-01

    We propose a new method to help physicians assess, using a hepatobiliary iminodiacetic acid scan image, whether or not there is bile reflux into the stomach. The degree of bile reflux is an important index for clinical diagnosis of stomach diseases. The proposed method applies image-processing technology combined with a hydrodynamic model to determine the extent of bile reflux or whether the duodenum is also folded above the stomach. This condition in 2D dynamic images suggests that bile refluxes into the stomach, when endoscopy shows no bile reflux. In this study, we used optical flow to analyze images from Tc99m-diisopropyl iminodiacetic acid cholescintigraphy (Tc99m-DISIDA) to ascertain the direction and velocity of bile passing through the pylorus. In clinical diagnoses, single photon emission computed tomography (SPECT) is the main clinical tool for evaluating functional images of hepatobiliary metabolism. Computed tomography (CT) shows anatomical images of the external contours of the stomach, liver, and biliary extent. By exploiting the functional fusion of the two kinds of medical image, physicians can obtain a more accurate diagnosis. We accordingly reconstructed 3D images from SPECT and CT to help physicians choose which cross sections to fuse with software and to help them more accurately diagnose the extent and quantity of bile reflux. Copyright © 2015 Elsevier Ltd. All rights reserved.

  8. Comparison of initial and delayed myocardial imaging with beta-methyl-p-[123I]-iodophenylpentadecanoic acid in acute myocardial infarction

    International Nuclear Information System (INIS)

    Naruse, Hitoshi; Yoshimura, Noriko; Yamamoto, Juro; Morita, Masato; Fukutake, Naoshige; Ohyanagi, Mitsumasa; Iwasaki, Tadaaki; Fukuchi, Minoru

    1994-01-01

    Myocardial imaging using β-methyl-p-[ 123 I]-iodophenylpentadecanoic acid (BMIPP) of 15 patients with acute myocardial infarction was performed to assess 'fill-in' and 'washout' defects in the delayed myocardial image. The initial and delayed images were evaluated by a visual and quantitative washout rate method. Visual judgement found 8/180 (4%) segments showed 'fill-in' defects, and 24/180 segments (13%) showed 'washout' defects. There was no relationship between days from onset to the study and the frequency of fill-in and washout defects. The mean washout rate in the segments with 'fill-in' defects was 9.0±16.6%, and that of 'washout' defects was 24.9±18.1% which was significantly higher than in controls (8.7±15.4%, p<0.05). There was no correlation between mean washout rate and total blood lipids, total cholesterol, triglyceride and HDL-cholesterol. Therefore, neither time from onset nor blood lipids level was related to changes from the initial image to the delayed image. These changes may be due to relative (false) findings due to changes in circumference, and may be based on myocardial characteristics after myocardial infarction and/or reperfusion. (author)

  9. [Comparison of initial and delayed myocardial imaging with beta-methyl-p-[123I]-iodophenylpentadecanoic acid in acute myocardial infarction].

    Science.gov (United States)

    Naruse, H; Yoshimura, N; Yamamoto, J; Morita, M; Fukutake, N; Ohyanagi, M; Iwasaki, T; Fukuchi, M

    1994-01-01

    Myocardial imaging using beta-methyl-p-[123I]-iodophenylpentadecanoic acid (BMIPP) of 15 patients with acute myocardial infarction was performed to assess "fill-in" and "washout" defects in the delayed myocardial image. The initial and delayed images were evaluated by a visual and quantitative washout rate method. Visual judgement found 8/180 (4%) segments showed "fill-in" defects, and 24/180 segments (13%) showed "washout" defects. There was no relationship between days from onset to the study and the frequency of fill-in and washout defects. The mean washout rate in the segments with "fill-in" defects was 9.0 +/- 16.6%, and that of "washout" defects was 24.9 +/- 18.1% which was significantly higher than in controls (8.7 +/- 15.4%, p < 0.05). There was no correlation between mean washout rate and total blood lipids, total cholesterol, triglyceride and HDL-cholesterol. Therefore, neither time from onset nor blood lipids level was related to changes from the initial image to the delayed image. These changes may be due to relative (false) findings due to changes in circumference, and may be based on myocardial characteristics after myocardial infarction and/or reperfusion.

  10. Evaluation of /sup 201/TlCl and delayed scan for thyroid imaging agent

    Energy Technology Data Exchange (ETDEWEB)

    Taniguchi, Tatsuyoshi; Harada, Taneichi; Takahashi, Tatsuo; Senoo, Tsuneaki; Ohtsuka, Nobuaki; Ito, Yasuhiko [Kawasaki Medical School, Kurashiki, Okayama (Japan)

    1982-11-01

    The results of 189 patients with nodular goiter by imaging with /sup 201/TlCl following with sup(99m)TcO/sub 4//sup -/ was presented. Accumulation of /sup 201/TlCl to the corresponding area was observed in 85.5% of cancer, 62.2% of adenoma, 42.5% of adenomatous goiter, and the usefulness of /sup 201/TlCl (early scan) for thyroid imaging agent was recognized. On the other hand, delayed scan for purpose of differentiation from benign to malignant was also performed. However, no significant differences were obtained.

  11. Gadoxetate Acid-Enhanced MR Imaging for HCC: A Review for Clinicians

    Directory of Open Access Journals (Sweden)

    Jendana Chanyaputhipong

    2011-01-01

    Full Text Available Hepatocellular carcinoma (HCC is increasingly being detected at an earlier stage, owing to the screening programs and regular imaging follow-up in high-risk populations. Small HCCs still pose diagnostic challenges on imaging due to decreased sensitivity and increased frequency of atypical features. Differentiating early HCC from premalignant or benign nodules is important as management differs and has implications on both the quality of life and the overall survival for the patients. Gadoxetate acid (Gd-EOB-DTPA, Primovist®, Bayer Schering Pharma is a relatively new, safe and well-tolerated liver-specific contrast agent for magnetic resonance (MR imaging of the liver that has combined perfusion- and hepatocyte-specific properties, allowing for the acquisition of both dynamic and hepatobiliary phase images. Its high biliary uptake and excretion improves lesion detection and characterization by increasing liver-to-lesion conspicuity in the added hepatobiliary phase imaging. To date, gadoxetate acid-enhanced MRI has been mostly shown to be superior to unenhanced MRI, computed tomography, and other types of contrast agents in the detection and characterization of liver lesions. This review article focuses on the evolving role of gadoxetate acid in the characterization of HCC, differentiating it from other mimickers of HCC.

  12. Radionuclide imaging and diagnosis of benign tumours of the liver

    International Nuclear Information System (INIS)

    Zerbib, E.

    1996-01-01

    Radionuclide scanning takes advantages of the function of the liver. Hepatic scintigraphy can be suggested in the evaluation of solid liver masses greater than 1.5 cm and whose diagnosis has not been established by another imaging technique. 99m Tc-labeled-red-blood-cell (RBC) scintigraphy is very specific of cavernous hepatic hemangioma (100 %). Sensibility increases with tumoral size: 85 % from 1.5 to 3 cm and near 100 % beyond 3 cm. RBC scintigraphy should be performed when MRI does not assert diagnosis or cannot be performed. With 99m Tc-nanocolloids, focal nodular hyperplasia (FNH) can show intense concentration which is quite specific but appears in only 10 to 15 % of cases. A normal uptake is seen in 50 to 60 % of cases but only suggests FNH since almost 10 % of the adenomas get the same appearance. A negative defect, seen in 30 to 40 % of cases, does not allow any conclusion. Using hepatobiliary radiopharmaceuticals (IDA) FNH appears with an increased uptake during the perfusion phase, a normal uptake during the first 10 minutes and again an increased uptake during late images (hot spot). Hepatic adenoma can appear as a negative defect (over 90 % of cases) or with normal uptake (less than 10 % of cases). Increased uptake is never seen. Its aspect using hepatobiliary radio-hepatobiliary radio-pharmaceuticals is not well established but it appears as a negative defect on the perfusion phase which should discriminate it from FHN. (author)

  13. MRI findings of sacroiliitis in ankylosing spondylitis: roles of MPGR and delayed post-contrast T1-weighted images

    International Nuclear Information System (INIS)

    Jeon, Eui Yong; Joo, Kyung Bin; Koo, Ja Hong; Moon, Won Jin; Hahm, Chang Kok; Kim, Tae Hwan; Kim, Seong Yoon

    1997-01-01

    For early diagnosis of sacroiliitis in spondyloarthropathy, the MRI findings of sacroiliitis, roles of MPGR(multiplanar Gradient Recalled Acquisition in Steady State), and delayed post-contrast T1-weighted images were evaluated. Twenty six patients with seronegative spondyloarthropathy(Probable clinical diagnosis of ankylosing spondylitis) were grouped as either less than radiographic grade 1(group A) or more than grade 2(group B). The MRI findings of both sacroiliac joints were evaluated in every patient, and predominant sites were determined. The two groups were then compared. In 17 patients, the number of enhancing panni seen on early and delayed post-contrast T1-weighted images was counted and compared between the two groups. Panni were found in all cases, and in both groups, predominant patterns of involvement were the lower and iliac aspects of the sacroiliac joints in both groups; in group A, the synovial joints and punctate pannus were predominantly involved, and in group B, the ligamentous joints as well as the synovial joints and linear pannus. In group B, More periarticular fat accumulation than periarticular osteitis was found. For the evaluation of changes in joint space, MPGR images were superior to spin echo images. For the delineation of enhancing pannus less than radiographic grade I, delayed post-contrast images were statistically superior to those which were early post-contrast. MRI can detect early sacroiliitic change according to the predominant sites of involvement, and deslyed post-contrast images play a role in the diagnosis of early sacroiliitis. MPGR imaging is good for the evaluation of joint space change

  14. MRI findings of sacroiliitis in ankylosing spondylitis: roles of MPGR and delayed post-contrast T1-weighted images

    Energy Technology Data Exchange (ETDEWEB)

    Jeon, Eui Yong; Joo, Kyung Bin; Koo, Ja Hong; Moon, Won Jin; Hahm, Chang Kok; Kim, Tae Hwan; Kim, Seong Yoon [Hanyang Univ. College of Medicine, Seoul (Korea, Republic of)

    1997-10-01

    For early diagnosis of sacroiliitis in spondyloarthropathy, the MRI findings of sacroiliitis, roles of MPGR(multiplanar Gradient Recalled Acquisition in Steady State), and delayed post-contrast T1-weighted images were evaluated. Twenty six patients with seronegative spondyloarthropathy(Probable clinical diagnosis of ankylosing spondylitis) were grouped as either less than radiographic grade 1(group A) or more than grade 2(group B). The MRI findings of both sacroiliac joints were evaluated in every patient, and predominant sites were determined. The two groups were then compared. In 17 patients, the number of enhancing panni seen on early and delayed post-contrast T1-weighted images was counted and compared between the two groups. Panni were found in all cases, and in both groups, predominant patterns of involvement were the lower and iliac aspects of the sacroiliac joints in both groups; in group A, the synovial joints and punctate pannus were predominantly involved, and in group B, the ligamentous joints as well as the synovial joints and linear pannus. In group B, More periarticular fat accumulation than periarticular osteitis was found. For the evaluation of changes in joint space, MPGR images were superior to spin echo images. For the delineation of enhancing pannus less than radiographic grade I, delayed post-contrast images were statistically superior to those which were early post-contrast. MRI can detect early sacroiliitic change according to the predominant sites of involvement, and deslyed post-contrast images play a role in the diagnosis of early sacroiliitis. MPGR imaging is good for the evaluation of joint space change.

  15. Augmented reality technology for preoperative planning and intraoperative navigation during hepatobiliary surgery: A review of current methods.

    Science.gov (United States)

    Tang, Rui; Ma, Long-Fei; Rong, Zhi-Xia; Li, Mo-Dan; Zeng, Jian-Ping; Wang, Xue-Dong; Liao, Hong-En; Dong, Jia-Hong

    2018-04-01

    Augmented reality (AR) technology is used to reconstruct three-dimensional (3D) images of hepatic and biliary structures from computed tomography and magnetic resonance imaging data, and to superimpose the virtual images onto a view of the surgical field. In liver surgery, these superimposed virtual images help the surgeon to visualize intrahepatic structures and therefore, to operate precisely and to improve clinical outcomes. The keywords "augmented reality", "liver", "laparoscopic" and "hepatectomy" were used for searching publications in the PubMed database. The primary source of literatures was from peer-reviewed journals up to December 2016. Additional articles were identified by manual search of references found in the key articles. In general, AR technology mainly includes 3D reconstruction, display, registration as well as tracking techniques and has recently been adopted gradually for liver surgeries including laparoscopy and laparotomy with video-based AR assisted laparoscopic resection as the main technical application. By applying AR technology, blood vessels and tumor structures in the liver can be displayed during surgery, which permits precise navigation during complex surgical procedures. Liver transformation and registration errors during surgery were the main factors that limit the application of AR technology. With recent advances, AR technologies have the potential to improve hepatobiliary surgical procedures. However, additional clinical studies will be required to evaluate AR as a tool for reducing postoperative morbidity and mortality and for the improvement of long-term clinical outcomes. Future research is needed in the fusion of multiple imaging modalities, improving biomechanical liver modeling, and enhancing image data processing and tracking technologies to increase the accuracy of current AR methods. Copyright © 2018 First Affiliated Hospital, Zhejiang University School of Medicine in China. Published by Elsevier B.V. All rights

  16. Imaging of irradiated liver with Tc-99m-sulfur colloid and Tc-99m-IDA

    International Nuclear Information System (INIS)

    Gelfand, M.J.; Saha, S.; Aron, B.S.

    1981-01-01

    In three cases, irradiated regions of liver failed to concentrate Tc-99m-sulfur colloid. In two of these three, imaging with Tc-99m-acetanilide iminodiacetic acid (IDA) agents within five days showed near normal hepatic uptake of this hepatobiliary imaging agent. The hepatic parenchymal cells may be imaged with Tc-99m-IDA in some irradiated regions of liver, despite loss of reticuloendothelial cell function

  17. Relevance of 123I-BMIPP delayed scintigraphic imaging for patients with angina pectoris – a pilot study

    Science.gov (United States)

    Koyama, Kohei; Akashi, Yoshihiro J.; Kida, Keisuke; Suzuki, Kengo; Ishibashi, Yuki; Musha, Haruki; Banach, Maciej

    2011-01-01

    Introduction The study was designed to clarify the role of 123I-β-methyl-iodophenylpentadecanoic acid (123I-BMIPP) in the evaluation of myocardial fatty acid metabolism in patients with stable angina pectoris (AP) before and after percutaneous coronary intervention (PCI). Material and methods Ten controls (mean age: 70.4 ±10.5 years) and 12 patients with AP (mean age: 67.4 ±11.6 years) and single vessel coronary artery disease participated in the radionuclide cardiac study. Scintigraphic images were acquired at 30 min and at 4 h after 123I-BMIPP injection to determine early and delayed BMIPP uptake, respectively. The heart-to-mediastinum (H/M) ratio and the washout rate (WR) were calculated from the planar images. All patients underwent scintigraphy one day before PCI and again 1 month after successful PCI. Results No significant differences in the early or delayed H/M ratios were observed between the patients and the controls before PCI (early: 2.70 ±0.36 vs. 2.73 ±0.57; delayed: 2.26 ±0.33 vs. 2.40 ±0.43; p > 0.2 for both). The early and delayed H/M ratios remained unchanged with the comparison with before PCI (early: 2.72 ±0.27, delayed: 2.23 ±0.22; p > 0.2 for both). The global WR before PCI was significantly higher in the patients than in the control group (36.7 ±9.3%, vs. 28.1 ±8.2%, p = 0.02). However, the WR after PCI did not significantly differ between the patients and the controls (34.3 ±7.8% vs. 28.1 ±8.2%, p = 0.1). Conclusions These data may suggest that the WR of 123I-BMIPP determined from the planar images enhances the presence of myocardial ischaemia. PMID:22295024

  18. Brain Magnetic Resonance Imaging Findings in Developmentally Delayed Children

    Directory of Open Access Journals (Sweden)

    Ali Akbar Momen

    2011-01-01

    Full Text Available Background. Developmental disorders are failure or inability to acquire various age-specific skills at expected maturational age, which affects about 5–10% of preschool children. One of the most important methods for evaluation of developmentally delayed children is neuroimaging, especially, brain magnetic resonance imaging (MRI that provides useful information regarding brain tissue structures and anomalies. Method and Material. In this study, hospital records of 580 developmentally delayed children (aged 2 months to 15 years who admitted in pediatric ward of Golestan Hospital from 1997 to 2009 were selected. Information such as age, MRI findings were collected in the questionnaire and statistically analyzed. Results. Total, 580 children including 333 males (57.4% and 247 females (42.6% were studied. Abnormal brain MRI was observed in 340 (58.6% cases (204 Males, 136 females. The finding includes nonspecific in 38 (6.6%, congenital and developmental anomalies of brain in 39 (6.7%, recognizable syndromes in 3 (0.5%, neurovascular diseases or trauma in 218 (37.6%, and metabolic or neurodegenerative diseases in 42 (7.2% cases. Conclusion. Because 60% of all study groups showed abnormal brain MRI, using this method could be effective in diagnosis, management, and almost prognosis determination processes.

  19. Scintigraphic hepatobiliary function studies in newborn infants to diagnose biliary hypoplasia or atresia

    International Nuclear Information System (INIS)

    Askari-Sabi, Z.

    1987-01-01

    The results obtained from scintigraphic hepatobiliary function studies, intraoperative cholangiography and histological examinations in a total of 17 infants suspected of having biliary atresia were compared and analysed with reference to the clinical signs and symptoms observed. In most cases, the individual diagnostic procedures led to consistent findings, even though there were some variations in the clinical picture. Patient outcome is largely determined by the site of atresia, due to which fact surgical correction should be carried out as soon as possible, in any case before the 8th week post partum. (TRV) [de

  20. Identity disorder and social-psychological adaptation in patients with hepatobiliary disease

    Directory of Open Access Journals (Sweden)

    V. V. Khramtsova

    2017-12-01

    Full Text Available Negative bodily experience due to health complications and disability is perceived as a difficult life situation. The success of adaptation, commitment to treatment and cooperation with a doctor depend on the personality characteristics that define behavioral representations. Aim. Investigate the structure of identity and mechanisms of social-psychological adaptation of patients with the hepatobiliary system disease. Contingent and methods. 75 patients with a diffuse liver disease - chronic hepatitis, mostly of viral etiology (36 people and liver cirrhosis (39 patients have been examined. We have applied clinical, clinical-psychological, mathematical and empirical methods, semi-structured cross-interviews ("patient-doctor", "patient-psychologist", diagnostics of personal characteristics, identity structure, social-psychological components of adaptation. Three leading personality profiles have been highlighted. Results. Persons with a disharmonious personality development are characterized by disorders in the area of identity formation and development. Fragmentation, the impossibility of personal integration and severe penetrability from the environment contribute to social-psychological maladjustment. The coping is aimed at preserving the problem situation and intensifying the intrapersonal conflict. For persons with difficulties in the adaptation of the personality, a violation of activity interaction with the surrounding world is characteristic, a ban on one's self-identity. Social adaptation is often disrupted due to instability in the emotional-volitional sphere and choosing low-adaptive coping strategies. Genuine "I" and identity formation is impeded for the individuals suppressing aggressive impulses. Adaptability tends to be discrete. With mental stress increasing, the likelihood of choosing low-adaptive coping strategies increases. Conclusions. When drafting psycho-correction programs and medical treatment of people with a hepatobiliary

  1. Detection of common bile duct stone by hepatobiliary scintigraphy

    International Nuclear Information System (INIS)

    Itoh, Hisao; Sakai, Toyohiko; Takahashi, Norio

    1991-01-01

    Hepatobiliary scintigraphy and direct X-ray cholangiography were compared in 29 patients with common bile duct (CBD) stones confirmed at surgery. The scintigraphic findings included no visualization of the biliary system (NV), pooling of bile in the biliary system (PB), prolonged transit time over 60 min (PTT), filling defect in the CBD image (FD), and reflux of bile toward the intrahepatic ducts after gallbladder stimulation (RB). The positive rates of NV, PB, PTT, FD, and RB in patients with CBD stones were 7%, 31%, 17%, 48%, and 14%, respectively. One or more of these five findings was found in 83%. Although the NV was a useful finding suggesting complete obstruction of the CBD, it shared little in the diagnosis of CBD stone. The positive rate of the PB was relatively high and it would be a useful finding as an indication of the presence of passage disturbance of the CBD. The PB was usually accompanied by the FD. The PTT had some usefulness in the detection of incomplete obstruction of the CBD in patients with a visualized gallbladder. In patients with no visualization of the gallbladder, however, the transit time tended to be shorter than that of gallbladder visualized patients. Therefore, the judgement of PTT in patients with no visualized gallbladder needed another criteria. The FD was the most frequent among the five findings and the sites of FD correlated well with CBD stones on direct X-ray cholangiography. The FD would be a reliable finding indicating CBD stone or CBD stenosis. Although the RB was a finding limited in patients with a visualized gallbladder, it seemed to be a helpful findings for the detection of CBD stone in patients with a mildly dilated CBD. (author)

  2. Microproteinuria during Opisthorchis viverrini infection: a biomarker for advanced renal and hepatobiliary pathologies from chronic opisthorchiasis.

    Directory of Open Access Journals (Sweden)

    Prasert Saichua

    Full Text Available Approximately 680 million people are at risk of infection with Opisthorchis viverrini (OV and Clonorchis sinensis, with an estimated 10 million infected with OV in Southeast Asia alone. While opisthorchiasis is associated with hepatobiliary pathologies, such as advanced periductal fibrosis (APF and cholangiocarcinoma (CCA, animal models of OV infection show that immune-complex glomerulonephritis is an important renal pathology that develops simultaneously with hepatobiliary pathologies. A cardinal sign of immune-complex glomerulonephritis is the urinary excretion of immunoglobulin G (IgG (microproteinuria. In community-based studies in OV endemic areas along the Chi River in northeastern Thailand, we observed that over half of the participants had urine IgG against a crude OV antigen extract (OV antigen. We also observed that elevated levels of urine IgG to OV antigen were not associated with the intensity of OV infection, but were likely the result of immune-complex glomerulonephritis as seen in animal models of OV infection. Moreover, we observed that urine IgG to OV antigen was excreted at concentrations 21 times higher in individuals with APF and 158 times higher in individuals with CCA than controls. We also observed that elevated urine IgG to OV antigen could identify APF+ and CCA+ individuals from non-cases. Finally, individuals with urine IgG to OV antigen had a greater risk of APF as determined by Odds Ratios (OR = 6.69; 95%CI: 2.87, 15.58 and a greater risk of CCA (OR = 71.13; 95%CI: 15.13, 334.0 than individuals with no detectable level of urine IgG to OV antigen. Herein, we show for the first time the extensive burden of renal pathology in OV endemic areas and that a urine biomarker could serve to estimate risk for both renal and hepatobiliary pathologies during OV infection, i.e., serve as a "syndromic biomarker" of the advanced pathologies from opisthorchiasis.

  3. Scintigraphic imaging with 99mTc- exorphin C in rabbits

    International Nuclear Information System (INIS)

    Ertay, T.; Uenak, P.; Tasci, C.; Zihnioglu, F.; Durak, H.

    2005-01-01

    Exorphin C is a peptide with five amino acids [(Tyr-Pro-Ile-Ser-Leu) Trifluoroacetate salt] (Sigma) that has an affinity to opioid receptor-expressing tissues and tumors. Exorphin-C was labeled with 99m Tc using glucoheptonate (GH) as bifunctional chelating agent. Then, we investigated its radiopharmaceutical potential as opioid receptor-expressing tissue on rabbits. Quality controls were performed by ITLC, paper electrophoresis and HPLC. Labeling efficiency was higher than 98%. The compound was stable for at least 5 h at room temperature. Scintigraphic imaging with 99m Tc-GH-exorphin C ( 99m Tc-GE) was performed on male Albino rabbits. Static images were obtained from anterior projection using a Camstar XR/T gamma camera at several time intervals. Although a significant amount of activity was seen in the brain, less activity was seen on receptor saturation studies at 30 min. Slight hepatobiliary excretion was seen, though the main excretion route was renal. After saturating, the receptor hepatobiliary excretion was not seen; the only excretion route was renal

  4. Comparison of initial and delayed myocardial imaging with beta-methyl-p-[[sup 123]I]-iodophenylpentadecanoic acid in acute myocardial infarction

    Energy Technology Data Exchange (ETDEWEB)

    Naruse, Hitoshi; Yoshimura, Noriko; Yamamoto, Juro; Morita, Masato; Fukutake, Naoshige; Ohyanagi, Mitsumasa; Iwasaki, Tadaaki; Fukuchi, Minoru (Hyogo Coll. of Medicine, Nishinomiya (Japan))

    Myocardial imaging using [beta]-methyl-p-[[sup 123]I]-iodophenylpentadecanoic acid (BMIPP) of 15 patients with acute myocardial infarction was performed to assess 'fill-in' and 'washout' defects in the delayed myocardial image. The initial and delayed images were evaluated by a visual and quantitative washout rate method. Visual judgement found 8/180 (4%) segments showed 'fill-in' defects, and 24/180 segments (13%) showed 'washout' defects. There was no relationship between days from onset to the study and the frequency of fill-in and washout defects. The mean washout rate in the segments with 'fill-in' defects was 9.0[+-]16.6%, and that of 'washout' defects was 24.9[+-]18.1% which was significantly higher than in controls (8.7[+-]15.4%, p<0.05). There was no correlation between mean washout rate and total blood lipids, total cholesterol, triglyceride and HDL-cholesterol. Therefore, neither time from onset nor blood lipids level was related to changes from the initial image to the delayed image. These changes may be due to relative (false) findings due to changes in circumference, and may be based on myocardial characteristics after myocardial infarction and/or reperfusion. (author).

  5. Nuclear imaging in pediatrics

    International Nuclear Information System (INIS)

    Siddiqui, A.R.

    1985-01-01

    The author's intent is to familiarize practicing radiologists with the technical aspects and interpretation of nuclear medicine procedures in children and to illustrate the indications for nuclear medicine procedures in pediatric problems. Pediatric doses, dosimetry, sedation, and injection techniques, organ systems, oncology and infection, testicular scanning and nuclear crystography, pediatric endocrine and skeletal systems, ventilation and perfusion imaging of both congenital and acquired pediatric disorders, cardiovascular problems, gastrointestinal, hepatobiliary, reticuloendothelial studies, and central nervous system are all topics which are included and discussed

  6. Troubleshooting arterial-phase MR images of gadoxetate disodium-enhanced liver

    Energy Technology Data Exchange (ETDEWEB)

    Huh, Ji Mi; Kim, So Yeon; Lee, Seung Soo; Kim, Kyoung Won [Dept. of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Seoul (Korea, Republic of); Yeh, Benjamin M.; Wang, Z. Jane [Dept. of Radiologyand Biomedical Imaging, University of California San Francisco, San Francisco (United States); Wu, En Haw [Dept. of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Chang Gung University College of Medicine, Taoyuan (China); Zhao, Li Qin [Beijing Friendship Hospital, Capital Medical University, Beijing (China); Chang, Wei Chou [Tri-Service General Hospital and National Defense Medical Center, Taipei (China)

    2015-12-15

    Gadoxetate disodium is a widely used magnetic resonance (MR) contrast agent for liver MR imaging, and it provides both dynamic and hepatobiliary phase images. However, acquiring optimal arterial phase images at liver MR using gadoxetate disodium is more challenging than using conventional extracellular MR contrast agent because of the small volume administered, the gadolinium content of the agent, and the common occurrence of transient severe motion. In this article, we identify the challenges in obtaining high-quality arterial-phase images of gadoxetate disodium-enhanced liver MR imaging and present strategies for optimizing arterial-phase imaging based on the thorough review of recent research in this field.

  7. Troubleshooting arterial-phase MR images of gadoxetate disodium-enhanced liver

    International Nuclear Information System (INIS)

    Huh, Ji Mi; Kim, So Yeon; Lee, Seung Soo; Kim, Kyoung Won; Yeh, Benjamin M.; Wang, Z. Jane; Wu, En Haw; Zhao, Li Qin; Chang, Wei Chou

    2015-01-01

    Gadoxetate disodium is a widely used magnetic resonance (MR) contrast agent for liver MR imaging, and it provides both dynamic and hepatobiliary phase images. However, acquiring optimal arterial phase images at liver MR using gadoxetate disodium is more challenging than using conventional extracellular MR contrast agent because of the small volume administered, the gadolinium content of the agent, and the common occurrence of transient severe motion. In this article, we identify the challenges in obtaining high-quality arterial-phase images of gadoxetate disodium-enhanced liver MR imaging and present strategies for optimizing arterial-phase imaging based on the thorough review of recent research in this field

  8. Gadobenate-dimeglumine-enhanced magnetic resonance imaging for hepatic lesions in children

    Energy Technology Data Exchange (ETDEWEB)

    Chavhan, Govind B.; Mann, Erika [The Hospital for Sick Children and University of Toronto, Department of Diagnostic Imaging, Toronto (Canada); Kamath, Binita M. [The Hospital for Sick Children and University of Toronto, Division of Gastroenterology, Hepatology and Nutrition, Toronto (Canada); Babyn, Paul S. [Royal University Hospital, Department of Medical Imaging, Saskatoon (Canada)

    2014-10-15

    Magnetic resonance imaging enhanced by hepatocyte-specific contrast media has been found useful to characterize liver lesions in adults and children. To present our experience with gadobenate dimeglumine (Gd-BOPTA)-enhanced MRI for evaluation of focal liver lesions in children. We retrospectively reviewed gadobenate-dimeglumine-enhanced MR images obtained for evaluation of suspected hepatic lesions in 30 children. Signal characteristics on various sequences including 45- to 60-min hepatobiliary phase images were noted by two radiologists. Chart review identified relevant clinical details including history of cancer treatment, available pathology and stability of lesion size on follow-up imaging. Of the 30 children who had gadobenate-enhanced MRI, 26 showed focal lesions. Diagnoses in 26 children were focal nodular hyperplasia (FNH) in 15, hemangiomas in 3, regenerating nodules in 3, focal fatty infiltration in 2, indeterminate lesions in 3, and one patient each with adenomas, hepatoblastoma and metastasis. Two patients had multiple diagnoses. All FNH lesions (39), all regenerative nodules (19) and an indeterminate lesion were iso- or hyperintense on hepatobiliary-phase images while all other lesions (28) were hypointense to hepatic parenchyma. The average follow-up period was 21.7 months. Our experience with gadobenate-enhanced MRI indicates potential utility of gadobenate in the evaluation of pediatric hepatic lesions in differentiating FNH and regenerating nodules from other lesions. (orig.)

  9. Agreement between microscopic examination and bacterial culture of bile samples for detection of bactibilia in dogs and cats with hepatobiliary disease.

    Science.gov (United States)

    Pashmakova, Medora B; Piccione, Julie; Bishop, Micah A; Nelson, Whitney R; Lawhon, Sara D

    2017-05-01

    OBJECTIVE To evaluate the agreement between results of microscopic examination and bacterial culture of bile samples from dogs and cats with hepatobiliary disease for detection of bactibilia. DESIGN Cross-sectional study. ANIMALS 31 dogs and 21 cats with hepatobiliary disease for which subsequent microscopic examination and bacterial culture of bile samples was performed from 2004 through 2014. PROCEDURES Electronic medical records of included dogs and cats were reviewed to extract data regarding diagnosis, antimicrobials administered, and results of microscopic examination and bacterial culture of bile samples. Agreement between these 2 diagnostic tests was assessed by calculation of the Cohen κ value. RESULTS 17 (33%) dogs and cats had bactibilia identified by microscopic examination of bile samples, and 11 (21%) had bactibilia identified via bacterial culture. Agreement between these 2 tests was substantial (percentage agreement [positive and negative results], 85%; κ = 0.62; 95% confidence interval, 0.38 to 0.89) and improved to almost perfect when calculated for only animals that received no antimicrobials within 24 hours prior to sample collection (percentage agreement, 94%; κ = 0.84; 95% confidence interval, 0.61 to 1.00). CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that agreement between microscopic examination and bacterial culture of bile samples for detection of bactibilia is optimized when dogs and cats are not receiving antimicrobials at the time of sample collection. Concurrent bacterial culture and microscopic examination of bile samples are recommended for all cats and dogs evaluated for hepatobiliary disease.

  10. Direct integral linear least square regression method for kinetic evaluation of hepatobiliary scintigraphy

    International Nuclear Information System (INIS)

    Shuke, Noriyuki

    1991-01-01

    In hepatobiliary scintigraphy, kinetic model analysis, which provides kinetic parameters like hepatic extraction or excretion rate, have been done for quantitative evaluation of liver function. In this analysis, unknown model parameters are usually determined using nonlinear least square regression method (NLS method) where iterative calculation and initial estimate for unknown parameters are required. As a simple alternative to NLS method, direct integral linear least square regression method (DILS method), which can determine model parameters by a simple calculation without initial estimate, is proposed, and tested the applicability to analysis of hepatobiliary scintigraphy. In order to see whether DILS method could determine model parameters as good as NLS method, or to determine appropriate weight for DILS method, simulated theoretical data based on prefixed parameters were fitted to 1 compartment model using both DILS method with various weightings and NLS method. The parameter values obtained were then compared with prefixed values which were used for data generation. The effect of various weights on the error of parameter estimate was examined, and inverse of time was found to be the best weight to make the error minimum. When using this weight, DILS method could give parameter values close to those obtained by NLS method and both parameter values were very close to prefixed values. With appropriate weighting, the DILS method could provide reliable parameter estimate which is relatively insensitive to the data noise. In conclusion, the DILS method could be used as a simple alternative to NLS method, providing reliable parameter estimate. (author)

  11. Tc-99m-diethyl-IDA imaging: clinical evaluation in jaundiced patients

    International Nuclear Information System (INIS)

    Pauwels, S.; Piret, L.; Schoutens, A.; Vandermoten, G.; Beckers, C.

    1980-01-01

    Hepatobiliary imaging with Tc-99m-N,α-(2,6-diethylacetanilide)-iminodiacetic acid (Tc-diethyl-IDA) was performed in 91 jaundiced patients with documented hepatobiliary damage and serum total bilirubin up to 35 mg/dl. There were 56 patients with obstructive jaundice and 35 with hepatocellular disease. Correct discrimination between hepatocellular and obstructive jaundice was possible with an overall accuracy of 90%. Agreement with the final clinical diagnosis was obtained in 97% of patients with hepatocellular disease, and in 86% of patients with obstructive jaundice. The reliability of the test was inversely related to the serum bilirubin levels below 10 mg/dl to 83% for bilirubin between 10 and 20 mg/dl. Above 20 mg/dl, the demonstration of a mechanical obstruction was possible in only one out of the four patients with obstructive jaundice. The high predictive values of the test illustrate that Tc-diethyl-IDA imaging constitutes a reliable method to demonstrate an obstructive cause for the jaundice as long as the bilirubin level remains below 20 mg/dl

  12. A Review of Circulating Tumor DNA in Hepatobiliary Malignancies

    Directory of Open Access Journals (Sweden)

    Kabir Mody

    2018-06-01

    Full Text Available Circulating tumor DNA (ctDNA is released into circulation (blood specifically from tumor cells undergoing metabolic secretion, apoptosis, or necrosis, carries tumor-specific genetic or epigenetic alterations. Technologies enabling clinical evaluation of ctDNA continue to advance rapidly and allow for the assessment of patient-specific tumoral genetic and epigenetic alterations. This holds great potential for earlier detection of disease, serial monitoring of tumor heterogeneity, identification of therapeutic targets, and evaluation of treatment response and mechanisms of resistance. Hepatobiliary malignancies are often diagnosed late, recur commonly, yield limited available tumor on biopsy, and harbor several genomic alterations with potential therapeutic impacts. Patients suffering from or at risk for these diseases thus stand to benefit immensely from this technology. Herein, we review the limited literature pertaining to the potential for ctDNA technologies in such patients. Patients with these cancers stand to benefit greatly from the application of ctDNA technologies, and concerted efforts at further investigation of such are ongoing and greatly needed.

  13. Comparison of traditional methods with 3D computer models in the instruction of hepatobiliary anatomy.

    Science.gov (United States)

    Keedy, Alexander W; Durack, Jeremy C; Sandhu, Parmbir; Chen, Eric M; O'Sullivan, Patricia S; Breiman, Richard S

    2011-01-01

    This study was designed to determine whether an interactive three-dimensional presentation depicting liver and biliary anatomy is more effective for teaching medical students than a traditional textbook format presentation of the same material. Forty-six medical students volunteered for participation in this study. Baseline demographic information, spatial ability, and knowledge of relevant anatomy were measured. Participants were randomized into two groups and presented with a computer-based interactive learning module comprised of animations and still images to highlight various anatomical structures (3D group), or a computer-based text document containing the same images and text without animation or interactive features (2D group). Following each teaching module, students completed a satisfaction survey and nine-item anatomic knowledge post-test. The 3D group scored higher on the post-test than the 2D group, with a mean score of 74% and 64%, respectively; however, when baseline differences in pretest scores were accounted for, this difference was not statistically significant (P = 0.33). Spatial ability did not statistically significantly correlate with post-test scores for the 3D group or the 2D group. In the post-test satisfaction survey the 3D group expressed a statistically significantly higher overall satisfaction rating compared to students in the 2D control group (4.5 versus 3.7 out of 5, P = 0.02). While the interactive 3D multimedia module received higher satisfaction ratings from students, it neither enhanced nor inhibited learning of complex hepatobiliary anatomy compared to an informationally equivalent traditional textbook style approach. . Copyright © 2011 American Association of Anatomists.

  14. SHARP - III. First use of adaptive-optics imaging to constrain cosmology with gravitational lens time delays

    NARCIS (Netherlands)

    Chen, Geoff C. -F; Suyu, Sherry H.; Wong, Kenneth C.; Fassnacht, Christopher D.; Chiueh, Tzihong; Halkola, Aleksi; Hu, I. Shing; Auger, Matthew W.; Koopmans, Léon V. E.; Lagattuta, David J.; McKean, John P.; Vegetti, Simona

    2016-01-01

    Accurate and precise measurements of the Hubble constant are critical for testing our current standard cosmological model and revealing possibly new physics. With Hubble Space Telescope (HST) imaging, each strong gravitational lens system with measured time delays can allow one to determine the

  15. Delayed growth

    Science.gov (United States)

    ... Slow rate of growth; Retarded growth and development; Growth delay Images Toddler development References Cooke DW, Divall SA, Radovick S. Normal and aberrant growth in children. In: Melmed S, Polonsky KS, Larsen PR, ...

  16. Clinical usefulness of delayed exercise images on 99mTc-tetrofosmin myocardial SPECT in the diagnosis of vasospastic angina pectoris

    International Nuclear Information System (INIS)

    Ito, Kazuki; Zen, Kan; Hikosaka, Takatou; Adachi, Yoshihiko; Yoneyama, Satoshi; Katoh, Shuuji; Sugihara, Hiroki; Nakamura, Tomoki; Azuma, Akihiro

    2000-01-01

    This study was designed to evaluate the clinical usefulness of delayed exercise images in 99m Tc-tetrofosmin (TF) myocardial SPECT in the diagnosis of vasospastic angina pectoris. We studied 30 patients with vasospastic angina, 10 of 30 patients (group A) had both effort and rest angina, 20 of 30 patients (group B) had rest angina. A 370 MBq of TF was intravenously injected at peak exercise, and initial (EX-I) and delayed exercise (EX-D) images were obtained at 30 min and 180 min after the injection. An additional 740 MBq of TF was intravenously reinjected after EX-D image acquisition, and rest images were obtained 30 min after the reinjection. The left ventricular wall was divided into 9 segments. Regional myocardial uptakes of TF were scored by 4-point defect score (0=normal, 1=mildly reduced, 2=moderately reduced, and 3=severely reduced). Total defect score (TDS) was calculated from the sum of defect scores in 9 segments. Reverse redistribution (RR) was defined as increase of more than 2 in TDS on EX-D images. In group A, 4 of 10 cases (40%) showed decreased uptake on EX-I images, 6 of 10 cases (60%) revealed RR on EX-D images, and none of the patients showed decreased uptake on rest images. In group B, no one showed decreased uptake on EX-I and rest images, 11 of 20 cases (55%) revealed RR on EX-D images. The mean±SD of TDS were 2.9±3.4, 5.1±4.5, 0.5±0.5 on EX-I, EX-D, rest images in group A, and serially 0.4±0.5, 3.3±3.6, 0.4±0.5 in group B. Regional wall motion abnormality was reduced in regions with RR. RR on EX-D images may reflect ischemic damaged but viable myocardium in vasospastic angina. The clinical usefulness of exercise-rest TF imaging in detection of organic coronary artery disease has been well established. Therefore, exercise-rest TF imaging with additional delayed exercise image could evaluate not only organic coronary artery disease but also coronary artery vasospasm. (author)

  17. Study On Preparation Of Lyophilized DISIDA Kit For Labeling With 99mTc Using In Nuclear Medicine To Diagnose Hepatobiliary Diseases

    International Nuclear Information System (INIS)

    Duong Van Dong; Bui Van Cuong; Pham Ngoc Dien; Chu Van Khoa; Mai Phuoc Tho; Nguyen Thi Thu; Vo Thi Cam Hoa

    2011-01-01

    Lyophilization is the method of choice for preserving a variety of health care pharmaceutical as the type of kit used labeled with radioactive isotopes. Lyophilization ensures the overall stability of the product, inhibit bacterial growth and create good conditions for transportation. A more significant is that it helps ensure the durability of stannous chloride in the composition of the kit. In the process of freeze-dried, the first product to be frozen, then reducing the surrounding pressure and temperature increase sufficient to allow the water molecules in the material sublimates directly from solid to gas. This report presents freeze-drying method and quality control of compound iminoacetic 2,6-diisopropylcetanilido acid (DISIDA) for long term storage, convenient for transportation to remote areas for nuclear medicine diagnosis of hepatobiliary disease. The purpose of the study were the survey of labeling process of 99m Tc with DISIDA and established freeze-drying process of DISIDA having standard quality for nuclear medicine diagnosis of hepatobiliary diseases. (author)

  18. Comparative evaluation of intragastric bile acids and hepatobiliary scintigraphy in the diagnosis of duodenogastric reflux.

    Science.gov (United States)

    Chen, Teng-Fei; Yadav, Praveen K; Wu, Rui-Jin; Yu, Wei-Hua; Liu, Chang-Qin; Lin, Hui; Liu, Zhan-Ju

    2013-01-01

    To assess the diagnostic value of a combination of intragastric bile acids and hepatobiliary scintigraphy in the detection of duodenogastric reflux (DGR). The study contained 99 patients with DGR and 70 healthy volunteers who made up the control group. The diagnosis was based on the combination of several objective arguments: a long history of gastric symptoms (i.e., nausea, epigastric pain, and/or bilious vomiting) poorly responsive to medical treatment, gastroesophageal reflux symptoms unresponsive to proton-pump inhibitors, gastritis on upper gastrointestinal (GI) endoscopy and/or at histology, presence of a bilious gastric lake at > 1 upper GI endoscopy, pathologic 24-h intragastric bile monitoring with the Bilitec device. Gastric juice was aspirated in the GI endoscopy and total bile acid (TBA), total bilirubin (TBIL) and direct bilirubin (DBIL) were tested in the clinical laboratory. Continuous data of gastric juice were compared between each group using the independent-samples Mann-Whitney U-test and their relationship was analysed by Spearman's rank correlation test and Fisher's linear discriminant analysis. Histopathology of DGR patients and 23 patients with chronic atrophic gastritis was compared by clinical pathologists. Using the Independent-samples Mann-Whitney U-test, DGR index (DGRi) was calculated in 28 patients of DGR group and 19 persons of control group who were subjected to hepatobiliary scintigraphy. Receiver operating characteristic curve was made to determine the sensitivity and specificity of these two methods in the diagnosis of DGR. The group of patients with DGR showed a statistically higher prevalence of epigastric pain in comparison with control group. There was no significant difference between the histology of gastric mucosa with atrophic gastritis and duodenogastric reflux. The bile acid levels of DGR patients were significantly higher than the control values (Z: TBA: -8.916, DBIL: -3.914, TBIL: -6.197, all P Reflux: Y = 0.012TBA + 0

  19. Diagnostic imaging in internal medicine

    International Nuclear Information System (INIS)

    Eisenberg, R.L.

    1985-01-01

    This book examines medical diagnostic techniques. Topics considered include biological considerations in the approach to clinical medicines; infectious diseases; disorders of the heart; disorders of the vascular system; disorders of the respiratory system; diseases of the kidneys and urinary tract; disorders of the alimentary tract; disorders of the hepatobiliary system and pancreas; disorders of the hematopoietic system; disorders of bone and bone mineralization; disorders of the joints, connective tissues, and striated muscles; disorders of the nervous system; miscellaneous disorders; and procedures in diagnostic imaging

  20. Clinical Significance of Reverse Redistribution Phenomenon on Delayed Tc-99m Tetrofosmin Myocardial Perfusion Imaging in Patients with Acute Myocardial Infarction

    International Nuclear Information System (INIS)

    Park, Soon Ah; Kim, Dae Weung; Kim, Chang Guhn; Jeong, Jin Won; Kim, Nam Ho; Yun, Kyeong Ho

    2009-01-01

    This study was performed to investigate the clinical significance of reverse redistribution (RR) phenomenon detected on delayed Tc-99m tetrofosmin myocardial single photon emission computed tomography (SPECT) in patients with acute myocardial infarction after revascularization. A Tc-99m tetrofrosmin myocardial SPECT was performed in 67 consecutive patients after revascularization for acute myocardial infarction. Myocardial SPECT imaging was performed for early imaging at 40 min and for delayed imaging at 180 min after reinjection at myocardial stress. Regional myocardial uptakes were scored by 4-point scoring in the left ventricular wall divided into 17 segments. Reverse redistribution was defined as an increase of more than 2 point in the activity score on the delayed image. Follow-up myocardial SPECT and coronary angiography (CAG) were performed 9 months later. On myocardial SPECT performed following revascularization, RR was observed in 100 of all 319 segments (31%) and in 43 patients (64%). The abnormalities of perfusion and regional wall motion were more severe in the patients with RR compared to those without RR (p<0.05). On follow-up myocardial SPECT, the myocardial perfusion, regional wall motion, and myocardial thickness were significantly improved in the patients with RR (p<0.05) however, these changes were not significant in those without RR. There was no significant difference between the patients with RR and those without RR in the occurrence of restenosis on CAG. In patients with acute myocardial infarction, the regions showing the RR phenomenon on delayed Tc-99m tetrofosmin SPECT may reflect viable myocardium and indicate recovery of salvaged myocardium

  1. Specific imaging characteristic of solitary necrotic nodule of the liver: Marked peripheral rim-like enhancement with internal hypointensity on longer delayed MRI

    Energy Technology Data Exchange (ETDEWEB)

    Fang, Jiayang; Yu, Dexin; Ma, Xiangxing; Xiang, Ying; Guo, Lijuan [Qilu Hospital of Shandong University, Department of Radiology, Ji' nan City, Shandong (China); Ma, Xiaoyuan [Qilu Hospital of Shandong University, Department of Orthopaedics, Ji' nan City (China)

    2017-09-15

    To obtain specific imaging findings of solitary necrotic nodule of the liver (SNNL) using longer delayed contrast-enhanced MRI and compare them with those of three mimic hepatic diseases. Sixteen patients with SNNL underwent plain and contrast-enhanced triphasic CT and multiphasic MRI with delayed time prolonged to 2 h after contrast bolus injection. Twenty-three patients with mimic lesions including seven with eight HCCs, five with five iCCs and 11 with metastatic lesions served as the control group. Those patients also received plain and multiphasic contrast-enhanced MRI. Imaging features of lesions such as peripheral wash-out time were evaluated. Among the 16 SNNLs, with a prolonged delayed MRI time, the enhancement degree of tumour periphery increased gradually. When it was up to 1 h, all lesions represented moderate/marked peripheral enhancement with internal hypointensity. However, the peripheral wash-out in seven HCCs (87.5%) and all metastatic lesions except three appeared at 10 or 15 min, one iCC (20%) at 30 min and the other lesions at 1 h. Longer MRI with a delayed time of 1-2 h may be useful in diagnosis SNNL, revealing the specific imaging characteristic of SNNL as pronounced peripheral enhancement with internal hypointensity. (orig.)

  2. Delayed enhancement imaging in a contemporary patient cohort following correction of tetralogy of Fallot.

    Science.gov (United States)

    Preim, Uta; Sommer, Philipp; Hoffmann, Janine; Kehrmann, Jana; Lehmkuhl, Lukas; Daehnert, Ingo; Gutberlet, Matthias; Grothoff, Matthias

    2015-10-01

    To test the hypothesis that myocardial scars after repair of tetralogy of Fallot are related to impaired cardiac function and adverse clinical outcome. A total of 53 patients were retrospectively analysed after repair of tetralogy of Fallot. The median patient age was 20 years (range 2-48). Cardiac MRI with a 1.5 T magnet included cine sequences to obtain volumes and function, phase-sensitive inversion recovery delayed enhancement imaging to detect myocardial scars, and flow measurements to determine pulmonary regurgitation fraction. In addition, clinical parameters were obtained. An overall 83% of patients were in NYHA class I. All patients with the exception of 2 (96%) had pulmonary insufficiency. Mean ejection fraction and end-diastolic volume index were 46% and 128 ml/m2 for the right ventricle and 54% and 82 ml/m² for the left ventricle, respectively. Excluding enhancement of the septal insertion and prosthetic patches, delayed enhancement was seen in 11/53 cases (21%). Delayed enhancement of the right ventricle was detected in 6/53 patients (11%) and of the left ventricle in 5/53 patients (9%). The patient group with delayed enhancement was significantly older (p=0.003), had later repair (p=0.007), and higher left ventricular myocardial mass index (p=0.009) compared with the group without delayed enhancement. This study reveals that scarring is common in patients after surgical repair of tetralogy of Fallot and is associated with older age and late repair. However, there was no difference in right ventricular function, NYHA class, or occurrence of clinically relevant arrhythmias between patients with and those without myocardial scars.

  3. Dynamic autofocus for continuous-scanning time-delay-and-integration image acquisition in automated microscopy.

    Science.gov (United States)

    Bravo-Zanoguera, Miguel E; Laris, Casey A; Nguyen, Lam K; Oliva, Mike; Price, Jeffrey H

    2007-01-01

    Efficient image cytometry of a conventional microscope slide means rapid acquisition and analysis of 20 gigapixels of image data (at 0.3-microm sampling). The voluminous data motivate increased acquisition speed to enable many biomedical applications. Continuous-motion time-delay-and-integrate (TDI) scanning has the potential to speed image acquisition while retaining sensitivity, but the challenge of implementing high-resolution autofocus operating simultaneously with acquisition has limited its adoption. We develop a dynamic autofocus system for this need using: 1. a "volume camera," consisting of nine fiber optic imaging conduits to charge-coupled device (CCD) sensors, that acquires images in parallel from different focal planes, 2. an array of mixed analog-digital processing circuits that measure the high spatial frequencies of the multiple image streams to create focus indices, and 3. a software system that reads and analyzes the focus data streams and calculates best focus for closed feedback loop control. Our system updates autofocus at 56 Hz (or once every 21 microm of stage travel) to collect sharply focused images sampled at 0.3x0.3 microm(2)/pixel at a stage speed of 2.3 mms. The system, tested by focusing in phase contrast and imaging long fluorescence strips, achieves high-performance closed-loop image-content-based autofocus in continuous scanning for the first time.

  4. Diagnostic performance of traditional hepatobiliary biomarkers of drug-induced liver injury in the rat.

    Science.gov (United States)

    Ennulat, Daniela; Magid-Slav, Michal; Rehm, Sabine; Tatsuoka, Kay S

    2010-08-01

    Nonclinical studies provide the opportunity to anchor biochemical with morphologic findings; however, liver injury is often complex and heterogeneous, confounding the ability to relate biochemical changes with specific patterns of injury. The aim of the current study was to compare diagnostic performance of hepatobiliary markers for specific manifestations of drug-induced liver injury in rat using data collected in a recent hepatic toxicogenomics initiative in which rats (n = 3205) were given 182 different treatments for 4 or 14 days. Diagnostic accuracy of alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (Tbili), serum bile acids (SBA), alkaline phosphatase (ALP), gamma glutamyl transferase (GGT), total cholesterol (Chol), and triglycerides (Trig) was evaluated for specific types of liver histopathology by Receiver Operating Characteristic (ROC) analysis. To assess the relationship between biochemical and morphologic changes in the absence of hepatocellular necrosis, a second ROC analysis was performed on a subset of rats (n = 2504) given treatments (n = 152) that did not cause hepatocellular necrosis. In the initial analysis, ALT, AST, Tbili, and SBA had the greatest diagnostic utility for manifestations of hepatocellular necrosis and biliary injury, with comparable magnitude of area under the ROC curve and serum hepatobiliary marker changes for both. In the absence of hepatocellular necrosis, ALT increases were observed with biochemical or morphologic evidence of cholestasis. In both analyses, diagnostic utility of ALP and GGT for biliary injury was limited; however, ALP had modest diagnostic value for peroxisome proliferation, and ALT, AST, and total Chol had moderate diagnostic utility for phospholipidosis. None of the eight markers evaluated had diagnostic value for manifestations of hypertrophy, cytoplasmic rarefaction, inflammation, or lipidosis.

  5. An image compression method for space multispectral time delay and integration charge coupled device camera

    International Nuclear Information System (INIS)

    Li Jin; Jin Long-Xu; Zhang Ran-Feng

    2013-01-01

    Multispectral time delay and integration charge coupled device (TDICCD) image compression requires a low-complexity encoder because it is usually completed on board where the energy and memory are limited. The Consultative Committee for Space Data Systems (CCSDS) has proposed an image data compression (CCSDS-IDC) algorithm which is so far most widely implemented in hardware. However, it cannot reduce spectral redundancy in multispectral images. In this paper, we propose a low-complexity improved CCSDS-IDC (ICCSDS-IDC)-based distributed source coding (DSC) scheme for multispectral TDICCD image consisting of a few bands. Our scheme is based on an ICCSDS-IDC approach that uses a bit plane extractor to parse the differences in the original image and its wavelet transformed coefficient. The output of bit plane extractor will be encoded by a first order entropy coder. Low-density parity-check-based Slepian—Wolf (SW) coder is adopted to implement the DSC strategy. Experimental results on space multispectral TDICCD images show that the proposed scheme significantly outperforms the CCSDS-IDC-based coder in each band

  6. Diffusion Tensor Imaging of Normal-Appearing White Matter as Biomarker for Radiation-Induced Late Delayed Cognitive Decline

    International Nuclear Information System (INIS)

    Chapman, Christopher H.; Nagesh, Vijaya; Sundgren, Pia C.; Buchtel, Henry; Chenevert, Thomas L.; Junck, Larry; Lawrence, Theodore S.; Tsien, Christina I.; Cao, Yue

    2012-01-01

    Purpose: To determine whether early assessment of cerebral white matter degradation can predict late delayed cognitive decline after radiotherapy (RT). Methods and Materials: Ten patients undergoing conformal fractionated brain RT participated in a prospective diffusion tensor magnetic resonance imaging study. Magnetic resonance imaging studies were acquired before RT, at 3 and 6 weeks during RT, and 10, 30, and 78 weeks after starting RT. The diffusivity variables in the parahippocampal cingulum bundle and temporal lobe white matter were computed. A quality-of-life survey and neurocognitive function tests were administered before and after RT at the magnetic resonance imaging follow-up visits. Results: In both structures, longitudinal diffusivity (λ ‖ ) decreased and perpendicular diffusivity (λ ⊥ ) increased after RT, with early changes correlating to later changes (p ⊥ at 3 weeks, and patients with >50% of cingula volume receiving >12 Gy had a greater increase in λ ⊥ at 3 and 6 weeks (p ‖ (30 weeks, p ‖ changes predicted for post-RT changes in verbal recall scores (3 and 6 weeks, p < .05). The neurocognitive test scores correlated significantly with the quality-of-life survey results. Conclusions: The correlation between early diffusivity changes in the parahippocampal cingulum and the late decline in verbal recall suggests that diffusion tensor imaging might be useful as a biomarker for predicting late delayed cognitive decline.

  7. Magnetic resonance (MR) imaging in delayed encephalopathy of acute carbon monoxide poisoning - comparison with CT -

    International Nuclear Information System (INIS)

    Chang, Kee Hyun; Suh, Chang Hae; Choo, In Wook

    1986-01-01

    Eleven magnetic resonance (MR) and computed tomographic (CT) imaging were performed in nine patients with mild to moderate degree of delayed neuropsychiatric symptoms following acute carbon monoxide (CO) poisoning, to evaluate the capability of MR in demonstrating any additional finding to CT. The MR images were obtained using 0.15 Tesla resistive system with various combination of three pulse sequences, including partial saturation recovery, T2-weighted spin echo and inversion recovery. Bilateral white matter abnormalities suggesting demyelination were demonstrated in 4 patients with MR and in only 2 patients with CT. The contrast discrimination between normal and abnormal white matter proved to be better with T2-weighted spin echo and inversion recovery than with partial saturation recovery and CT. But necrosis of the globus pallidus (1 patient) and diffuse atrophy (3 patients) were equally demonstrated on both MR and CT. It is suggested that MR be used as a initial imaging method in the evaluation of the delayed encephalopathy following acute CO poisoning, especially for the detection of the possible white matter lesions. Acute carbon monoxide (CO) poisoning produces hypoxia by displacing oxygen from hemoglobin and preventing its release from hemoglobin in tissues, often resulting in fetal event. Victims who survive acute CO poisoning may have various delayed symptoms and signs. Occasionally, an apparent recovery is followed within two days to three weeks by a sudden neurological deterioration. The degree of neuropsychiatric symptoms depends upon the extent and severity of the pathologic changes in the brain. The pathologic effects of CO poisoning are present in almost all organs of patients. However, the most important changes occur in the brain, which consist of necrosis of the globus pallidus and reticular zone of the substantia nigra, and the degeneration of the cerebral white matter. The diagnostic superiority of magnetic resonance (MR) over CT has already

  8. Delayed Occurrence of Diabetes Insipidus After Transsphenoidal Surgery with Radiologic Evaluation of the Pituitary Stalk on Magnetic Resonance Imaging.

    Science.gov (United States)

    Hayashi, Yasuhiko; Aida, Yasuhiro; Sasagawa, Yasuo; Oishi, Masahiro; Kita, Daisuke; Tachibana, Osamu; Ueda, Fumiaki; Nakada, Mitsutoshi

    2018-02-01

    Diabetes insipidus (DI) is a major complication of transsphenoidal surgery (TSS). DI usually occurs within a couple of days after TSS. Delayed occurrence of postoperative DI is rarely observed and its developing mechanisms remain unknown. Six patients were identified as having postoperative delayed DI, which was defined as DI that first occurred 2 or more weeks after TSS. They consisted of 1 male and 5 females, and their mean age was 38.3 years (range, 10-76 years). Five patients were histologically diagnosed with Rathke cleft cyst (RCC), and one had RCC coexisting with prolactin-secreting adenoma. Sequential T1-weighted magnetic resonance imaging was evaluated for hyperintensity (HI) in the pituitary stalk and the posterior lobe, indicating the location of antidiuretic hormone. No patients had any DI before TSS. Delayed DI occurred 2 weeks to 3 months after TSS and persisted for 2 weeks to 5 months. T1-weighted magnetic resonance imaging showed that the HI in the posterior lobe became faint but did not disappear after DI occurrence, and their intensities increased with recovery from DI. In contrast, the HI in the pituitary stalk was found faintly preoperatively and turned clear postoperatively and decreased with recovery from DI. The morphologic patterns were dependent on DI duration. In the delayed occurrence of DI, it was suggested that preoperative antidiuretic hormone transport was mildly congested yet not completely blocked when DI manifested postoperatively. Gradual spreading of inflammation to the infundibulum after RCC removal was considered as 1 possible mechanism of this delayed DI development. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Experimental and clinical studies on hepatobiliary scintigraphy and function test with sup(99m)Tc-E-HIDA

    International Nuclear Information System (INIS)

    Narabayashi, Isamu; Otsuka, Nobuaki; Terashima, Hideaki; Yokobayashi, Tsuneo; Kaji, Tatsumi

    1980-01-01

    In experimental and clinical studies, the usefulness of sup(99m)Tc-E-HIDA has been evaluated for dynamic imaging and function test. Biological distribution of sup(99m)Tc-E-HIDA in rabbits at 1 hour after the intravenous administration indicated that activity was 62% of the injected dose in the gallbladder and intestine, 2% in the liver, and 9% in the kidneys and urine. Hepatic uptake and excretion of sup(99m)Tc-E-HIDA were discussed in comparison with those of sup(99m)Tc-p-butyl-IDA, sup(99m)Tc-HIDA, sup(99m)Tc-PI and 123 I-RB. Radiochemical purity was ascertained by thin layer chromatography in saline. Labelling was nearly 100%, namely no unreacted pertechnetate was detected. In clinical study, the imaging of liver, bile ducts, gallbladder and intestine was satisfactory with sup(99m)Tc-E-HIDA. There was no or faint renal visualization in cases with hepatic uptake on the hepatogram. Quantitative analysis of blood retention, blood clearance and hepatogram with sup(99m)Tc-E-HIDA reflected excretory liver function in various hepatobiliary disorders. We concluded that sup(99m)Tc-E-HIDA has a lower urinary excretion and seems more effective than the other sup(99m)Tc-labels, such as sup(99m)Tc-HIDA and sup(99m)Tc-PI, at higher bilirubin levels. However, when the level of the bilirubin in blood rises above 7.4 mg/dl, no hepatic uptake of sup(99m)Tc-E-HIDA was obtained with greater renal excretion. (author)

  10. Thermally activated delayed fluorescence organic dots for two-photon fluorescence lifetime imaging

    Science.gov (United States)

    He, Tingchao; Ren, Can; Li, Zhuohua; Xiao, Shuyu; Li, Junzi; Lin, Xiaodong; Ye, Chuanxiang; Zhang, Junmin; Guo, Lihong; Hu, Wenbo; Chen, Rui

    2018-05-01

    Autofluorescence is a major challenge in complex tissue imaging when molecules present in the biological tissue compete with the fluorophore. This issue may be resolved by designing organic molecules with long fluorescence lifetimes. The present work reports the two-photon absorption (TPA) properties of a thermally activated delayed fluorescence (TADF) molecule with carbazole as the electron donor and dicyanobenzene as the electron acceptor (i.e., 4CzIPN). The results indicate that 4CzIPN exhibits a moderate TPA cross-section (˜9 × 10-50 cm4 s photon-1), high fluorescence quantum yield, and a long fluorescence lifetime (˜1.47 μs). 4CzIPN was compactly encapsulated into an amphiphilic copolymer via nanoprecipitation to achieve water-soluble organic dots. Interestingly, 4CzIPN organic dots have been utilized in applications involving two-photon fluorescence lifetime imaging (FLIM). Our work aptly demonstrates that TADF molecules are promising candidates of nonlinear optical probes for developing next-generation multiphoton FLIM applications.

  11. Gd-EOB-DTPA-enhanced magnetic resonance images of hepatocellular carcinoma: correlation with histological grading and portal blood flow

    Energy Technology Data Exchange (ETDEWEB)

    Kogita, Sachiyo; Imai, Yasuharu; Fukuda, Kazuto; Igura, Takumi; Sawai, Yoshiyuki [Ikeda Municipal Hospital, Department of Gastroenterology, Osaka (Japan); Okada, Masahiro; Murakami, Takamichi [Kinki University, School of Medicine, Department of Radiology, Osaka (Japan); Kim, Tonsok; Onishi, Hiromitsu; Hori, Masatoshi [Osaka University, Graduate School of Medicine, Department of Radiology, Osaka (Japan); Takamura, Manabu [Ikeda Municipal Hospital, Department of Radiology, Osaka (Japan); Morimoto, Osakuni [Ikeda Municipal Hospital, Department of Surgery, Osaka (Japan); Nagano, Hiroaki [Osaka University, Graduate School of Medicine, Department of Surgery, Osaka (Japan); Wakasa, Kenichi [Osaka City University, Graduate School of Medicine, Department of Diagnostic Pathology, Osaka (Japan); Hayashi, Norio [Osaka University, Graduate School of Medicine, Department of Gastroenterology and Hepatology, Osaka (Japan)

    2010-10-15

    To retrospectively investigate enhancement patterns of hepatocellular carcinoma (HCC) and dysplastic nodule (DN) in the hepatobiliary phase of gadolinium-ethoxybenzyl-diethylenetriamine (Gd-EOB-DTPA)-enhanced MRI in relation to histological grading and portal blood flow. Sixty-nine consecutive patients with 83 histologically proven HCCs and DNs were studied. To assess Gd-EOB-DTPA uptake, we calculated the EOB enhancement ratio, which is the ratio of the relative intensity of tumorous lesion to surrounding nontumorous area on hepatobiliary phase images (post-contrast EOB ratio) to that on unenhanced images (pre-contrast EOB ratio). Portal blood flow was evaluated by CT during arterial portography. Post-contrast EOB ratios significantly decreased as the degree of differentiation declined in DNs (1.00 {+-} 0.14) and well, moderately and poorly differentiated HCCs (0.79 {+-} 0.19, 0.60 {+-} 0.27, 0.49 {+-} 0.10 respectively). Gd-EOB-DTPA uptake, assessed by EOB enhancement ratios, deceased slightly in DNs and still more in HCCs, while there was no statistical difference in the decrease between different histological grades of HCC. Reductions in portal blood flow were observed less frequently than decreases in Gd-EOB-DTPA uptake in DNs and well-differentiated HCCs. Reduced Gd-EOB-DTPA uptake might be an early event of hepatocarcinogenesis, preceding portal blood flow reduction. The hepatobiliary phase of Gd-EOB-DTPA-enhanced MRI may help estimate histological grading, although difficulties exist in differentiating HCCs from DNs. (orig.)

  12. Imaging-pathologic correlation of multi-step hepatocarcinogenesis

    International Nuclear Information System (INIS)

    Matsui, O.

    2012-01-01

    malignancy of the nodules. Signal intensity on hepatobiliary phase of Gd-EOBDTPA MR imaging is also useful to estimate the grade of malignancy of hepatocellular nodules. The expression of uptake transporter OATP8(1B3) significantly decreases during multistep hepatocarcinogenesis, which might explain the decrease in the enhancement ratio of hepatocellular nodules in the hepatobiliary phase in accordance with the elevation of the grade of malignancy and around 80% of early HCC can show hypointensity. (3) Imaging features of HCC; Imaging features of early HCC include indistinct margin, hypo or isoattenuation on dynamic CT and MRI, decreased but not absent intranodular portal supply on CTAP, hyperintensity on T1 and iso or hypointensity on T2 - weighted images, occasional fatty change, nodule in nodule appearance hypervascular focus on dynamic CT or MRI) when hypervascular less differentiated HCC emerges within early HCC. SPIO usually accumulates in early HCC. On hepatobiliary phase of Gd-EOB-DTPA enhanced MRI, early HCC is frequently visualized as hypointense nodule. In addition, imaging features of classical HCCs will be discussed including both typical and atypical histological features

  13. The significance of resting thallium-201 delayed SPECT for assessing viability of infarcted regions

    International Nuclear Information System (INIS)

    Mori, Takao; Yamabe, Hiroshi; Yoshida, Hiroyuki; Maeda, Kazumi; Fukuzaki, Hisashi

    1991-01-01

    Thirty-eight patients with old myocardial infarction (OMI) and 35 patients with effort angina pectoris (EAP) underwent resting thallium-201 (Tl) SPECT one week after exercise (Ex) Tl SPECT. On the basis of both resting and Ex Tl SPECT scans, OMI patients were divided into 3 groups: those who had Tl redistribution (RD) on Ex images and the same perfusion defect (PD) on both resting and Ex delayed images (n=12, Group 1); those who had a lower PD on resting delayed images than Ex delayed images (n=15, Group 2); and those who had no Tl RD on Ex images in spite of the same PD on both resting and EX delayed images (n=11, Group 3). EAP patients were divided into Group 1 (n=18) in whom no PD was seen on Ex delayed image and Group 2 (n=17) in whom PD was not seen on Ex delayed images either, but seen on resting delayed images. EX images showed higher pulmonary artery wedge pressure in Group 2 than Group 1 of both OMI and EAP patients (27±7 mmHg vs 15±6 mmHg for OMI patients; 22±6 mmHg vs 12±7 mmHg for EAP patients). For PD, Tl uptake rate on Ex initial images was higher in Group 1 than Gorup 2 of both OMI and EAP patients (63±7% vs 55±9% for OMI patients; 72±7% vs 65±9% for EAP patients). Resting delayed images for OMI patients showed the highest Tl uptake rate in Group 1 (78±7%), followed by Group 2 (74±8%) and then Group 3 (41±10%). In the group of OMI patients, the incidence of akinetic or dyskinetic wall motion on left ventriculography was the highest in Group 3 (85.7%), followed by Group 2 (52.2%) and Group 1 (24.3%). OMI patients, as well as EAP patients, had lower PD on resting delayed images than EX delayed images. Thus, severer ischemia may be associated with stress and infarcted areas may not involve viable muscle when Tl PD is decreased on resting delayed images. (N.K.)

  14. Imaging of ascariasis

    International Nuclear Information System (INIS)

    Das, C. J.; Chaudhry, A.; Kumar, J.; Debnath, J.

    2007-01-01

    Full text: Ascaris lumbricoides is one of the most common parasitic infestations of the gastrointestinal tract worldwide. During the intestinal phase of the disease, the adult worms usually remain clinically silent, sometimes causing a variety of non-specific abdominal symptoms. When present in large numbers, the worms may get intertwined into a bolus, causing intestinal obstruction, volvulus or even perforation. Occasionally, the adult Ascaris worm may migrate into the Vater's ampulla and enter the bile duct, gall bladder or pancreatic duct, leading to a variety of complications such as biliary colic, gallstone formation, cholecystitis, pyogenic cholangitis, liver abscess and pancreatitis. Imaging plays a significant role in showing the presence of worms and possible complications in intestinal as well as hepatobiliary ascariasis. This pictorial essay aims to illustrate various imaging features of ascariasis and its associated complications

  15. Mycobacterium marinum infections of the distal upper extremities: clinical course and imaging findings in two cases with delayed diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Amrami, K.K.; Sundaram, M. [Dept. of Radiology, Mayo Clinic, SW, Rochester, MN (United States); Shin, A.Y.; Bishop, A.T. [Dept. of Orthopedics, Mayo Clinic, Rochester, MN (United States)

    2003-09-01

    Mycobacterium marinum infections cause tenosynovitis of the distal upper extremities and develop as a consequence of skin abrasions acquired in contaminated water. We report on two patients whose MR imaging studies showed tenosynovitis of the distal upper extremity secondary to M. marinum. In one patient sequential MR imaging showed development of bony erosions. Appropriate treatment was delayed in both patients because the diagnosis was not considered. We report on and discuss the clinical course and MR imaging findings in two patients with M. marinum infection. (orig.)

  16. Mycobacterium marinum infections of the distal upper extremities: clinical course and imaging findings in two cases with delayed diagnosis

    International Nuclear Information System (INIS)

    Amrami, K.K.; Sundaram, M.; Shin, A.Y.; Bishop, A.T.

    2003-01-01

    Mycobacterium marinum infections cause tenosynovitis of the distal upper extremities and develop as a consequence of skin abrasions acquired in contaminated water. We report on two patients whose MR imaging studies showed tenosynovitis of the distal upper extremity secondary to M. marinum. In one patient sequential MR imaging showed development of bony erosions. Appropriate treatment was delayed in both patients because the diagnosis was not considered. We report on and discuss the clinical course and MR imaging findings in two patients with M. marinum infection. (orig.)

  17. Hepatobiliary ultrasonography

    Science.gov (United States)

    Sembiring, J.

    2018-03-01

    Ultrasound is one of the most widely used imaging technologies in medicine. It is portable, free of radiation risk, non-invasive and relatively inexpensive when compared with other imaging modalities, such as magnetic resonance and computed tomography. Ultrasound is a useful procedure for evaluating many structures organ in our body. An examination may include the entirety of the abdomen and retroperitoneum from a single organ to several organs. An abdominal ultrasound examination survey would include the liver, gallbladder, biliary tree, pancreas, spleen, kidneys and retroperitoneal structures. It needsperforming when there is a valid medical reason.

  18. Multiple Time-Point 68Ga-PSMA I&T PET/CT for Characterization of Primary Prostate Cancer: Value of Early Dynamic and Delayed Imaging.

    Science.gov (United States)

    Schmuck, Sebastian; Mamach, Martin; Wilke, Florian; von Klot, Christoph A; Henkenberens, Christoph; Thackeray, James T; Sohns, Jan M; Geworski, Lilli; Ross, Tobias L; Wester, Hans-Juergen; Christiansen, Hans; Bengel, Frank M; Derlin, Thorsten

    2017-06-01

    The aims of this study were to gain mechanistic insights into prostate cancer biology using dynamic imaging and to evaluate the usefulness of multiple time-point Ga-prostate-specific membrane antigen (PSMA) I&T PET/CT for the assessment of primary prostate cancer before prostatectomy. Twenty patients with prostate cancer underwent Ga-PSMA I&T PET/CT before prostatectomy. The PET protocol consisted of early dynamic pelvic imaging, followed by static scans at 60 and 180 minutes postinjection (p.i.). SUVs, time-activity curves, quantitative analysis based on a 2-tissue compartment model, Patlak analysis, histopathology, and Gleason grading were compared between prostate cancer and benign prostate gland. Primary tumors were identified on both early dynamic and delayed imaging in 95% of patients. Tracer uptake was significantly higher in prostate cancer compared with benign prostate tissue at any time point (P ≤ 0.0003) and increased over time. Consequently, the tumor-to-nontumor ratio within the prostate gland improved over time (2.8 at 10 minutes vs 17.1 at 180 minutes p.i.). Tracer uptake at both 60 and 180 minutes p.i. was significantly higher in patients with higher Gleason scores (P dynamic and static delayed Ga-PSMA ligand PET images. The tumor-to-nontumor ratio in the prostate gland improves over time, supporting a role of delayed imaging for optimal visualization of prostate cancer.

  19. GPU accelerated real-time confocal fluorescence lifetime imaging microscopy (FLIM) based on the analog mean-delay (AMD) method

    Science.gov (United States)

    Kim, Byungyeon; Park, Byungjun; Lee, Seungrag; Won, Youngjae

    2016-01-01

    We demonstrated GPU accelerated real-time confocal fluorescence lifetime imaging microscopy (FLIM) based on the analog mean-delay (AMD) method. Our algorithm was verified for various fluorescence lifetimes and photon numbers. The GPU processing time was faster than the physical scanning time for images up to 800 × 800, and more than 149 times faster than a single core CPU. The frame rate of our system was demonstrated to be 13 fps for a 200 × 200 pixel image when observing maize vascular tissue. This system can be utilized for observing dynamic biological reactions, medical diagnosis, and real-time industrial inspection. PMID:28018724

  20. Linear-array photoacoustic imaging using minimum variance-based delay multiply and sum adaptive beamforming algorithm

    Science.gov (United States)

    Mozaffarzadeh, Moein; Mahloojifar, Ali; Orooji, Mahdi; Kratkiewicz, Karl; Adabi, Saba; Nasiriavanaki, Mohammadreza

    2018-02-01

    In photoacoustic imaging, delay-and-sum (DAS) beamformer is a common beamforming algorithm having a simple implementation. However, it results in a poor resolution and high sidelobes. To address these challenges, a new algorithm namely delay-multiply-and-sum (DMAS) was introduced having lower sidelobes compared to DAS. To improve the resolution of DMAS, a beamformer is introduced using minimum variance (MV) adaptive beamforming combined with DMAS, so-called minimum variance-based DMAS (MVB-DMAS). It is shown that expanding the DMAS equation results in multiple terms representing a DAS algebra. It is proposed to use the MV adaptive beamformer instead of the existing DAS. MVB-DMAS is evaluated numerically and experimentally. In particular, at the depth of 45 mm MVB-DMAS results in about 31, 18, and 8 dB sidelobes reduction compared to DAS, MV, and DMAS, respectively. The quantitative results of the simulations show that MVB-DMAS leads to improvement in full-width-half-maximum about 96%, 94%, and 45% and signal-to-noise ratio about 89%, 15%, and 35% compared to DAS, DMAS, MV, respectively. In particular, at the depth of 33 mm of the experimental images, MVB-DMAS results in about 20 dB sidelobes reduction in comparison with other beamformers.

  1. Evaluation of delayed contrast-enhanced CT scan in diagnosing hilar cholangiocarcinoma

    International Nuclear Information System (INIS)

    Li Jianding; Liang Chenyang; Zhang Hua; Zhang Yuezhen; Li Rui

    2001-01-01

    Objective: To assess the diagnostic value of delayed CT contrast enhancement patterns in hilar cholangiocarcinoma based on two-phased dynamic incremental CT scanning. Methods: Fifty-two patients with suspected hilar tumor and bile duct obstruction underwent spiral CT scan. The scan time for one revolution of the X-ray tube was 1 second. To elucidate the delay time for optimal imaging, all proved cholangiocarcinoma with delayed (6, 8, 10, 15, 20, 30 minutes) post-equilibrium-phase contrast-enhanced CT scans were acquired with unenhanced, dynamic contrast-enhanced, and delayed images. Degree of delayed enhancement was compared with that of surrounding liver parenchyma. Results: (1) 8-15 minutes after IV injection of contrast material was the delay time for optimal imaging. (2) Of 29 cholangiocarcinomas, the early CT showed hypo-attenuating (lower than that of liver parenchyma) in 23 tumors, iso-attenuating (equal to that of the liver) in 4 tumors, and hyper-attenuating (higher than that of liver) in 2 tumors. The delayed CT scan showed iso-attenuating in 8 tumors, hyper-attenuating in 21 tumors, and no hypo-attenuating. Most of delay imaging of hilar cholangiocarcinoma may appear hyper-attenuating (U = -4.3073, P 2 = 9.09, P < 0.01). Conclusion: When assessing hilar tumor, delayed CT contrast enhancement patterns based on two-phase dynamic incremental CT scans is useful in the detection and characterization of hilar cholangiocarcinoma

  2. Cholangiocarcinoma in Cirrhosis: Value of Hepatocyte Specific Magnetic Resonance Imaging.

    Science.gov (United States)

    Piscaglia, Fabio; Iavarone, Massimo; Galassi, Marzia; Vavassori, Sara; Renzulli, Matteo; Forzenigo, Laura Virginia; Granito, Alessandro; Salvatore, Veronica; Sangiovanni, Angelo; Golfieri, Rita; Colombo, Massimo; Bolondi, Luigi

    2015-10-01

    The diagnosis of intrahepatic cholangiocellular carcinoma (ICC) remains elusive at imaging, which is a critical issue in cirrhotic patients in whom a diagnosis of hepatocellular carcinoma (HCC) can be established only by imaging. The aim of the study was to evaluate the potential of MRI in the diagnosis of ICC in cirrhosis using 'hepatocyte-specific' Gadolinium (Gd)-based contrast agents. Sixteen histologically proven and retrospectively identified ICCs on cirrhosis were investigated with hepatocyte-specific magnetic resonance contrast agents (6 in Bologna with Gd-EOB-DTPA and 10 in Milan with Gd-BOPTA). The control group consisted of 41 consecutively and prospectively collected nodules (31 HCCs) imaged with Gd-EOB-DTPA. Fifteen ICC nodules (94%) displayed hypointensity in the hepatobiliary phase, suggesting malignancy. Thirteen cholangiocarcinomas (81%) showed hyperenhancement in the venous phase. Only 2 cholangiocarcinoma nodules showed hypoenhancement in the venous phase, corresponding to washout, in both cases preceded by rim enhancement in arterial phase. All the hepatocarcinomas showed hypointensity in hepatobiliary phase, but was always preceded by hypointensity in the venous phase; arterial rim enhancement was never observed in any hepatocarcinoma or regenerative nodule. MRI with hepatocyte-specific Gd-based contrast agents showed a pattern of malignancy in almost all the ICCs, concurrently avoiding misdiagnosis with hepatocarcinoma. These findings suggest a greater diagnostic capacity for this technique compared with the results of MRI with conventional contrast agents reported in the literature in this setting. © 2015 S. Karger AG, Basel.

  3. Prognostic impact of hepatobiliary scintigraphy in diagnosis and postoperative follow-up of newborns with biliary atresia

    International Nuclear Information System (INIS)

    Rossmueller, B.; Porn, U.; Dresel, S.; Hahn, K.; Schuster, T.; Lang, T.

    2000-01-01

    Aim: To investigate the prognostic relevance of hepatobiliary scintigraphy (HBS) in newborns suffering from biliary atresia (BA) for establishing the primary diagnosis and in the postoperative follow-up after portoenterostomy (Kasai). Methods: Twenty newborns with direct hyperbilirubinemia and 6 children after operative treatment of BA (Kasai) underwent HBS with Tc-99m-DEIDA. In patients without intestinal drainage, hepatocellular extraction was estimated visually and calculated semiquantitatively by means of liver/heart-ratio 5 min p.i. Results: 10/20 patients with hyperbilirubinemia did not display biliary drainage; 6 had BA, 3 intrahepatic hypoplasia, and one showed a bile plug syndrom. 4/6 with BA but none of the 4 children with diagnoses other than BA presented with a good extraction. All of the 4 children with BA, who had either pre- or postoperatively a bad extraction, needed liver transplantation due to liver failure. Both of the two newborns with BA and favourable outcome after Kasai had a good extraction in the preoperative HBS and demonstrated good intestinal drainage in the postoperative scan. Conclusion: HBS rules out BA with high accuracy by demonstrating drainage of bile into the intestine. In newborns without drainage a good extraction favours the diagnosis of BA. In newborns with BA a bad extraction seems to indicate a poor postoperative prognosis after Kasai operation. HBS might therefore help to select those children who will not benefit from portoenterostomy. Postoperatively, HBS can easily and quickly confirm the successful hepatobiliary anastomosis by demonstrating biliary drainage into the intestine. (orig.) [de

  4. Intraindividual comparison of myocardial delayed enhancement MR imaging using gadobenate dimeglumine at 1.5 T and 3 T

    Energy Technology Data Exchange (ETDEWEB)

    Klumpp, Bernhard D.; Seeger, Achim; Fenchel, Michael; Kramer, Ulrich; Claussen, Claus D.; Miller, Stephan [Eberhard Karls University Tuebingen, Department for Diagnostic Radiology, Tuebingen (Germany); Sandstede, Joern [Roentgenzentrum, Hamburg (Germany); Lodemann, Klaus P. [Bracco Altana Pharma, Konstanz (Germany); Hoevelborn, Tobias [Eberhard Karls University Tuebingen, Department for Cardiology, Tuebingen (Germany)

    2009-05-15

    For contrast-enhanced imaging techniques relying on strong T1 weighting, 3 T provides increased contrast compared with 1.5 T. The aim of our study was the intraindividual comparison of delayed enhancement MR imaging at 1.5 T and at 3 T. Twenty patients with myocardial infarction were examined at 1.5 T and 3 T. Fifteen minutes after injection of contrast agent (0.1 mmol gadobenate dimeglumine per kg body weight), inversion recovery gradient recalled echo (IR-GRE) sequences were acquired (1.5 T/3 T: TR 11.0/9.9 ms, TE 4.4/4.9 ms, flip 30 /30 , slice thickness 6/6 mm) to assess myocardial viability. Two observers rated image quality (Wilcoxon signed rank test). Quantification of hyperenhanced myocardium and standardized SNR/CNR measurements were performed (Student's t test). There was no significant difference with respect to image quality (1.5 T/3 T: 3.5/3.3, p = 0.34, reader 1; 2.4/2.7, p = 0.12, reader 2) and infarction size (760 {+-} 566/828 {+-} 677 mm{sup 2} at 1.5 T, 808 {+-} 639/826 {+-} 726 mm{sup 2} at 3 T, reader 1/reader 2, p > 0.05). Mean SNR in hyperenhanced/normal myocardium was 19.2/6.2 at 1.5 T and 29.5/8.8 at 3 T (p < 0.05). Mean CNR was 14.3 at 1.5 T and 26.0 at 3 T (p < 0.05). Delayed enhancement MR imaging at 3 T is a robust procedure yielding superior tissue contrast at 3 T compared with 1.5 T which is, however, not reflected by increased image quality. (orig.)

  5. A Fast Time-Delay Calculation Method in Through-Wall-Radar Detection Scenario

    Directory of Open Access Journals (Sweden)

    Zhang Qi

    2016-01-01

    Full Text Available In TWR (Through Wall Radar signal processing procedure, time delay estimation is one of the key steps in target localization and high resolution imaging. In time domain imaging procedure such as back projection imaging algorithm, round trip propagation time delay at the path of “transmitter-target-receiver” needs to be calculated for each pixel in imaging region. In typical TWR scenario, transmitter and receiver are at one side and targets at the other side of a wall. Based on two-dimensional searching algorithm or solving two variables equation of four times, traditional time delay calculation algorithms are complex and time consuming, and cannot be used to real-time imaging procedure. In this paper, a new fast time-delay (FTD algorithm is presented. Because of that incident angle at one side equals to refracting angle at the other side, an equation of lateral distance through the wall can be established. By solving this equation, the lateral distance can be obtained and total propagation time delay can be calculated subsequently. Through processing simulation data, the result shows that new algorithm can be applied effectively to real-time time-delay calculation in TWR signal processing.

  6. Microscopic time-resolved imaging of singlet oxygen by delayed fluorescence in living cells.

    Science.gov (United States)

    Scholz, Marek; Dědic, Roman; Hála, Jan

    2017-11-08

    Singlet oxygen is a highly reactive species which is involved in a number of processes, including photodynamic therapy of cancer. Its very weak near-infrared emission makes imaging of singlet oxygen in biological systems a long-term challenge. We address this challenge by introducing Singlet Oxygen Feedback Delayed Fluorescence (SOFDF) as a novel modality for semi-direct microscopic time-resolved wide-field imaging of singlet oxygen in biological systems. SOFDF has been investigated in individual fibroblast cells incubated with a well-known photosensitizer aluminium phthalocyanine tetrasulfonate. The SOFDF emission from the cells is several orders of magnitude stronger and much more readily detectable than the very weak near-infrared phosphorescence of singlet oxygen. Moreover, the analysis of SOFDF kinetics enables us to estimate the lifetimes of the involved excited states. Real-time SOFDF images with micrometer spatial resolution and submicrosecond temporal-resolution have been recorded. Interestingly, a steep decrease in the SOFDF intensity after the photodynamically induced release of a photosensitizer from lysosomes has been demonstrated. This effect could be potentially employed as a valuable diagnostic tool for monitoring and dosimetry in photodynamic therapy.

  7. Clinical comparison of diisopropyl-IDA Tc 99m and diethyl-IDA Tc 99m for evaluation of the hepatobiliary system

    International Nuclear Information System (INIS)

    Klingensmith, W.C.; Fritzberg, A.R.; Spitzer, V.M.; Kuni, C.C.; Shanahan, W.S.

    1981-01-01

    Thirty-one patients with a wide range of hepatobiliary function and clinical diagnoses were studied with both diisopropyl-IDA Tc 99m and diethyl-IDA Tc 99m. Images were similar except for an increased liver-to-kidney ratio with diisopropyl-IDA Tc 99m (p less than 0.01) and a tendency toward an increased liver-to-background ratio at five minutes with diisopropyl-IDA Tc 99m (p greater than 0.05). Quantification of the relative hepatocyte extraction efficiency indicated a 16% higher extraction efficiency for diisopropyl-IDA Tc 99m (p greater than 0.05). Cumulative three-hour urine collections following injection demonstrated no significant difference in renal excretion in patients with normal total serum bilirubin levels. Both radiopharmaceuticals demonstrated increasing renal excretion with increasing total serum bilirubin levels; however, renal excretion of diisopropyl-IDA Tc 99m increased more slowly than excretion of diethyl-IDA Tc 99m (p less than 0.01). We conclude that, while the overall differences between these two radiopharmaceuticals are small, diisopropyl-IDA Tc 99m is superior because of a lower renal excretion rate in patients with decreased hepatocyte function

  8. Linear-array photoacoustic imaging using minimum variance-based delay multiply and sum adaptive beamforming algorithm.

    Science.gov (United States)

    Mozaffarzadeh, Moein; Mahloojifar, Ali; Orooji, Mahdi; Kratkiewicz, Karl; Adabi, Saba; Nasiriavanaki, Mohammadreza

    2018-02-01

    In photoacoustic imaging, delay-and-sum (DAS) beamformer is a common beamforming algorithm having a simple implementation. However, it results in a poor resolution and high sidelobes. To address these challenges, a new algorithm namely delay-multiply-and-sum (DMAS) was introduced having lower sidelobes compared to DAS. To improve the resolution of DMAS, a beamformer is introduced using minimum variance (MV) adaptive beamforming combined with DMAS, so-called minimum variance-based DMAS (MVB-DMAS). It is shown that expanding the DMAS equation results in multiple terms representing a DAS algebra. It is proposed to use the MV adaptive beamformer instead of the existing DAS. MVB-DMAS is evaluated numerically and experimentally. In particular, at the depth of 45 mm MVB-DMAS results in about 31, 18, and 8 dB sidelobes reduction compared to DAS, MV, and DMAS, respectively. The quantitative results of the simulations show that MVB-DMAS leads to improvement in full-width-half-maximum about 96%, 94%, and 45% and signal-to-noise ratio about 89%, 15%, and 35% compared to DAS, DMAS, MV, respectively. In particular, at the depth of 33 mm of the experimental images, MVB-DMAS results in about 20 dB sidelobes reduction in comparison with other beamformers. (2018) COPYRIGHT Society of Photo-Optical Instrumentation Engineers (SPIE).

  9. Indocyanine green labeled with 123I for dynamic studies of the hepato-biliary system

    International Nuclear Information System (INIS)

    Lambrecht, R.M.; Ansari, A.N.; Wolf, A.P.; Atkins, H.L.

    1975-01-01

    This report summarizes the results to develop an iodine-123 labeled agent for dynamic studies of the hepato-biliary system. Iodine-123 is an ideal nuclide for radiopharmaceuticals, because of its short half-life (T/sub 1 / 2 / = 13.3 hr); its decay with a high abundance (83%) of 159 keV photons; and the reduced patient radiation exposure (a factor of 100 less than iodine-131). Indocyanine green, a tricarbanocyanine dye, was introduced by Heseltine and co-workers in 1956, has several characteristics which suggested that iodine-123 labeled ICG might be potentially useful for hepatic functional evaluation. The plasma clearance and biliary excretion kinetics of 123 I-ICG (in dogs) will be compared to 131 I-rose bengal and bromosulphalein labeled with iodine-125

  10. Intravascular Large B-Cell Lymphoma Presenting with Diffuse Gallbladder Wall Thickening: A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Sayf Al-Katib

    2018-01-01

    Full Text Available Intravascular large B-cell lymphoma is a rare subtype of extranodal diffuse B-cell lymphoma characterized by proliferation of neoplastic cells within the lumen of small and medium sized vessels. Clinical and imaging findings are nebulous as the intravascular subtype of lymphoma can involve a multitude of organs. Involvement of the gallbladder is extremely uncommon, and imaging findings can be easily confused for more prevalent pathologies. We report a case of intravascular large B-cell lymphoma in an 83-year-old male and review clinical presentation and imaging findings on CT, ultrasound, hepatobiliary iminodiacetic acid (HIDA scan, and MRI. It is important for the radiologist to know about this disease as the imaging findings are atypical of other types of lymphoma, and this may lead to a delay in diagnosis and treatment.

  11. Radionuclide diagnosis of hepatobiliary system functional state at complex treatment of uterine cancer

    International Nuclear Information System (INIS)

    Vusik, Yi.M.; Slabodchikov, M.Je.; Nesterov, V.G.

    1993-01-01

    The study involved 68 patients with uterine cancer (stage II-III) who underwent complex treatment and 16 healthy women aged 27-69. The patients were performed hepatography (44 of them - dynamic liver scintigraphy with Tc 99m - mezida) before the treatment, immediately after and 1-1.5 and 2-3 years after the course of radiotherapy. Latent disturbance of hepatobiliary system function which can be revealed with radionuclide study is shown to be observed in the patients with uterine cancer before the treatment. The level of hepatocytes functioning after the treatment depends largely on their initial functional state. Computer assisted multichannel radiography with evaluation of effective blood flow in the liver and effective fraction of minute volume of the blood flow is the most reasonable for monitoring hepatocytes function during treatment in the patients with uterine cancer

  12. Overcoming obstacles to establish a multidisciplinary team approach to hepatobiliary diseases: a working model in a Caribbean setting.

    Science.gov (United States)

    Cawich, Shamir O; Johnson, Peter B; Shah, Sundeep; Roberts, Patrick; Arthurs, Milton; Murphy, Trevor; Bonadie, Kimon O; Crandon, Ivor W; Harding, Hyacinth E; Abu Hilal, Mohammed; Pearce, Neil W

    2014-01-01

    By providing a structured forum to exchange information and ideas, multidisciplinary team meetings improve working relationships, expedite investigations, promote evidence-based treatment, and ultimately improve clinical outcomes. This discursive paper reports the introduction of a multidisciplinary team approach to manage hepatobiliary diseases in Jamaica, focusing on the challenges encountered and the methods used to overcome these obstacles. Despite multiple challenges in resource-limited environments, a multidisciplinary team approach can be incorporated into clinical practice in developing nations. Policy makers should make it a priority to support clinical, operational, and governance aspects of the multidisciplinary teams.

  13. The value of paradoxical uptake of hepatocellular carcinoma on the hepatobiliary phase of gadoxetic acid-enhanced liver magnetic resonance imaging for the prediction of lipiodol uptake after transcatheter arterial chemoembolization

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jeong Woo, E-mail: pridebio@naver.com [Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Seoul (Korea, Republic of); Lee, Chang Hee, E-mail: chlee86@korea.ac.kr [Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Seoul (Korea, Republic of); Park, Yang Shin, E-mail: pys797979@naver.com [Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Seoul (Korea, Republic of); Seo, Tae Seok, E-mail: g1q1papa@korea.ac.kr [Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Seoul (Korea, Republic of); Song, Myung Gyu, E-mail: acube808@naver.com [Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Seoul (Korea, Republic of); Kim, Ji Hoon, E-mail: kjhhepar@naver.com [Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul (Korea, Republic of); Kim, Kyeong Ah, E-mail: kahkim@korea.ac.kr [Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Seoul (Korea, Republic of); Park, Cheol Min, E-mail: radpic@hanmail.net [Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Seoul (Korea, Republic of)

    2017-04-15

    Highlights: • HCC{sub para} shows more frequent initial compact lipiodol uptake after TACE than HCC{sub def}. • HCC{sub para} demonstrates less frequent early local recurrence after TACE. • HCC{sub para} has larger mean size, lower AER, and more frequent capsule appearance. - Abstract: Purpose: To compare the response to transcatheter arterial chemoembolization (TACE) between hepatocellular carcinoma (HCC) with paradoxical uptake on the hepatobiliary phase (HBP) (HCC{sub para}) and HCC with defect on the HBP (HCC{sub def}), and to identify some imaging features that can differentiate between two groups. Materials and methods: Ninety-three HCCs from 54 patients who underwent gadoxetic acid-enhanced liver magnetic resonance imaging (MRI) prior to TACE were included. HCCs were classified into two groups according to the signal intensity (SI) on the HBP: HCC{sub para} and HCC{sub def}. Using post-TACE computed tomography (CT) as a reference standard, initial compact lipiodol uptake was assessed and compared between groups. The arterial enhancement ratio (AER), SI ratios of the arterial phase and HBP, and presence of the capsule appearance were compared between groups. After initial response, local tumor recurrence within 6 and 18 months was evaluated based on follow-up CT or MRI. Results: Fifteen HCC{sub para} and 78 HCC{sub def} were included. Compared to HCC{sub def}, HCC{sub para} showed more frequent initial compact lipiodol uptake (p = 0.009), larger mean size (p = 0.019), lower AER (p = 0.005), higher SI ratio of the HBP (p < 0.0001), and more frequent capsule appearance (p < 0.0001). Local tumor recurrence rate within 6 months was also significantly lower in HCC{sub para} than in HCC{sub def} (p = 0.008). Conclusion: Despite larger size and lower AER, HCC{sub para} showed more frequent initial compact lipiodol uptake and lower early local recurrence rate after TACE than did HCC{sub def}.

  14. Synthesis of 99mTc-aroylhydrazinocarbo-nylmethyliminodiacetic acids and their animal study, hepatobiliary pharmaceuticals

    International Nuclear Information System (INIS)

    He Yong; Zhou Xirui; Chen Shaoliang; Chen Guohui

    1994-01-01

    Based on the structure specificity of a new compound isonicotinoylhydrazino-carbonylmethyliminodiacetic acid, nine similar derivatives were synthesized by esterification of aromatic acids, followed by hydrazinolysis, and acylation with nitrilotriacetic acid. The 99m Tc-complexes of these compounds were prepared by stannous chloride reduction of sodium pertechnetate in aqueous solution at pH 6 ∼ 7. The experimental results in mice and rabbits showed that the 99m Tc-complexes all exhibited varying degrees in the uptake by the liver cells, cleared off from the blood and excreted into the biliary tract. The hepatobiliary specificity of 99m Tc-2-methoxy-5-bromobenzoylhydrazinocarbonylmethyliminodiacetic acid was the best among them. It is concluded preliminarily that the aroylhydrazinocarbonylmethyliminodiacetic acids provide to be a fruitful source for 99m Tc-labeledhepatobiliary radiopharmaceuticals

  15. Cellular MR Imaging

    Directory of Open Access Journals (Sweden)

    Michel Modo

    2005-07-01

    Full Text Available Cellular MR imaging is a young field that aims to visualize targeted cells in living organisms. In order to provide a different signal intensity of the targeted cell, they are either labeled with MR contrast agents in vivo or prelabeled in vitro. Either (ultrasmall superparamagnetic iron oxide [(USPIO] particles or (polymeric paramagnetic chelates can be used for this purpose. For in vivo cellular labeling, Gd3+- and Mn2+- chelates have mainly been used for targeted hepatobiliary imaging, and (USPIO-based cellular imaging has been focused on imaging of macrophage activity. Several of these magneto-pharmaceuticals have been FDA-approved or are in late-phase clinical trials. As for prelabeling of cells in vitro, a challenge has been to induce a sufficient uptake of contrast agents into nonphagocytic cells, without affecting normal cellular function. It appears that this issue has now largely been resolved, leading to an active research on monitoring the cellular biodistribution in vivo following transplantation or transfusion of these cells, including cell migration and trafficking. New applications of cellular MR imaging will be directed, for instance, towards our understanding of hematopoietic (immune cell trafficking and of novel guided (stem cell-based therapies aimed to be translated to the clinic in the future.

  16. Application of indocyanine green-fluorescence imaging to full-thickness cholecystectomy.

    Science.gov (United States)

    Morita, Kiyomi; Ishizawa, Takeaki; Tani, Keigo; Harada, Nobuhiro; Shimizu, Atsushi; Yamamoto, Satoshi; Takemura, Nobuyuki; Kaneko, Junichi; Aoki, Taku; Sakamoto, Yoshihiro; Sugawara, Yasuhiko; Hasegawa, Kiyoshi; Kokudo, Norihiro

    2014-05-01

    Fluorescence imaging using indocyanine green (ICG) has recently been applied to laparoscopic surgery to identify cancerous tissues, lymph nodes, and vascular anatomy. Here we report the application of ICG-fluorescence imaging to visualize the boundary between the liver and subserosal tissues of the gallbladder during laparoscopic full-thickness cholecystectomy. A patient with a potentially malignant gallbladder lesion was administered 2.5-mg intravenous ICG just before laparoscopic full-thickness cholecystectomy. Intraoperative fluorescence imaging enabled the real-time delineation of both extrahepatic bile duct anatomy and hepatic parenchyma throughout the procedure, which resulted in complete removal of subserosal tissues between liver and gallbladder. Safe and feasible ICG-fluorescence imaging can be widely applied to laparoscopic hepatobiliary surgery by utilizing a biliary excretion property of ICG. © 2014 Japan Society for Endoscopic Surgery, Asia Endosurgery Task Force and Wiley Publishing Asia Pty Ltd.

  17. Cardiac carcinoid: tricuspid delayed hyperenhancement on cardiac 64-slice multidetector CT and magnetic resonance imaging.

    LENUS (Irish Health Repository)

    Martos, R

    2012-02-01

    INTRODUCTION: Carcinoid heart disease is a rare condition in adults. Its diagnosis can be easily missed in a patient presenting to a primary care setting. We revised the advantages of using coronary multidetector computed tomography (MDCT) and cardiac magnetic resonance imaging (MRI) in diagnosing this condition. MATERIALS AND METHODS: We studied a 65-year-old patient with carcinoid heart disease and right heart failure using transthoracic Doppler-echocardiogram, cardiac MDCT and MRI. Cardiac echocardiogram revealed marked thickening and retraction of the tricuspid leaflets with dilated right atrium and ventricle. Cardiac MDCT and MRI demonstrated fixation and retraction of the tricuspid leaflets with delayed contrast hyperenhancement of the tricuspid annulus. CONCLUSION: This case demonstrates fascinating imaging findings of cardiac carcinoid disease and highlights the increasing utility of contrast-enhanced MRI and cardiac MDCT in the diagnosis of this interesting condition.

  18. Prevalence of hepatobiliary dysfunction in a regional group of patients with chronic inflammatory bowel disease

    DEFF Research Database (Denmark)

    Wewer, V; Gluud, C; Schlichting, P

    1991-01-01

    A regional group of outpatients with chronic inflammatory bowel disease (ulcerative colitis, n = 396, and Crohn's disease, n = 125) was biochemically screened to estimate the prevalence of hepatobiliary dysfunction. Among the 396 patients with ulcerative colitis, 69 (17%; 95% confidence limits, 14...... primary sclerosing cholangitis, of whom two were primarily diagnosed; one patient had cholangiocarcinoma also primarily diagnosed; and two patients were found to have alcoholic hepatic damage. Among the 125 patients with Crohn's disease, 38 (30%; 95% confidence limits, 23-38%) had at least 1 abnormal...... the criteria for further evaluation as described above. One patient appeared to have epithelioid granuloma in the liver and one patient had alcoholic liver disease, whereas one patient refused further examination.(ABSTRACT TRUNCATED AT 250 WORDS)...

  19. MR imaging signal enhancement of normal intracranial and extracranial structures

    International Nuclear Information System (INIS)

    Muraki, A.S.; Carvlin, M.J.; Francisco, J.; Rocklage, S.M.; Quay, S.

    1988-01-01

    The authors report their initial experience using a paramagnetic manganese chelate complex as a contrast agent for magnetic resonance (MR) imaging of the central nervous system. Five female cats weighing 2-4 kg were used, and anesthesia was induced and maintained with intravenous nembutal (15-25 mg/kg). This contrast agent, manganese (II) N, N'-bis(pyridoxal-5-phosphate) ethylenediamine-N,N'-diacetic acid, or Mn(DPDP)(Salutar), has previously shown efficacy for MR imaging of the hepatobiliary axis but has not been employed in neuroradiologic imaging. T1-weighted (repetition time, 400 msec, echo time, 15, 26 msec; 4-mm sections) spin-echo images were acquired before and after intravenous administration (100 μmol/kg) of the contrast agent. On post-contrast images, the pituitary gland, infundibulum and portohypophyseal system of the hypothalamus and choroid lexus demonstrated signal increase at t=0-30 minutes after injection

  20. Magnetic resonance cholangiopancreatography. The fine art of bilio-pancreatic imaging.

    Science.gov (United States)

    Adamek, H E; Breer, H; Layer, G; Riemann, J F

    2002-01-01

    With the introduction of endoscopic retrograde cholangio-pancreatography in the early 1970s, gastroenterologists have a lot of diagnostic options in the biliopancreatic system to their disposal. Meanwhile, magnetic resonance cholangiopancreatography (MRCP) has become a competitive replacement for diagnostic ERCP with the advantage of avoiding complications related to endoscopic techniques. Mounting evidence suggests that both MRCP and MRI (magnetic resonance imaging) have a profound influence of diagnostic algorithms in a variety of hepatobiliary and pancreatic diseases. Copyright 2002 S. Karger AG, Basel and IAP

  1. Delay generation methods with reduced memory requirements

    DEFF Research Database (Denmark)

    Tomov, Borislav Gueorguiev; Jensen, Jørgen Arendt

    2003-01-01

    Modern diagnostic ultrasound beamformers require delay information for each sample along the image lines. In order to avoid storing large amounts of focusing data, delay generation techniques have to be used. In connection with developing a compact beamformer architecture, recursive algorithms were......) For the best parametric approach, the gate count was 2095, the maximum operation speed was 131.9 MHz, the power consumption at 40 MHz was 10.6 mW, and it requires 4 12-bit words for each image line and channel. 2) For the piecewise-linear approximation, the corresponding numbers are 1125 gates, 184.9 MHz, 7...

  2. Hemodynamic segmentation of brain perfusion images with delay and dispersion effects using an expectation-maximization algorithm.

    Directory of Open Access Journals (Sweden)

    Chia-Feng Lu

    Full Text Available Automatic identification of various perfusion compartments from dynamic susceptibility contrast magnetic resonance brain images can assist in clinical diagnosis and treatment of cerebrovascular diseases. The principle of segmentation methods was based on the clustering of bolus transit-time profiles to discern areas of different tissues. However, the cerebrovascular diseases may result in a delayed and dispersed local perfusion and therefore alter the hemodynamic signal profiles. Assessing the accuracy of the segmentation technique under delayed/dispersed circumstance is critical to accurately evaluate the severity of the vascular disease. In this study, we improved the segmentation method of expectation-maximization algorithm by using the results of hierarchical clustering on whitened perfusion data as initial parameters for a mixture of multivariate Gaussians model. In addition, Monte Carlo simulations were conducted to evaluate the performance of proposed method under different levels of delay, dispersion, and noise of signal profiles in tissue segmentation. The proposed method was used to classify brain tissue types using perfusion data from five normal participants, a patient with unilateral stenosis of the internal carotid artery, and a patient with moyamoya disease. Our results showed that the normal, delayed or dispersed hemodynamics can be well differentiated for patients, and therefore the local arterial input function for impaired tissues can be recognized to minimize the error when estimating the cerebral blood flow. Furthermore, the tissue in the risk of infarct and the tissue with or without the complementary blood supply from the communicating arteries can be identified.

  3. Gd-EOB-DTPA enhanced MRI of the liver: Correlation of relative hepatic enhancement, relative renal enhancement, and liver to kidneys enhancement ratio with serum hepatic enzyme levels and eGFR

    Energy Technology Data Exchange (ETDEWEB)

    Talakic, Emina; Steiner, Jürgen; Kalmar, Peter; Lutfi, Andre [Division of General Radiology, Department of Radiology, Medical University of Graz, Auenbruggerplatz 9, 8036 Graz (Austria); Quehenberger, Franz [Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Auenbruggerplatz 2, 8036 Graz (Austria); Reiter, Ursula; Fuchsjäger, Michael [Division of General Radiology, Department of Radiology, Medical University of Graz, Auenbruggerplatz 9, 8036 Graz (Austria); Schöllnast, Helmut, E-mail: helmut.schoellnast@medunigraz.at [Division of General Radiology, Department of Radiology, Medical University of Graz, Auenbruggerplatz 9, 8036 Graz (Austria)

    2014-04-15

    Objectives: To assess the correlation of relative hepatic enhancement (RHE), relative renal enhancement (RRE) and liver to kidneys enhancement ratio (LKR) with serum hepatic enzyme levels and eGFR in Gd-EOB-DTPA enhanced MRI of the liver and to assess threshold levels for predicting enhancement of the liver parenchyma. Methods: Data of 75 patients who underwent Gd-EOB-DTPA enhanced MRI of the liver were collected. Images were obtained before contrast injection, during the early arterial phase, late arterial phase, venous phase, delayed phase, and hepatobiliary phase which was 20 min after Gd-EOB-DTPA administration. Signal intensity of the liver and the kidneys in all phases was defined using region-of-interest measurements for relative enhancement calculation. Serum hepatic enzyme levels and eGFR were available in all patients. Spearman correlation test was used to test the correlation of RHE, RRE and LKR with serum hepatic enzyme levels and eGFR. Results: In the hepatobiliary phase all serum hepatic enzymes were significantly correlated with RHE; total bilirubin (TBIL) and cholin esterase (CHE) showed strongest correlations. TBIL and CHE were significantly correlated with RRE in the arterial phases. TBIL and CHE were significantly correlated with LKR in the arterial phase and hepatobiliary phase. eGFR showed no correlation. Conclusions: In Gd-EOB-DTPA enhanced MRI, TBIL and CHE levels may predict RHE, RRE and LKR.

  4. Photodynamic effect of photosensitizer-loaded hollow silica nanoparticles for hepatobiliary malignancies: an in vitro and in vivo study

    Science.gov (United States)

    Deng, Xiaofeng; Xiong, Li; Wen, Yu; Liu, Zhongtao; Pei, Dongni; Huang, Yaxun; Miao, Xiongying

    2014-03-01

    Background and aims: Nanoparticles have been explored recently as an efficient delivery system for photosensitizers in photodynamic therapy. In this study, polyhematoporphyrin (C34H38N4NaO5,) was loaded into hollow silica nanoparticles (HSNP) by one-step wet chemical-based synthetic route. We evaluate the efficacy and safety of polyhematoporphyrin-loaded HSNP with hepatobiliary malignant cells and in vivo models. Methods: Human liver cancer, cholangiocarcinoma and gallbladder cancer cells were cultured with the HSNP and cellular viability was determined by MTT assay. Apoptotic and necrotic cells were measured by flow cytometry. Finally, we investigate its effect in vivo. Results: In MTT assay, the cell viability of QBC939, Huh-7, GBC-SD and HepG2 cells of the HSNP was 6.4+/-1.3%, 6.5+/-1.2%, 3.7+/-1.2% and 4.7+/-2.0%, respectively, which were significant different from that of free polyhematoporphyrin 62.4+/-4.7%, 62.5+/-6.0%, 33.4+/-6.5% and 44.3+/-1.9%. Flow cytometry demonstrated the laser-induced cell death with polyhematoporphyrin-loaded HSNP was much more severe. Similarly, in vivo results of each kind of cell revealed 14 days post-photoradiated, tumor sizes of the HSNP group were significantly smaller. Administration of the HSNP without illumination cannot cause killing effect both in vitro and in vivo experiments. Conclusions: HSNP is a desirable delivery system in photodynamic therapy for hepatobiliary malignacies, with improved aqueous solubility, stability and transport efficiency of photosensitizers.

  5. Spectral pulsed-wave tissue Doppler imaging lateral-to-septal delay fails to predict clinical or echocardiographic outcome after cardiac resynchronization therapy

    NARCIS (Netherlands)

    O.I.I. Soliman (Osama Ibrahim Ibrahim); D.A.M.J. Theuns (Dominic); M.L. Geleijnse (Marcel); A. Nemes (Attila); K. Caliskan (Kadir); W.B. Vletter (Wim); L.J.L.M. Jordaens (Luc); F.J. ten Cate (Folkert)

    2007-01-01

    textabstractAims: The current study sought to assess if pre-implantation lateral-to-septal delay (LSD) ≥60 ms assessed by spectral pulsed-wave myocardial tissue Doppler imaging (PW-TDI) could predict successful long-term outcome after cardiac resynchronization therapy (CRT). Methods and results

  6. Differentiating Focal Eosinophilic Infiltration from Metastasis in the Liver with Gadoxetic Acid-Enhanced Magnetic Resonance Imaging

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Mi Hee; Kim, Seong Hyun; Kim, Hee Jung; Lee, Min Woo; Lee, Won Jae [Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2011-08-15

    To determine the most useful findings of gadoxetic acid-enhanced 3.0 Tesla (T) MRI for differentiating focal eosinophilic infiltration (FEI) from hepatic metastasis with verification of their usefulness. Pathologically or clinically proven 39 FEIs from 25 patients and 79 hepatic metastases from 51 patients were included in the study. Gadoxetic acid-enhanced 3.0T MRI was performed in all cancer patients. Size differences measured between T2-weighted and hepatobiliary-phase images for lesions > 1 cm and morphologic findings (margin, shape, signal intensity on T1- and T2-weighted images, enhancement pattern on dynamic images, and target appearance on hepatobiliary-phase images) were compared between two groups via Student's t test as well as univariate and multivariate analyses. Diagnostic predictive values of two observers for differentiating two groups were assessed before (session 1) and after (session 2) recognition of results. Mean size difference (2.1 mm) in FEIs between the two images was significantly greater than for metastases (0.7 mm) (p < 0.05). An ill-defined margin and isointensity on T1-weighted images were independently significant morphologic findings (p < 0.05) for differentiating the two groups. All observers achieved a higher diagnostic accuracy in session 2 (97% and 98%) than session 1 (92% and 89%) with statistical significance in observer 2 (p < 0.05). All observers had significantly higher sensitivities (95%) and negative predictive values (NPVs) (98%) in session 2 than in session 1 (sensitivity, 74% in two observers; NPV, 89% and 88%) (p < 0.05). With the size change, an ill-defined margin and isointensity on T1-weighted images are the most useful findings for differentiating FEI from hepatic metastasis on gadoxetic acid-enhanced 3.0T MRI.

  7. X-ray microtomography scanner using time-delay integration for elimination of ring artefacts in the reconstructed image

    International Nuclear Information System (INIS)

    Davis, G.R.; London Univ.; Elliott, J.C.; London Univ.

    1997-01-01

    Most X-ray microtomography scanners work on the same principle as third-generation medical CT scanners, that is, the same point in each projection is measured by the same detector element. This leads to ring artefacts in the reconstructed image if the X-ray sensitivities of the individual detector elements, after any analytical correction, are not all identical. We have developed an X-ray microtomography scanner which uses the time-delay integration method of imaging with a CCD detector to average the characteristics of all the detector elements in each linear projection together. This has the added advantage of allowing specimens which are larger than the detector and X-ray field to be scanned. The device also uses a novel mechanical stage to ''average out'' inhomogeneities in the X-ray field. The results show that ring artefacts in microtomographic images are eliminated using this technique. (orig.)

  8. The predictive value of MR diffusion weighted imaging on the delayed encephalopathy after carbon monoxide poisoning

    International Nuclear Information System (INIS)

    Xiao Xinlan; Fu Lihui; Xi Weimin; Yin Jianhua; Gong Liangeng; Yuan Aimei; Yang Xinyue; Liu Zhiyong

    2007-01-01

    Objective: To investigate the value of diffusion weighted imaging (DWI)in predicting delayed encephalopathy of the rabbits brain after carbon monoxide (CO)poisoning. Methods: Sixty healthy rabbits were put into self-made poisoning cabinet and were poisoned by inhalation of CO. Aeration of CO was stopped when the rabbits became comatous, and the cabinet was kept airpoof for 6 h. The rabbits underwent MRI before poisoning , at 1 h, 3 d, 5 d, 7 d, 15 d, 30 d ,45 d, and 60 d after poisoning respectively. Axial and sagittal T 2 WI, axial T 1 WI and DWI were performed. In the rabbits that did not show symptoms of delayed encephalopathy, the observation was discontinued on the 60th day. In the rabbit that showed the symptoms, the observation was discontinued on the 30th-45th day. The changing pattern of cortical ADC values before and after CO poisoning was observed and its relationship with delayed encephalopathy was investigated. Results: In the group without delayed encephalopathy (15 rabbits), the ADC value at 1 h after poisoning [(7.58±0.36) x 10 -4 mm 2 /s] decreased significantly compared with the pre- poisoning value [(8.02±0.35) x 10 -4 mm 2 /s] (q=0.4441, P -4 mm 2 /s], and maintained at the same level as pre- poisoning at 60 d after poisoning (P >0.05). In the group with delayed encephalopathy (15 rabbits), the ADC value at 1 h after poisoning [(7.40±0.32) x 10 -4 mm 2 /s] decreased significantly compared with the pre- poisoning value [(8.08± 0.32) x 10 -4 mm 2 /s] (q=0.6728, P -4 mm 2 /s], secondly significantly decreased at 15 d [(7.29±0.93) x 10 -4 mm 2 /s] without further recovery. The ADC value decrease at 15d alter poisoning [(7.29±0.93) x 10 -4 mm 2 /s] was significant compared with the prepoisoning ADC value (q=0.7850, P<0.01). Conclusions: There is a correlation between the decrease of the ADC value and the degree of tissue damage. The decrease of the ADC value in acute stage can predict the delayed encephalopathy. The second significant decrease

  9. Improved visualization of delayed perfusion in lung MRI

    International Nuclear Information System (INIS)

    Risse, Frank; Eichinger, Monika; Kauczor, Hans-Ulrich; Semmler, Wolfhard; Puderbach, Michael

    2011-01-01

    Introduction: The investigation of pulmonary perfusion by three-dimensional (3D) dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) was proposed recently. Subtraction images are generated for clinical evaluation, but temporal information is lost and perfusion defects might therefore be masked in this process. The aim of this study is to demonstrate a simple analysis strategy and classification for 3D-DCE-MRI perfusion datasets in the lung without omitting the temporal information. Materials and methods: Pulmonary perfusion measurements were performed in patients with different lung diseases using a 1.5 T MR-scanner with a time-resolved 3D-GRE pulse sequence. 25 3D-volumes were acquired after iv-injection of 0.1 mmol/kg KG Gadolinium-DTPA. Three parameters were determined for each pixel: (1) peak enhancement S n,max normalized to the arterial input function to detect regions of reduced perfusion; (2) time between arterial peak enhancement in the large pulmonary artery and tissue peak enhancement τ to visualize regions with delayed bolus onset; and (3) ratio R = S n,max /τ was calculated to visualize impaired perfusion, irrespectively of whether related to reduced or delayed perfusion. Results: A manual selection of peak perfusion images is not required. Five different types of perfusion can be found: (1) normal perfusion; (2) delayed non-reduced perfusion; (3) reduced non-delayed perfusion; (4) reduced and delayed perfusion; and (5) no perfusion. Types II and IV could not be seen in subtraction images since the temporal information is necessary for this purpose. Conclusions: The analysis strategy in this study allows for a simple and observer-independent visualization and classification of impaired perfusion in dynamic contrast-enhanced pulmonary perfusion MRI by using the temporal information of the datasets.

  10. Thermally activated delayed fluorescence of fluorescein derivative for time-resolved and confocal fluorescence imaging.

    Science.gov (United States)

    Xiong, Xiaoqing; Song, Fengling; Wang, Jingyun; Zhang, Yukang; Xue, Yingying; Sun, Liangliang; Jiang, Na; Gao, Pan; Tian, Lu; Peng, Xiaojun

    2014-07-09

    Compared with fluorescence imaging utilizing fluorophores whose lifetimes are in the order of nanoseconds, time-resolved fluorescence microscopy has more advantages in monitoring target fluorescence. In this work, compound DCF-MPYM, which is based on a fluorescein derivative, showed long-lived luminescence (22.11 μs in deaerated ethanol) and was used in time-resolved fluorescence imaging in living cells. Both nanosecond time-resolved transient difference absorption spectra and time-correlated single-photon counting (TCSPC) were employed to explain the long lifetime of the compound, which is rare in pure organic fluorophores without rare earth metals and heavy atoms. A mechanism of thermally activated delayed fluorescence (TADF) that considers the long wavelength fluorescence, large Stokes shift, and long-lived triplet state of DCF-MPYM was proposed. The energy gap (ΔEST) of DCF-MPYM between the singlet and triplet state was determined to be 28.36 meV by the decay rate of DF as a function of temperature. The ΔE(ST) was small enough to allow efficient intersystem crossing (ISC) and reverse ISC, leading to efficient TADF at room temperature. The straightforward synthesis of DCF-MPYM and wide availability of its starting materials contribute to the excellent potential of the compound to replace luminescent lanthanide complexes in future time-resolved imaging technologies.

  11. Gd-EOB-DTPA-Enhanced MR Imaging of the Liver: The Effect on T2 Relaxation Times and Apparent Diffusion Coefficient (ADC)

    International Nuclear Information System (INIS)

    Cieszanowski, Andrzej; Podgórska, Joanna; Rosiak, Grzegorz; Maj, Edyta; Grudziński, Ireneusz P.; Kaczyński, Bartosz; Szeszkowski, Wojciech; Milczarek, Krzysztof; Rowiński, Olgierd

    2016-01-01

    To investigate the effect of gadoxetic acid disodium (Gd-EOB-DTPA) on T2 relaxation times and apparent diffusion coefficient (ADC) values of the liver and focal liver lesions on a 1.5-T system. Magnetic resonance (MR) studies of 50 patients with 35 liver lesions were retrospectively analyzed. All examinations were performed at 1.5T and included T2-weighted turbo spin-echo (TSE) and diffusion-weighted (DW) images acquired before and after intravenous administration of Gd-EOB-DTPA. To assess the effect of this hepatobiliary contrast agent on T2-weighted TSE images and DW images T2 relaxation times and ADC values of the liver and FLLs were calculated and compared pre- and post-injection. The mean T2 relaxation times of the liver and focal hepatic lesions were lower on enhanced than on unenhanced T2-weighted TSE images (decrease of 2.7% and 3.6% respectively), although these differences were not statistically significant. The mean ADC values of the liver showed statistically significant decrease (of 4.6%) on contrast-enhanced DW images, compared to unenhanced images (P>0.05). The mean ADC value of liver lesions was lower on enhanced than on unenhanced DW images, but this difference (of 2.9%) did not reach statistical significance. The mean T2 relaxation times of the liver and focal liver lesions as well as the mean ADC values of liver lesions were not significantly different before and after administration of Gd-EOB-DTPA. Therefore, acquisition of T2-weighted and DW images between the dynamic contrast-enhanced examination and hepatobiliary phase is feasible and time-saving

  12. Abnormalities on magnetic resonance imaging seen acutely following mild traumatic brain injury: correlation with neuropsychological tests and delayed recovery

    International Nuclear Information System (INIS)

    Hughes, David G.; Jackson, Alan; Mason, Damon L.; Berry, Elizabeth; Hollis, Sally; Yates, David W.

    2004-01-01

    Mild traumatic brain injury (MTBI) is a common reason for hospital attendance and is associated with significant delayed morbidity. We studied a series of 80 persons with MTBI. Magnetic resonance imaging (MRI) and neuropsychological testing were used in the acute phase and a questionnaire for post-concussion syndrome (PCS) and return to work status at 6 months. In 26 subjects abnormalities were seen on MRI, of which 5 were definitely traumatic. There was weak correlation with abnormal neuropsychological tests for attention in the acute period. There was no significant correlation with a questionnaire for PCS and return to work status. Although non-specific abnormalities are frequently seen, standard MRI techniques are not helpful in identifying patients with MTBI who are likely to have delayed recovery. (orig.)

  13. Dynamic and delayed contrast enhancement in upper abdominal MRI studies: Comparison of gadoxetic acid and gadobutrol

    Energy Technology Data Exchange (ETDEWEB)

    Zizka, Jan [Department of Radiology, Charles University Hospital, Sokolska 581, CZ-500 05 Hradec Kralove (Czech Republic)]. E-mail: zizka@fnhk.cz; Klzo, Ludovit [Department of Radiology, Charles University Hospital, Sokolska 581, CZ-500 05 Hradec Kralove (Czech Republic); Ferda, Jiri [Department of Radiology, Charles University Hospital, Alej Svobody 80, CZ-306 40 Plzen (Czech Republic); Mrklovsky, Milan [Department of Radiology and Imaging Centre Pardubice, Regional Hospital, Kyjevska 44, CZ-530 01 Pardubice (Czech Republic); Bukac, Josef [Department of Biophysics, Medical Faculty, Charles University, Simkova 870, CZ-500 38 Hradec Kralove (Czech Republic)

    2007-05-15

    Objective: To prospectively compare contrast properties of extracelullar (gadobutrol) and hepatospecific (gadoxetic acid) contrast agents in upper abdominal MRI studies. Materials and methods: Standardized (0.1 ml/kg) dose of gadobutrol (56 subjects) and gadoxetic acid (51 subjects) was administered intravenously by MRI-compatible injector at 2 ml/s, followed by 20 ml saline flush. MR signal intensity changes (SIC) between precontrast scans and arterial phase, portal venous phase, equilibrium, and delayed scans at 10 and 20 min were measured in abdominal aorta, portal vein, common bile duct, liver, and spleen. Mean SIC values for gadobutrol and gadoxetic acid were compared by a two-sample t-test with p-value <0.05 considered significant. Results: In abdominal aorta, the mean SIC in the arterial phase did not significantly differ between gadobutrol (330%) and gadoxetic acid (295%). In portal vein, the mean SIC in the portal venous phase significantly differed between gadobutrol (267%) and gadoxetic acid (176%). Liver parenchyma enhancement was significantly higher for gadobutrol than for gadoxetic acid in both arterial phase (28 versus 13%) and portal venous phase (81 versus 46%). On the contrary, gadobutrol reached significantly lower mean SIC in the liver on delayed scans at 10 min (47 versus 59%) and 20 min (40 versus 67%), as well as in common bile duct at 10 min (54 versus 133%) and 20 min (57 versus 457%), respectively. In the spleen, mean SIC for gadobutrol was significantly higher at all phases. Conclusion: Gadobutrol showed superior enhancement of upper abdominal structures in the dynamic phases whereas gadoxetic acid showed better enhancement of the hepatobiliary structures on delayed scans.

  14. Micromachined silicon parallel acoustic delay lines as time-delayed ultrasound detector array for real-time photoacoustic tomography

    Science.gov (United States)

    Cho, Y.; Chang, C.-C.; Wang, L. V.; Zou, J.

    2016-02-01

    This paper reports the development of a new 16-channel parallel acoustic delay line (PADL) array for real-time photoacoustic tomography (PAT). The PADLs were directly fabricated from single-crystalline silicon substrates using deep reactive ion etching. Compared with other acoustic delay lines (e.g., optical fibers), the micromachined silicon PADLs offer higher acoustic transmission efficiency, smaller form factor, easier assembly, and mass production capability. To demonstrate its real-time photoacoustic imaging capability, the silicon PADL array was interfaced with one single-element ultrasonic transducer followed by one channel of data acquisition electronics to receive 16 channels of photoacoustic signals simultaneously. A PAT image of an optically-absorbing target embedded in an optically-scattering phantom was reconstructed, which matched well with the actual size of the imaged target. Because the silicon PADL array allows a signal-to-channel reduction ratio of 16:1, it could significantly simplify the design and construction of ultrasonic receivers for real-time PAT.

  15. Micromachined silicon parallel acoustic delay lines as time-delayed ultrasound detector array for real-time photoacoustic tomography

    International Nuclear Information System (INIS)

    Cho, Y; Chang, C-C; Zou, J; Wang, L V

    2016-01-01

    This paper reports the development of a new 16-channel parallel acoustic delay line (PADL) array for real-time photoacoustic tomography (PAT). The PADLs were directly fabricated from single-crystalline silicon substrates using deep reactive ion etching. Compared with other acoustic delay lines (e.g., optical fibers), the micromachined silicon PADLs offer higher acoustic transmission efficiency, smaller form factor, easier assembly, and mass production capability. To demonstrate its real-time photoacoustic imaging capability, the silicon PADL array was interfaced with one single-element ultrasonic transducer followed by one channel of data acquisition electronics to receive 16 channels of photoacoustic signals simultaneously. A PAT image of an optically-absorbing target embedded in an optically-scattering phantom was reconstructed, which matched well with the actual size of the imaged target. Because the silicon PADL array allows a signal-to-channel reduction ratio of 16:1, it could significantly simplify the design and construction of ultrasonic receivers for real-time PAT. (paper)

  16. Microstructural callosal abnormalities in normal-appearing brain of children with developmental delay detected with diffusion tensor imaging

    International Nuclear Information System (INIS)

    Ding, Xiao-Qi; Sun, Yimeng; Illies, Till; Zeumer, Hermann; Fiehler, Jens; Kruse, Bernd; Lanfermann, Heinrich

    2009-01-01

    Callosal fibres play an important role in psychomotor and cognitive functions. The purpose of this study was to investigate possible microstructural abnormalities of the corpus callosum in children with developmental delay, who have normal conventional brain MR imaging results. Seventeen pediatric patients (aged 1-9 years) with developmental delay were studied. Quantitative T2 and fractional anisotropy (FA) values were measured at the genu and splenium of the corpus callosum (CC). Fibre tracking, volumetric determination, as well as fibre density calculations of the CC were also carried out. The results were compared with those of the age-matched healthy subjects. A general elevation of T2 relaxation times (105 ms in patients vs. 95 ms in controls) and reduction of the FA values (0.66 in patients vs. 0.74 in controls) at the genu of the CC were found in patients. Reductions of the fibre numbers (5,464 in patients vs. 8,886 in controls) and volumes (3,415 ml in patients vs. 5,235 ml in controls) of the CC were found only in patients older than 5 years. The study indicates that despite their inconspicuous findings in conventional MRI microstructural brain abnormalities are evident in these pediatric patients suffering from developmental delay. (orig.)

  17. 99mTc labeled VIP analog: evaluation for imaging colorectal cancer

    International Nuclear Information System (INIS)

    Rao, P.S.; Thakur, M.L.; Pallela, V.; Patti, R.; Reddy, K.; Li, H.; Sharma, S.; Pham, H.L.; Diggles, L.; Minami, C.; Marcus, C.S.

    2001-01-01

    Early and reliable diagnosis of colorectal cancer continues to be demanding and challenging. Colorectal cancer cells express Vasoactive Intestinal Peptide (VIP) receptors in high density. We have prepared a VIP analog (TP3654), labeled it with 99m Tc, and evaluated it in experimental animals as an agent for imaging colorectal cancer. The tissue distribution of 99m Tc-TP3654 has been compared with that of 111 In-DTPA-Octreotide and 99m Tc-anti-CEA scan in nude mice bearing human colorectal cancer LS174T. Finally, pharmacokinetic and tissue distribution studies of 99m Tc-TP3654 have been performed in four normal human volunteers. Data suggest that 99m Tc-TP3654 can be prepared efficiently without loss of its receptor specificity and biological activity. Although the 24 hr tumor uptake of 99m Tc-TP3654 in the animal model used was modest (0.21 ± 0.07% I.D./g), the tissue distribution profile was more favorable than that of 111 In-DTPA-Octreotide or 99m Tc-anti-CEA scan. Human studies indicated that 99m Tc-TP3654 had no adverse effect in any subject. Within 24 hours, approximately 70% of the injected dose cleared through the kidneys, and approximately 20% through the hepatobiliary system. In these non-fasting volunteers hepatobiliary clearance was slow and in cancer patients tumor uptake was rapid. Data suggest that 99m Tc-TP3654 is a promising agent for imaging colorectal cancer

  18. Diagnostic value of radionuclide imaging combined with routine CT in detecting hepatic focal nodular hyperplasia

    International Nuclear Information System (INIS)

    Lu Xuemin; Yu Shuhong; Han Jiankui

    2011-01-01

    Objective: To investigate radionuclide imaging and routine CT in diagnosing hepatic focal nodular hyperplasia (FNH) and the combined diagnostic value of the two modalities. Methods: Thirty-two patients with hepatic FNH were retrospectively studied. All patients underwent routine CT scan. Twenty-four patients were examined by 99 Tc m -sulfur colloid (SC) hepatic planar scintigraphy and SPECT/CT imaging, and then patients who had abnormal foci underwent 99 Tc m -diethyl iminodiacetic acid (EHIDA) triple-phase hepatobiliary imaging. χ 2 -test of four-table or Fisher exact probabilities in 2 × 2 table was applied for statistical analysis. Results: Of all 32 patients pathologically diagnosed as FNH with single solitary nodule, 25 were classified as classic type and the rest 7 as non-classic type. Although routine CT found all hepatic lesions, only 15 cases were diagnosed pathologically as FNH classic type but the rest were either misdiagnosed or left as indeterminate. On radionuclide imaging (hepatic colloid scintigraphy plus triple-phase hepatobiliary images), 11 patients with big foci (with maximal diameter >3 cm) out of 24 patients were correctly diagnosed as FNH, with 7 diagnosed as classic type FNH and 4 as non-classic. Other 13 patients were either misdiagnosed or simply missed. The diagnosing rates of routine CT and radionuclide imaging were 60.0% (15/25) and 38.9% (7/18) for FNH classic type, 0/7 and 4/6 for non-classic type, 50.0% (10/20) and 73.3% (11/15) for big foci, 41.7% (5/12) and 0/9 for small foci (with maximal diameter ≤3 cm), respectively. The total diagnosing rate of radionuclide imaging combined with routine CT was significantly higher than that of routine CT or radionuclide imaging alone (χ 2 =4.48, P<0.05; χ 2 =4.27, P<0.05). Conclusion: Radionuclide imaging in combination with routine CT may improve the diagnostic accuracy for hepatic FNH patients. (authors)

  19. /sup 99m/Tc-IDA imaging in the differential diagnosis of acute cholecystitis and acute pancreatitis

    International Nuclear Information System (INIS)

    Fonseca, C.; Greenberg, D.; Rosenthall, L.; Arzoumanian, A.; Lisbona, R.

    1979-01-01

    Technetium-/sup 99m/-labelled dimethly-acetanilide-iminodiacetic acid (/sup 99m/Tc-IDA) hepato-biliary imaging was evaluated for its efficacy in distinguishing acute cholecystitis from acute pancreatitis. In a retrospective review, gallbladders were demonstrated by /sup 99m/Tc-IDA in 13 of 15 patients (87%) with acute pancreatitis. This is significantly higher than reports on the frequency of gallbladder filling with oral and intravenous cholangiography in the presence of acute cholecystitis

  20. Influence of ursodeoxycholic acid on hepatobiliary scintigraphy with /sup 99m/Tc-N-pyridoxyl-5-methyltryptophan in chronic liver diseases

    Energy Technology Data Exchange (ETDEWEB)

    Hayakawa, Tomihiro; Katagiri, Kenji; Shiraki, Shigehiro and others

    1988-11-01

    Hepatobiliary scintigraphy using /sup 99m/Tc-N-pyridoxyl-5-methyltryptophan (PMT) was used to elucidate the effect of ursodeoxycholic acid (UDCA) treatment on chronic liver diseases. After UDCA administration, the peak of the hepatic uptake-excretion curve of /sup 99m/Tc-PMT (peak time) was significantly shortened. Serum ..gamma..-GTP level also improved during UDCA therapy. These results suggest that UDCA enhances uptake especially of anions like /sup 99m/Tc-PMT, and increases their secretion into bile. Consequently, UDCA may be pharmachologically useful for chronic liver diseases.

  1. The influence of ursodeoxycholic acid on hepatobiliary scintigraphy with 99mTc-N-pyridoxyl-5-methyltryptophan in chronic liver diseases

    International Nuclear Information System (INIS)

    Hayakawa, Tomihiro; Katagiri, Kenji; Shiraki, Shigehiro

    1988-01-01

    Hepatobiliary scintigraphy using 99m Tc-N-pyridoxyl-5-methyltryptophan (PMT) was used to elucidate the effect of ursodeoxycholic acid (UDCA) treatment on chronic liver diseases. After UDCA administration, the peak of the hepatic uptake-excretion curve of 99m Tc-PMT (peak time) was significantly shortened. Serum γ-GTP level also improved during UDCA therapy. These results suggest that UDCA enhances uptake especially of anions like 99m Tc-PMT, and increases their secretion into bile. Consequently, UDCA may be pharmachologically useful for chronic liver diseases. (author)

  2. [A case of proptosis by traumatic delayed meningo-encephalocele].

    Science.gov (United States)

    Shi, Ming; Gao, Xue; Zhao, Mei

    2015-06-01

    A case of traumatic delayed meningo-encephalocele suffered orbital fracture, but bony defects in frontal sinus had not been found on CT scanning. We treated the patient with surgery of intranasal endoscopy and repaired the skull base defect successfully during the first attempt. There was no recurrence in 10 months followed up. The leak site may not correlate with imaging in traumatic delayed meningo-encephalocele by comparing operative findings with the imaging estimate and endoscopy. Therefore, endoscopical approaching is effective in seeking and treatment.

  3. Functional scintiscanning with sup(99m)technetium-diethyl-HIDA as a nuclear diagnostical means in hepatobiliary diseases

    International Nuclear Information System (INIS)

    Hummel, G.

    1982-01-01

    The study aimed to delimit the value of sequential hepatobiliary scintiscanning with the aid of sup(99m)technetium-diethyl-HIDA as a diagnostical method in functional or morphological disorders of the gall bladder and bile ducts. The most frequent indications to carry through the investigation therefore were inflammations calculosis in the biliary system, suspected intrahepatic icterus or conditions following biliodigestive anastomoses. Special attention was directed to the question in how far the results were in accordance with those of x-ray cholecystography/cholangiography. Furthermore the possibility for semiquantitative evaluation of serial functional scintiscanning was looked into and clearance determinations were carried through in part of the patients investigated. (orig./MG) [de

  4. Measurement of time delay for a prospectively gated CT simulator.

    Science.gov (United States)

    Goharian, M; Khan, R F H

    2010-04-01

    For the management of mobile tumors, respiratory gating is the ideal option, both during imaging and during therapy. The major advantage of respiratory gating during imaging is that it is possible to create a single artifact-free CT data-set during a selected phase of the patient's breathing cycle. The purpose of the present work is to present a simple technique to measure the time delay during acquisition of a prospectively gated CT. The time delay of a Philips Brilliance BigBore (Philips Medical Systems, Madison, WI) scanner attached to a Varian Real-Time Position Management (RPM) system (Varian Medical Systems, Palo Alto, CA) was measured. Two methods were used to measure the CT time delay: using a motion phantom and using a recorded data file from the RPM system. In the first technique, a rotating wheel phantom was altered by placing two plastic balls on its axis and rim, respectively. For a desired gate, the relative positions of the balls were measured from the acquired CT data and converted into corresponding phases. Phase difference was calculated between the measured phases and the desired phases. Using period of motion, the phase difference was converted into time delay. The Varian RPM system provides an external breathing signal; it also records transistor-transistor logic (TTL) 'X-Ray ON' status signal from the CT scanner in a text file. The TTL 'X-Ray ON' indicates the start of CT image acquisition. Thus, knowledge of the start time of CT acquisition, combined with the real-time phase and amplitude data from the external respiratory signal, provides time-stamping of all images in an axial CT scan. The TTL signal with time-stamp was used to calculate when (during the breathing cycle) a slice was recorded. Using the two approaches, the time delay between the prospective gating signal and CT simulator has been determined to be 367 +/- 40 ms. The delay requires corrections both at image acquisition and while setting gates for the treatment delivery

  5. Gadolinium-based contrast agents in pediatric magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Gale, Eric M.; Caravan, Peter [Massachusetts General Hospital, Harvard Medical School, Department of Radiology, The Martinos Center for Biomedical Imaging, Boston, MA (United States); Rao, Anil G. [Medical University of South Carolina, Department of Radiology and Radiological Science, Charleston, SC (United States); McDonald, Robert J. [College of Medicine, Mayo Clinic, Department of Radiology, Rochester, MN (United States); Winfeld, Matthew [University of Pennsylvania Perelman School of Medicine, Philadelphia, PA (United States); Fleck, Robert J. [Cincinnati Children' s Hospital Medical Center, Department of Pediatric Radiology, Cincinnati, OH (United States); Gee, Michael S. [MassGeneral Hospital for Children, Harvard Medical School, Division of Pediatric Imaging, Department of Radiology, Boston, MA (United States)

    2017-05-15

    Gadolinium-based contrast agents can increase the accuracy and expediency of an MRI examination. However the benefits of a contrast-enhanced scan must be carefully weighed against the well-documented risks associated with administration of exogenous contrast media. The purpose of this review is to discuss commercially available gadolinium-based contrast agents (GBCAs) in the context of pediatric radiology. We discuss the chemistry, regulatory status, safety and clinical applications, with particular emphasis on imaging of the blood vessels, heart, hepatobiliary tree and central nervous system. We also discuss non-GBCA MRI contrast agents that are less frequently used or not commercially available. (orig.)

  6. A Prototype Educational Model for Hepatobiliary Interventions: Unveiling the Role of Graphic Designers in Medical 3D Printing.

    Science.gov (United States)

    Javan, Ramin; Zeman, Merissa N

    2018-02-01

    In the context of medical three-dimensional (3D) printing, in addition to 3D reconstruction from cross-sectional imaging, graphic design plays a role in developing and/or enhancing 3D-printed models. A custom prototype modular 3D model of the liver was graphically designed depicting segmental anatomy of the parenchyma containing color-coded hepatic vasculature and biliary tree. Subsequently, 3D printing was performed using transparent resin for the surface of the liver and polyamide material to develop hollow internal structures that allow for passage of catheters and wires. A number of concepts were incorporated into the model. A representative mass with surrounding feeding arterial supply was embedded to demonstrate tumor embolization. A straight narrow hollow tract connecting the mass to the surface of the liver, displaying the path of a biopsy device's needle, and the concept of needle "throw" length was designed. A connection between the middle hepatic and right portal veins was created to demonstrate transjugular intrahepatic portosystemic shunt (TIPS) placement. A hollow amorphous structure representing an abscess was created to allow the demonstration of drainage catheter placement with the formation of pigtail tip. Percutaneous biliary drain and cholecystostomy tube placement were also represented. The skills of graphic designers may be utilized in creating highly customized 3D-printed models. A model was developed for the demonstration and simulation of multiple hepatobiliary interventions, for training purposes, patient counseling and consenting, and as a prototype for future development of a functioning interventional phantom.

  7. Quantification of FDG-PET/CT with delayed imaging in patients with newly diagnosed recurrent breast cancer.

    Science.gov (United States)

    Baun, Christina; Falch, Kirsten; Gerke, Oke; Hansen, Jeanette; Nguyen, Tram; Alavi, Abass; Høilund-Carlsen, Poul-Flemming; Hildebrandt, Malene G

    2018-05-09

    Several studies have shown the advantage of delayed-time-point imaging with 18F-FDG-PET/CT to distinguish malignant from benign uptake. This may be relevant in cancer diseases with low metabolism, such as breast cancer. We aimed at examining the change in SUV from 1 h (1h) to 3 h (3h) time-point imaging in local and distant lesions in patients with recurrent breast cancer. Furthermore, we investigated the effect of partial volume correction in the different types of metastases, using semi-automatic quantitative software (ROVER™). One-hundred and two patients with suspected breast cancer recurrence underwent whole-body PET/CT scans 1h and 3h after FDG injection. Semi-quantitative standardised uptake values (SUVmax, SUVmean) and partial volume corrected SUVmean (cSUVmean), were estimated in malignant lesions, and as reference in healthy liver tissue. The change in quantitative measures from 1h to 3h was calculated, and SUVmean was compared to cSUVmean. Metastases were verified by biopsy. Of the 102 included patients, 41 had verified recurrent disease with in median 15 lesions (range 1-70) amounting to a total of 337 malignant lesions included in the analysis. SUVmax of malignant lesions increased from 6.4 ± 3.4 [0.9-19.7] (mean ± SD, min and max) at 1h to 8.1 ± 4.4 [0.7-29.7] at 3h. SUVmax in breast, lung, lymph node and bone lesions increased significantly (p < 0.0001) between 1h and 3h by on average 25, 40, 33, and 27%, respectively. A similar pattern was observed with (uncorrected) SUVmean. Partial volume correction increased SUVmean significantly, by 63 and 71% at 1h and 3h imaging, respectively. The highest impact was in breast lesions at 3h, where cSUVmean increased by 87% compared to SUVmean. SUVs increased from 1h to 3h in malignant lesions, SUVs of distant recurrence were in general about twice as high as those of local recurrence. Partial volume correction caused significant increases in these values. However, it is questionable, if

  8. Delayed radiographic diagnosis of osteoid osteoma in the lumbar spine

    International Nuclear Information System (INIS)

    Louis-Ugbo, J.; Reddy, A.S.; Heller, J.G.

    1998-01-01

    Study design: Case report and literature review. Objectives: Describe a case of delayed diagnosis of osteoid osteoma of the spine due to misinterpretation of initial imaging studies within two months of onset of pain, and discuss the relevant imaging characteristics and their pitfalls. Summary of background data. Several cases of delayed diagnosis have been previously reported. Only one false negative bone scan has been reported; however other imaging modalities established the diagnosis. In our patient, all of the imaging modalities were initially interpreted as negative hence the delay in diagnosis. Methods: History, physical examination and imaging studies (x-rays, bone scan, MRI) of the patient were employed to evaluate the differential diagnosis of low back pain and sciatica in a 16 yr old. Repeat bone scan and CT scan were done six months after onset of symptoms because of persistent clinical suspicion of osteoid osteoma. Results: The repeat bone scan and CT scan confirmed-the diagnosis missed, during the first round of imaging. An osteoid osteoma of the L5 pedicle was removed without incident. Conclusion: Technetium bone scans remain the main stay of early diagnosis of osteoid osteoma when plain films and other imaging modalities are normal. However, when faced with persistent unexplained musculoskeletal pain in an adolescent, further follow-up and diagnostic efforts are indicated; possibly repeating a bone scan if initially interpreted as negative. (author)

  9. Postraumatic delayed loss of vision

    International Nuclear Information System (INIS)

    Partington, C.R.; Graves, V.B.; Ruetenacht, D.A.; Weinstein, J.M.; Strother, C.M.

    1989-01-01

    The imaging studies and clinical findings in 10 patients who suffered delayed vision loss beginning 1 day to 13 years after head trauma have been reviewed. Two different primary lesions could be identified: pseudoaneurysm of the internal carotid artery and carotid cavernous fistula. The pathologic changes associated with pseudoaneurysm included compression of the optic nerves and/or chiasm by arterial aneurysm and intracranial hematoma. Carotid cavernous fistula caused delayed vision loss by compression of the optic nerves and chiasm by saccular dilatation of the cavernous sinus and by abnormal orbital venous drainage with retinal venous stasis, retinal edema, and glaucoma

  10. Differential diagnosis between adrenal adenomas and non-adenomas with gadolinium MR in delayed scans: another diagnostic possibility

    International Nuclear Information System (INIS)

    Mondello, Eduardo J.; Eyheremendy, Eduardo P.; Stoisa, Daniela

    2001-01-01

    Purpose: To determine the value of measuring delayed post gadolinium signal intensity by displaying a curve, to make the differential diagnosis between adrenal adenomas and non-adenomas, and compare it to chemical shift MR imaging and unenhanced/delayed contrast enhanced CT. Material and methods: Nine adrenal masses have been evaluated by unenhanced/delayed contrast enhanced CT, chemical shift MR imaging and Dynamic Scan at 5, 15, 30 minutes or more, with measurement curves. The 'in phase' imaging have been compared to the 'out phase' ones. Results: Adenomas have shown drop of the curve at 30 minutes of the contrast injection. Non-adenomas have conserved an ascending curve with the same delay. Conclusion: Gadolinium-enhanced MR imaging at delayed scans can characterize adrenal masses as adenomas or non-adenomas. This technique could be considered as a new complementary diagnostic method. (author)

  11. Application of a simple, affordable quality metric tool to colorectal, upper gastrointestinal, hernia, and hepatobiliary surgery patients: the HARM score.

    Science.gov (United States)

    Brady, Justin T; Ko, Bona; Hohmann, Samuel F; Crawshaw, Benjamin P; Leinicke, Jennifer A; Steele, Scott R; Augestad, Knut M; Delaney, Conor P

    2018-06-01

    Quality is the major driver for both clinical and financial assessment. There remains a need for simple, affordable, quality metric tools to evaluate patient outcomes, which led us to develop the HospitAl length of stay, Readmission and Mortality (HARM) score. We hypothesized that the HARM score would be a reliable tool to assess patient outcomes across various surgical specialties. From 2011 to 2015, we identified colorectal, hepatobiliary, upper gastrointestinal, and hernia surgery admissions using the Vizient Clinical Database. Individual and hospital HARM scores were calculated from length of stay, 30-day readmission, and mortality rates. We evaluated the correlation of HARM scores with complication rates using the Clavien-Dindo classification. We identified 525,083 surgical patients: 206,981 colorectal, 164,691 hepatobiliary, 97,157 hernia, and 56,254 upper gastrointestinal. Overall, 53.8% of patients were admitted electively with a mean HARM score of 2.24; 46.2% were admitted emergently with a mean HARM score of 1.45 (p  4 (p  4, complication rates were 9.3, 23.2, 38.8, and 71.6%, respectively. There was a similar trend for increasing HARM score in emergent admissions as well. For all surgical procedure categories, increasing HARM score, with and without risk adjustment, correlated with increasing severity of complications by Clavien-Dindo classification. The HARM score is an easy-to-use quality metric that correlates with increasing complication rates and complication severity across multiple surgical disciplines when evaluated on a large administrative database. This inexpensive tool could be adopted across multiple institutions to compare the quality of surgical care.

  12. Time‐of‐flight secondary ion mass spectrometry imaging of biological samples with delayed extraction for high mass and high spatial resolutions

    Science.gov (United States)

    Vanbellingen, Quentin P.; Elie, Nicolas; Eller, Michael J.; Della‐Negra, Serge; Touboul, David

    2015-01-01

    Rationale In Time‐of‐Flight Secondary Ion Mass Spectrometry (TOF‐SIMS), pulsed and focused primary ion beams enable mass spectrometry imaging, a method which is particularly useful to map various small molecules such as lipids at the surface of biological samples. When using TOF‐SIMS instruments, the focusing modes of the primary ion beam delivered by liquid metal ion guns can provide either a mass resolution of several thousand or a sub‐µm lateral resolution, but the combination of both is generally not possible. Methods With a TOF‐SIMS setup, a delayed extraction applied to secondary ions has been studied extensively on rat cerebellum sections in order to compensate for the effect of long primary ion bunches. Results The use of a delayed extraction has been proven to be an efficient solution leading to unique features, i.e. a mass resolution up to 10000 at m/z 385.4 combined with a lateral resolution of about 400 nm. Simulations of ion trajectories confirm the experimental determination of optimal delayed extraction and allow understanding of the behavior of ions as a function of their mass‐to‐charge ratio. Conclusions Although the use of a delayed extraction has been well known for many years and is very popular in MALDI, it is much less used in TOF‐SIMS. Its full characterization now enables secondary ion images to be recorded in a single run with a submicron spatial resolution and with a mass resolution of several thousand. This improvement is very useful when analyzing lipids on tissue sections, or rare, precious, or very small size samples. © 2015 The Authors. Rapid Communications in Mass Spectrometry published by John Wiley & Sons Ltd. PMID:26395603

  13. Comparison of parenchymal phase of hepatobiliary gammagraphy with radiocolloid liver gammagram

    Energy Technology Data Exchange (ETDEWEB)

    Zimacek, J; Stupakova, E; Takacs, J

    1985-08-01

    A comparison was performed of the parenchymal phase of hepatobiliary gammagraphy (HBG) with radiocolloid gammagraphy (RCG) in 148 patients to assess the importance of both methods depending on the nature of the liver disease. Gammagraphic changes were mostly identical (43.9%), changes notable in HBG rather than RCG were more frequent (29.1%) than changes more marked in RCG (17.6%). Changes appearing only in HBG or only in RCG had the same frequency (4.7% each). The same results in both kinds of examination (identical findings) in all patients occurred only in metastases of malignant tumours of the liver, i.e., in these cases both examinations had the same diagnostic value. In HBG of hepatocellular carcinoma the defect found in RCG was supplemented in 1/4 of the patients, which shows high specificity in combination of both types of examination from the point of view of differential diagnosis. In mechanical jaundice and chronic hepatitis HBG is of greater importance and should be preferred to RCG. In acute hepatitis and further undifferentiated chronic hepatopathies most changes were identical for both HBG and RCG, but the relatively higher incidence of more notable changes with HBG made it preferrable to RCG. In liver cirrhosis RCG was more important.

  14. Delayed encephalopathy after acute carbon monoxide poisoning

    Directory of Open Access Journals (Sweden)

    Mehmet İbrahim Turan

    2014-03-01

    Full Text Available Carbon monoxide poisoning is a major cause of death following attempted suicide and accidental exposures. Although clinical presentation depends on the duration and the intensity of exposure, the assessment of the severity of intoxication is difficult. A small percentage of patients who show complete initial recovery may develop delayed neurological deficits. Delayed encephalopathy after acute carbon monoxide poisoning is a rare and poor prognosis neurologic disorders and there is no specific treatment. We present a case with early onset of delayed encephalopathy after acute carbon monoxide poisoning with typical cranial imaging findings in a child with atypical history and clinical presentation.

  15. Sequential hepato-biliary scintigraphy of the patients with constitutional jaundices and ICG excretory defect disease with sup(99m)Tc-HIDA and sup(99m)Tc-PI

    International Nuclear Information System (INIS)

    Ueda, Hideo; Asahara, Akira; Hishinuma, Sanpei; Toogin, Masayuki; Takagi, Masao

    1979-01-01

    The hepato-biliary scintigraphy with sup(99m)Tc-HIDA and sup(99m)Tc-PI and the measurement of hepatic clearance have been studied on constitutional hyperbilirubinemia and ICG excretory defect disease. The results obtained are as follows: 1) In Dubin-Johnson's syndrome cases, the hepatic uptake of sup(99m)Tc-HIDA was faster, but the excretion was extremely slower than in normal cases. 2) Hepatic uptake and excretion of sup(99m)Tc-PI were both almost normal in Dubin-Johnson's syndrome. 3) In Rotor's disease, hepatic uptake of sup(99m)Tc-HIDA was very poor, showing almost no hepatic image. 4) In Gilbert's disease and ICG excretory defect disease, hepatic uptake and excretion of sup(99m)Tc-HIDA were both within normal limit. From these results it can be presumed that Dubin-Johnson's syndrome and Rotor's disease differ in morbid condition. Dubin-Johnson's syndrome, Rotor's disease and Gilbert's disease show the different patterns between hepatic uptake and excretion on sup(99m)Tc-HIDA hepatoscintigraphy and the patterns contribute to the differential diagnosis of constitutional jaundice. (author)

  16. Diagnostic Significance of the Blood Disappearance Rate of 131I-Rose Bengal and of 198Au colloid in Hepatobiliary Diseases

    International Nuclear Information System (INIS)

    Chun, Young Kyoon; Hahn, Shim Suk; Koh, Chang Soon

    1971-01-01

    The liver function test was performed by means of two radioisotope tracer techniques in 20 normal subjects and in 63 patients with hepatobiliary diseases. The blood disappearance rates of 131 I-rose bengal and of 198 Au colloid were determined by external counting method. The hepatocellular function and the hepatic blood flow were estimated from the observed data and the results were compared with those of the conventional liver function tests. The results obtained were as follows: 1. The mean blood disappearance half time of 131 I-rose bengal was 6.6±0.63 minutes in normal control, 17.7±6.93 in cirrhosis of the liver, 16.6±4. 80 in acute hepatitis, and 14 7±3.46 in obstructive jaundice. It was markedly prolonged in the hepatobiliary diseases as compared with the normal control, but there was no significant difference among the hepatobiliary diseases. 2.The mean blood disappearance half time of 198 Au colloid was 4. 0±0. 66 minutes in normal control, 9.8±3.42 in cirrhosis of the liver, 4.4±0.82 in acute hepatitis, and 5.0±1.42 in obstructive jaundice. The difference between cirrhosis of the liver and normal control was statistically significant. However, there was no definite difference among acute hepatitis, obstructive jaundice, and normal control. The mean blood disappearance rate constant (K value) was 0.177±0.028/minute in normal control, In cirrhosis of the liver, it was markedly decreased which was suggestive of the reduced hepatic blood flow. 3. The ratio of 131 I-rose bengal blood disappearance half time to 198 Au colloid disappearance half time was 1.68±0.20 in normal control, 1.82±0.31 in cirrhosis of the liver, 3.80±0.82 in acute hepatitis, and 3.01±0.54 in obstructive jaundice. The ratios in acute hepatitis and obstructive jaundice were remarkably higher than those in normal control and cirrhosis of the liver. 4. There was a significant correlation between the blood disappearance half time of 131 I-rose bengal and that of 198 Au colloid in

  17. Comparison of /sup 99m/Tc diethyl-iminodiacetic acid and 131I rose bengal for hepatobiliary studies in liver-transplant patients: concise communication

    International Nuclear Information System (INIS)

    Klingensmith, W.C. III; Fritzberg, A.R.; Koep, L.J.

    1979-01-01

    Previous animal studies indicate that technetium-99m N,α-(2,6-diethylacetanilide)-iminodiacetic acid (/sup 99m/Tc diethyl-IDA) is superior to 131 I rose bengal ( 131 I RB) in most, but not all, physiologic parameters. Technetium-99m diethyl-IDA has a faster blood clearance, greater hepatic clearance, and a shorter hepatocyte transit time, but 131 I RB exhibits less renal clearance. We evaluated the relative merits of /sup 99m/Tc-diethyl-IDA and 131 I RB in paired studies in ten liver-transplant patients. Technetium-99m diethyl-IDA images were superior to 131 I RB images in demonstrating: (1) the liver parenchyma, (2) intrahepatic ducts, (3) small-bowel activity early after injection, and (4) in a smaller number of comparisons, colonic activity at 24 hr after injection. In addition, the percentage of dose excreted in the urine in 3 h for both radiopharmaceuticals was measured in 19 patients (total serum bilirubin range: 0.5 to 22.4 mg/dl). The percentage of dose of/sup 99m/Tc diethyl-IDA excreted in the urine averaged 7.5 in patients with normal total bilirubin levels and increased significantly with increasing total bilirubin levels. In the case of 131 I RB, normal patients averaged 4.9% of the injected dose in the urine and there was no increase with increasing total bilirubin levels. It is concluded that (1) /sup 99m/TC diethyl-IDA is superior to 131 I RB for imaging the hepatobiliary system, and (2) renal excretion of 131 I RB, unlike that of /sup 99m/Tc diethyl-IDA, is relatively unaffected by the total serum bilirubin level during the first 3 h after injection

  18. Study of optimal flip angle for inversion-recovery gradient echo method in delayed contrast-enhanced cardiac magnetic resonance imaging

    International Nuclear Information System (INIS)

    Ogawa, Masashi; Matsumura, Yoshio; Tsuchihashi, Toshio

    2013-01-01

    Delayed contrast-enhanced cardiac magnetic resonance imaging (MRI) is a valuable tool for detecting myocardial infarction and assessing myocardial viability. The standard viability MRI technique is the inversion-recovery gradient echo (IR-GRE) method. Several previous studies have demonstrated that this imaging technique provides superior image quality at high magnetic field strengths, e.g., 3.0 T. However, there are numerous possible flip angles. We investigated the optimal flip angle of IR-GRE in delayed contrast-enhanced cardiac MRI. Phantoms were made that modeled infarcted myocardium and normal myocardium after administration of contrast agent. To determine optimal flip angle, we compared the contrast-to-noise ratio (CNR) among these phantoms and evaluated the degree of artifacts induced by increased flip angle. The flip angle that showed the highest CNR for 2D IR-GRE and 3D IR-GRE was 30deg/15deg at 1.5 T and 25deg/15deg at 3.0 T. The flip angle that showed the highest CNR was independent of R-R interval. Streak artifacts induced by increased flip angle tended to occur more readily at 3.0 T than 1.5 T. The optimal flip angle for 2D IR-GRE and 3D IR-GRE at 1.5 T was 30deg and 15deg, respectively. At 3.0 T, taking into account the results for both CNR and streak artifacts, we concluded the optimal flip angle of 2D IR-GRE to be 15-20deg. (author)

  19. Gravitational Lens Time Delays Using Polarization Monitoring

    Directory of Open Access Journals (Sweden)

    Andrew Biggs

    2017-11-01

    Full Text Available Gravitational lens time delays provide a means of measuring the expansion of the Universe at high redshift (and therefore in the ‘Hubble flow’ that is independent of local calibrations. It was hoped that many of the radio lenses found in the JVAS/CLASS survey would yield time delays as these were selected to have flat spectra and are dominated by multiple compact components. However, despite extensive monitoring with the Very Large Array (VLA, time delays have only been measured for three of these systems (out of 22. We have begun a programme to reanalyse the existing VLA monitoring data with the goal of producing light curves in polarized flux and polarization position angle, either to improve delay measurements or to find delays for new sources. Here, we present preliminary results on the lens system B1600+434 which demonstrate the presence of correlated and substantial polarization variability in each image.

  20. Impulsive Synchronization of Reaction-Diffusion Neural Networks With Mixed Delays and Its Application to Image Encryption.

    Science.gov (United States)

    Chen, Wu-Hua; Luo, Shixian; Zheng, Wei Xing

    2016-12-01

    This paper presents a new impulsive synchronization criterion of two identical reaction-diffusion neural networks with discrete and unbounded distributed delays. The new criterion is established by applying an impulse-time-dependent Lyapunov functional combined with the use of a new type of integral inequality for treating the reaction-diffusion terms. The impulse-time-dependent feature of the proposed Lyapunov functional can capture more hybrid dynamical behaviors of the impulsive reaction-diffusion neural networks than the conventional impulse-time-independent Lyapunov functions/functionals, while the new integral inequality, which is derived from Wirtinger's inequality, overcomes the conservatism introduced by the integral inequality used in the previous results. Numerical examples demonstrate the effectiveness of the proposed method. Later, the developed impulsive synchronization method is applied to build a spatiotemporal chaotic cryptosystem that can transmit an encrypted image. The experimental results verify that the proposed image-encrypting cryptosystem has the advantages of large key space and high security against some traditional attacks.

  1. Measurement of time delay for a prospectively gated CT simulator

    Directory of Open Access Journals (Sweden)

    Goharian M

    2010-01-01

    Full Text Available For the management of mobile tumors, respiratory gating is the ideal option, both during imaging and during therapy. The major advantage of respiratory gating during imaging is that it is possible to create a single artifact-free CT data-set during a selected phase of the patient′s breathing cycle. The purpose of the present work is to present a simple technique to measure the time delay during acquisition of a prospectively gated CT. The time delay of a Philips Brilliance BigBore™ (Philips Medical Systems, Madison, WI scanner attached to a Varian Real-Time Position Management™ (RPM system (Varian Medical Systems, Palo Alto, CA was measured. Two methods were used to measure the CT time delay: using a motion phantom and using a recorded data file from the RPM system. In the first technique, a rotating wheel phantom was altered by placing two plastic balls on its axis and rim, respectively. For a desired gate, the relative positions of the balls were measured from the acquired CT data and converted into corresponding phases. Phase difference was calculated between the measured phases and the desired phases. Using period of motion, the phase difference was converted into time delay. The Varian RPM system provides an external breathing signal; it also records transistor-transistor logic (TTL ′X-Ray ON′ status signal from the CT scanner in a text file. The TTL ′X-Ray ON′ indicates the start of CT image acquisition. Thus, knowledge of the start time of CT acquisition, combined with the real-time phase and amplitude data from the external respiratory signal, provides time-stamping of all images in an axial CT scan. The TTL signal with time-stamp was used to calculate when (during the breathing cycle a slice was recorded. Using the two approaches, the time delay between the prospective gating signal and CT simulator has been determined to be 367 ± 40 ms. The delay requires corrections both at image acquisition and while setting gates for

  2. Measurement of time delay for a prospectively gated CT simulator

    International Nuclear Information System (INIS)

    Goharian, M.; Khan, R.F.H.

    2010-01-01

    For the management of mobile tumors, respiratory gating is the ideal option, both during imaging and during therapy. The major advantage of respiratory gating during imaging is that it is possible to create a single artifact-free CT data-set during a selected phase of the patient's breathing cycle. The purpose of the present work is to present a simple technique to measure the time delay during acquisition of a prospectively gated CT. The time delay of a Philips Brilliance BigBore (Philips Medical Systems, Madison, WI) scanner attached to a Varian Real-Time Position Management (RPM) system (Varian Medical Systems, Palo Alto, CA) was measured. Two methods were used to measure the CT time delay: using a motion phantom and using a recorded data file from the RPM system. In the first technique, a rotating wheel phantom was altered by placing two plastic balls on its axis and rim, respectively. For a desired gate, the relative positions of the balls were measured from the acquired CT data and converted into corresponding phases. Phase difference was calculated between the measured phases and the desired phases. Using period of motion, the phase difference was converted into time delay. The Varian RPM system provides an external breathing signal; it also records transistor-transistor logic (TTL) 'X-Ray ON' status signal from the CT scanner in a text file. The TTL 'X-Ray ON' indicates the start of CT image acquisition. Thus, knowledge of the start time of CT acquisition, combined with the real-time phase and amplitude data from the external respiratory signal, provides time-stamping of all images in an axial CT scan. The TTL signal with time-stamp was used to calculate when (during the breathing cycle) a slice was recorded. Using the two approaches, the time delay between the prospective gating signal and CT simulator has been determined to be 367 ± 40 ms. The delay requires corrections both at image acquisition and while setting gates for the treatment delivery

  3. Discussion on twenty-two hepatobiliary scintigraphs performed with technetium 99m-labelled N-(2,6 dimethylphenylcarbamoylmethyl) iminodiacetic acid (or HIDA-99mTc) at the Val-de-Grace Army Instruction Hospital

    International Nuclear Information System (INIS)

    Hoste, Philippe.

    1978-12-01

    Intraveinously injected technetium 99m-labelled N-(2,6 dimethyl-phenylcarbamoylmethyl) iminodiacetic acid, or HIDA-99mTc, is taken up by the hepatocytes and secreted in the bile, a fraction being normally eliminated by the kidneys. Isotopic examination with HIDA-99mTc gives valuable information on the morphology of the liver during the first minutes of the test, thus revealing the presence of parenchyma disease. In all observed cases of secondary hepatic localisations in particular the HIDA-99mTc images overlie those obtained with technetium colloids. By the examination it is also possible: - to establish the existence or otherwise of a functional vesicle, - to follow the path of the radiotracer along the bile duct. In short, HIDA-99mTc hepatobiliary scintigraphy is particularly useful for the study of hepatocyte uptake and bile elimination since it allows a continuous quantitative study of the liver-bile function under given physiological conditions [fr

  4. Pharmacokinetic and imaging studies of the hepatobiliary agent sup(99m)Tc-pyridoxal leucine

    International Nuclear Information System (INIS)

    Sawas-Dimopoulou, C.; Chiotellis, E.; Dassiou, A.; Papanicolaou, N.; Simitzis, G.; Koutoulidis, K.; Hadzilouka-Mantaka, A.

    1978-01-01

    An investigation into the usefulness of sup(99m)Tc-pyridoxal leucine has demonstrated its advantages over 131 I-rose bengal in the diagnosis of patients with several liver and gall bladder complaints. Toxicity studies in mice, rabbits and dogs showed no histological signs of tissular lesions at doses of up to 5000 to 25,000 times the clinical dose. Visualization of the liver, gall bladder and biliary excretion into intestines was rapid. The appearance of activity into the intestines was delayed in patients with partial obstruction of the common bile duct. Insufficient diagnostic information was provided in jaundiced patients with higher levels of bilirubin (7 to 12 mg%). These patients showed reduced liver uptake with high background, and intestinal activity was not always clearly visualized in an 18 h study. At bilirubin levels higher than 12 mg% no liver uptake was usually observed, but only renal activity. 131 I-rose bengal was preferable for the differential diagnosis of obstructive jaundice in these patients. (U.K.)

  5. Clinical use of 99mTc mebrofenin

    International Nuclear Information System (INIS)

    Chen Shaoliang; Zhao Huiyang

    1989-01-01

    A study of 124 subjects was undertaken to evaluate the image patterns of 99m Tc trimethylbromo iminodiacetic acid ( 99m Tc mebrofenin) in hepatobiliary disorders. It exhibits: (a) high specificity for the hepatobiliary system with low urinary excretion rate; (b) high competition to bilirubin; and (c) clearing more rapidly from the blood and rapid transit through the hepatobiliary system. Therefore 99m Tc mebrofenin result in the best visualization of the biliary system either in nonjaundiced or joundiced patient, and the hepatobiliary system can be clearly visualized even in patients with serum bilirubin level up to 30 mg%. The major drawback of this agent is that the urinary excretion rate increased in case of high serum bilirubin

  6. A TWO-YEAR TIME DELAY FOR THE LENSED QUASAR SDSS J1029+2623

    Energy Technology Data Exchange (ETDEWEB)

    Fohlmeister, Janine; Wambsganss, Joachim [Astronomisches Rechen-Institut, Zentrum fuer Astronomie der Universitaet Heidelberg, Moenchhofstr. 12-14, D-69120 Heidelberg (Germany); Kochanek, Christopher S. [Department of Astronomy, The Ohio State University, Columbus, OH 43210 (United States); Falco, Emilio E. [Harvard-Smithsonian Center for Astrophysics, Cambridge, MA 02138 (United States); Oguri, Masamune [Kavli Institute for the Physics and Mathematics of the Universe, Todai Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583 (Japan); Dai, Xinyu [Department of Physics and Astronomy, University of Oklahoma, 440 W. Brooks Street, Norman, OK 73019 (United States)

    2013-02-20

    We present 279 epochs of optical monitoring data spanning 5.4 years from 2007 January to 2012 June for the largest image separation (22.''6) gravitationally lensed quasar, SDSS J1029+2623. We find that image A leads the images B and C by {Delta} t {sub AB} = (744 {+-} 10) days (90% confidence); the uncertainty includes both statistical uncertainties and systematic differences due to the choice of models. With only a {approx}1% fractional error, the interpretation of the delay is limited primarily by cosmic variance due to fluctuations in the mean line-of-sight density. We cannot separate the fainter image C from image B, but since image C trails image B by only 2-3 days in all models, the estimate of the time delay between images A and B is little affected by combining the fluxes of images B and C. There is weak evidence for a low level of microlensing, perhaps created by the small galaxy responsible for the flux ratio anomaly in this system. Interpreting the delay depends on better constraining the shape of the gravitational potential using the lensed host galaxy, other lensed arcs, and the structure of the X-ray emission.

  7. Brain Structure Linking Delay Discounting and Academic Performance.

    Science.gov (United States)

    Wang, Song; Kong, Feng; Zhou, Ming; Chen, Taolin; Yang, Xun; Chen, Guangxiang; Gong, Qiyong

    2017-08-01

    As a component of self-discipline, delay discounting refers to the ability to wait longer for preferred rewards and plays a pivotal role in shaping students' academic performance. However, the neural basis of the association between delay discounting and academic performance remains largely unknown. Here, we examined the neuroanatomical substrates underlying delay discounting and academic performance in 214 adolescents via voxel-based morphometry (VBM) by performing structural magnetic resonance imaging (S-MRI). Behaviorally, we confirmed the significant correlation between delay discounting and academic performance. Neurally, whole-brain regression analyses indicated that regional gray matter volume (rGMV) of the left dorsolateral prefrontal cortex (DLPFC) was associated with both delay discounting and academic performance. Furthermore, delay discounting partly accounted for the association between academic performance and brain structure. Differences in the rGMV of the left DLPFC related to academic performance explained over one-third of the impact of delay discounting on academic performance. Overall, these results provide the first evidence for the common neural basis linking delay discounting and academic performance. Hum Brain Mapp 38:3917-3926, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  8. Accumulation of Bile in the Gallbladder: Evaluation by means of Serial Dynamic Contrast-Enhanced Magnetic Resonance Cholangiography with Gadolinium Ethoxybenzyl Diethylenetriaminepentaacetic Acid

    Directory of Open Access Journals (Sweden)

    Tsutomu Tamada

    2014-01-01

    Full Text Available The aim of this study was to evaluate the process of biliary excretion of gadolinium ethoxybenzyl diethylenetriaminepentaacetic acid (Gd-EOB-DTPA into the biliary tract and to assess the accumulation patterns in the gallbladder using MR cholangiography obtained with Gd-EOB-DTPA which is a liver-specific hepatobiliary contrast agent. Seventy-five patients underwent Gd-EOB-DTPA enhanced MR imaging. Serial multiphasic hepatobiliary phase imaging was qualitatively reviewed to evaluate the process of the biliary excretion of contrast agent into the bile duct and the gallbladder. The accumulation pattern of contrast agent into gallbladder was classified into two groups (group 1 = orthodromic type and group 2 = delayed type. Furthermore, the results in differences of the presence of T1 hyperintense bile or sludge of gallbladder, gall stones, wall thickening of gallbladder, chronic liver disease, and liver cirrhosis between two groups were compared. Forty-eight of 75 patients (64% were included in group 1, and remaining 27 (36% were in group 2. The frequency of the presence of T1 hyperintense bile or sludge of gallbladder was significantly higher in patients with group 2 than that in patients with group 1 (P=0.041. MR cholangiography obtained with Gd-EOB-DTPA showed that there may be an association between the biliary accumulation pattern in the gallbladder and the pathological condition.

  9. Added value of smooth hypointense rim in the hepatobiliary phase of gadoxetic acid-enhanced MRI in identifying tumour capsule and diagnosing hepatocellular carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    An, Chansik; Han, Kyunghwa; Choi, Jin-Young; Park, Mi-Suk; Kim, Myeong-Jin [Yonsei University College of Medicine, Department of Radiology, Research Institute of Radiological Science, Seoul (Korea, Republic of); Rhee, Hyungjin [Yonsei University College of Medicine, Department of Pathology, Brain Korea 21 PLUS Project for Medical Science, Integrated Genomic Research Center for Metabolic Regulation, Seoul (Korea, Republic of); Park, Young-Nyun [Yonsei University College of Medicine, Department of Pathology, Brain Korea 21 PLUS Project for Medical Science, Integrated Genomic Research Center for Metabolic Regulation, Seoul (Korea, Republic of); Yonsei University College of Medicine, Severance Biomedical Science Institute, Seoul (Korea, Republic of); Park, Sumi [National Health Insurance Service Ilsan Hospital, Department of Radiology, Goyang (Korea, Republic of)

    2017-06-15

    To examine the added value of considering smooth hypointense rim in the hepatobiliary phase (HBP) of gadoxetic acid-enhanced MRI as capsule appearance for diagnosing tumour capsules and hepatocellular carcinoma (HCC). A total of 377 hepatic lesions (330 HCCs, 35 non-HCC malignancies and 12 benign) were included from 345 patients who underwent resection after MRI between January 2008 and December 2011. Two radiologists assessed the presence or absence of conventional capsule appearance and smooth hypointense rim in the HBP, and categorized each hepatic lesion according to the Liver Imaging Reporting and Data System. Difference in diagnostic performance was evaluated using the generalized estimating equation method. For identifying capsule, the sensitivity and accuracy of HBP hypointense rim were significantly higher than those of conventional capsule appearance (81.5 % vs. 57.8 % and 76.1 % vs. 59.4 %, respectively; P < 0.001). For diagnosing HCC, the sensitivity and accuracy of LR-5 or LR-5 V were significantly higher when the HBP hypointense rim was also considered capsule appearance (83 % vs. 72.7 % and 84.1 % vs. 75.1 %, respectively; P < 0.001), with the same specificity (91.5 %). Regarding smooth hypointense rim in the HBP as capsule appearance could improve the detection of tumour capsule and the diagnosis of HCC. (orig.)

  10. The clinical and imaging characteristics of delayed encephalopathy after acute carbon monoxide poisoning

    International Nuclear Information System (INIS)

    Huang Chuming; Yin Zhao; Fang Yannan; Hong Weimin; Zeng Xianjie; Wang Tianwen

    2008-01-01

    Objective: To discuss the clinical and imaging characteristics of delayed encephalopathy after acute carbon monoxide poisoning (DEACMP). Methods: The clinical data of 14 patients with DEACMP were respectively analyzed. Results: Initial symptom included mentally falling (MMSE rate < 20 points) in 14 patients (100%), incontinence of urine in 11 patients (78%). Relatively significant increase of hematoma (HCT) (average level 0.503±0.027) was found in 6 patients. Three kinds of brain magnetic resonance imaging (MRI) appearance including diffuse white matter lesion, cortical lesion and basal nuclei lesion often existed in association. Therapy for improving circulation was given in 14 patients, and therapy with hormone was given in 9 patients; with 85% improvement rate. 5 patients without hormone therapy but with improving circulation therapy also received improvement. Conclusion: High level of HCT might be one of the causes of DECACMP due to acute disturbance of brain micro-circulation.. Close monitoring the change of HCT levels should be adopted for at least 3-6 months during therapy. Therapy for improving circulation and for anti-agglutination of platelets should be performed besides the routine high-tension oxygen therapy. Low FA value on DTI indicates the occurrence of a demyelization change in the brain long tract fibers, which indicated therapeutic effect of hormone treatment. And, therefore it would be better to perform DTI scan before therapy for individualized therapy. (authors)

  11. Synthesis of 2,6-diisopropyl-phenylcarbamoylmethyl-iminodiacetic acid (DISIDA) and 4-n-p-butyl-phenylcarbamoylmethyl-iminodiacetic acid (BUTYL-IDA). Preparation of lyophilized kit to be used as 99(supm)Tc agent in hepatobiliary system

    International Nuclear Information System (INIS)

    Hamada, E.S.; Barbosa, M.F. de; Theodora, M.A.; Almeida, M. de; Colturato, M.T.; Muramoto, E.; Silva, C.P.G. da.

    1987-08-01

    The synthesis of 2,6 diisopropyl IDA (DISIDA) and 4-n-butyl IDA (BUTIL-IDA) is described. Their spectroscopic properties, radiopharmaceutical preparation and their use as 99 (sup m)Tc complex agent in hepatobiliary studies, are also reported. (Author) [pt

  12. Human fMRI Reveals That Delayed Action Re-Recruits Visual Perception

    OpenAIRE

    Singhal, Anthony; Monaco, Simona; Kaufman, Liam D.; Culham, Jody C.

    2013-01-01

    Behavioral and neuropsychological research suggests that delayed actions rely on different neural substrates than immediate actions; however, the specific brain areas implicated in the two types of actions remain unknown. We used functional magnetic resonance imaging (fMRI) to measure human brain activation during delayed grasping and reaching. Specifically, we examined activation during visual stimulation and action execution separated by a 18-s delay interval in which subjects had to rememb...

  13. Reducing Delay in Diagnosis: Multistage Recommendation Tracking.

    Science.gov (United States)

    Wandtke, Ben; Gallagher, Sarah

    2017-11-01

    The purpose of this study was to determine whether a multistage tracking system could improve communication between health care providers, reducing the risk of delay in diagnosis related to inconsistent communication and tracking of radiology follow-up recommendations. Unconditional recommendations for imaging follow-up of all diagnostic imaging modalities excluding mammography (n = 589) were entered into a database and tracked through a multistage tracking system for 13 months. Tracking interventions were performed for patients for whom completion of recommended follow-up imaging could not be identified 1 month after the recommendation due date. Postintervention compliance with the follow-up recommendation required examination completion or clinical closure (i.e., biopsy, limited life expectancy or death, or subspecialist referral). Baseline radiology information system checks performed 1 month after the recommendation due date revealed timely completion of 43.1% of recommended imaging studies at our institution before intervention. Three separate tracking interventions were studied, showing effectiveness between 29.0% and 57.8%. The multistage tracking system increased the examination completion rate to 70.5% (a 52% increase) and reduced the rate of unknown follow-up compliance and the associated risk of delay in diagnosis to 13.9% (a 74% decrease). Examinations completed after tracking intervention generated revenue of 4.1 times greater than the labor cost. Performing sequential radiology recommendation tracking interventions can substantially reduce the rate of unknown follow-up compliance and add value to the health system. Unknown follow-up compliance is a risk factor for delay in diagnosis, a form of preventable medical error commonly identified in malpractice claims involving radiologists and office-based practitioners.

  14. Comparison of infarct size changes with delayed contrast-enhanced magnetic resonance imaging and electrocardiogram QRS scoring during the 6 months after acutely reperfused myocardial infarction

    DEFF Research Database (Denmark)

    Bang, L.E.; Ripa, R.S.; Grande, P.

    2008-01-01

    INTRODUCTION: Magnetic resonance imaging using the delayed contrast-enhanced (DE-MRI) method can be used for characterizing and quantifying myocardial infarction (MI). Electrocardiogram (ECG) score after the acute phase of MI can be used to estimate the portion of left ventricular myocardium...

  15. Comparative cardiac effects of three hepatobiliary radiopharmacologicals in the dog: concise communication

    International Nuclear Information System (INIS)

    Shani, J.; Sarel, O.; Rogel, S.; Weininger, J.; Lubin, E.

    1982-01-01

    Three hepatobiliary agents with an acetanilide-imidoacetic-acid moiety resembling that in lidocaine were investigated for their possible effects on contractility and conductivity in the heart and on arterial pressure and aortic blood flow. This was done in the light of lidocaine's numerous cardiac side effects. HIDA, BIDA, and DIPA, each with traces of decayed /sup 99m/Tc, were injected i.v. into anesthetized dogs with an A-V block, and their effects on the above parameters were followed until control levels were reestablished. Whereas lidocaine raises the diastolic threshold and prolongs the refractory period, the three agents tested do not prolong myocardial conductivity. Both HIDA and BIDA have an effect similar to that of lidocaine, but DIPA has no effect on the latter two parameters. Moreover, whereas lidocaine depressed myocardial contractility, blood pressure, and blood flow, HIDA has a less prominent effect on these parameters, and neither BIDA nor DIPA has any such effect. It is concluded that even though the effect of HIDA on the heart is milder than that of lidocaine, the effects of both BIDA and DIPA are even less pronounced, and they are less likely to cause cardiac side effects when similar doses are administered during nuclear medicine procedures

  16. Comparative cardiac effects of three hepatobiliary radiopharmacologicals in the dog: concise communication

    International Nuclear Information System (INIS)

    Shani, J.; Rogel, S.; Weininger, J.; Lubin, E.

    1982-01-01

    Three hepatobiliary agents with an acetanilide-imidoacetic-acid moiety resembling that in lidocaine were investigated for their possible effects on contractility and conductivity in the heart and on arterial pressure and aortic blood flow. This was done in the light of lidocaine's numerous cardiac side effects. HIDA, BIDA, and DIPA, each with traces of decayed Tc-99m, were injected i.v. into anesthetized dogs with an A-V block, and their effects on the above parameters were followed until control levels were reestablished. Wheras lidocaine raises the diastolic threshold and prolongs the refractory period, the three agents tested do not prolong myocardial conductivity. Both HIDA and BIDA have an effect similar to that of lidocaine, but DIPA has no effect on the latter two parameters. Moreover, whereas lidocaine depresses myocardial contractility, blood pressure, and blood flow, HIDA has a less prominent effect on these parameters, and neither BIDA nor DIPA has any such effect. It is concluded that even though the effect of HIDA on the heart is milder than that of lidocaine, the effects of both BIDA and DIPA are even less pronounced, and they are less likely to cause cardiac side effects when similar doses are administered during nuclear medicine procedures

  17. Delayed splenic rupture presenting 70 days following blunt abdominal trauma.

    Science.gov (United States)

    Resteghini, Nancy; Nielsen, Jonpaul; Hoimes, Matthew L; Karam, Adib R

    2014-01-01

    Delayed splenic rupture following conservative management of splenic injury is an extremely rare complication. We report a case of an adult patient who presented with delayed splenic rupture necessitating splenectomy, 2 months following blunt abdominal trauma. Imaging at the initial presentation demonstrated only minimal splenic contusion and the patient was discharge following 24 hours of observation. © 2014.

  18. Clinical diagnosis and brain imaging in nuclear medicine

    International Nuclear Information System (INIS)

    Fujie, Hiroshi

    1989-01-01

    Fifty-five patients of cerebral occlusive diseases were studied using IMP and single photon emission tomograph (HEADTOME-II). Early imaging was begun after intravenous injection of IMP and delayed imaging was performed 3 hours more later. We classified the change of IMP distribution into 4 types, type 1: no uptake of the lesion in both early and delayed images, type 2: low IMP uptake of the lesion in early images but recognized redistribution of IMP is delayed images, type 3: high IMP uptake of the lesion in both early and delayed images, type 4: high IMP uptake of the lesion in early images but it decreased more rapidly in delayed images. In cases of type 3 and 4 recanalization of the occlusive arteries was found by cerebral angiography. The difference of IMP distribution has relation to the time of recanalization and the amount of collateral circulation at the lesion. Clinical prognosis shows a tendency to be better in cases of type 2 and 4 than type 1 and 3. IMP brain scans with SPECT seems useful for estimating the prognosis of patients. (author)

  19. MR imaging evaluation of abdominal pain during pregnancy: appendicitis and other nonobstetric causes.

    Science.gov (United States)

    Spalluto, Lucy B; Woodfield, Courtney A; DeBenedectis, Carolynn M; Lazarus, Elizabeth

    2012-01-01

    Clinical diagnosis of the cause of abdominal pain in a pregnant patient is particularly difficult because of multiple confounding factors related to normal pregnancy. Magnetic resonance (MR) imaging is useful in evaluation of abdominal pain during pregnancy, as it offers the benefit of cross-sectional imaging without ionizing radiation or evidence of harmful effects to the fetus. MR imaging is often performed specifically for diagnosis of possible appendicitis, which is the most common illness necessitating emergency surgery in pregnant patients. However, it is important to look for pathologic processes outside the appendix that may be an alternative source of abdominal pain. Numerous entities other than appendicitis can cause abdominal pain during pregnancy, including processes of gastrointestinal, hepatobiliary, genitourinary, vascular, and gynecologic origin. MR imaging is useful in diagnosing the cause of abdominal pain in a pregnant patient because of its ability to safely demonstrate a wide range of pathologic conditions in the abdomen and pelvis beyond appendicitis. © RSNA, 2012.

  20. Effect of eating on thallium myocardial imaging

    International Nuclear Information System (INIS)

    Wilson, R.A.; Sullivan, P.J.; Okada, R.D.; Boucher, C.A.; Morris, C.; Pohost, G.M.; Strauss, H.W.

    1986-01-01

    To determine if eating between initial and delayed thallium images alters the appearance of the delayed thallium scan, a prospective study was performed; 184 subjects sent for routine thallium imaging were randomized into two groups, those who ate a meal high in carbohydrates between initial and delayed thallium myocardial images (n = 106), and those who fasted (n = 78). The 201 Tl images were interpreted in blinded fashion for global myocardial and pulmonary clearance of 201 Tl myocardial defects. The eating group had a significantly lower incidence of transient myocardial defects compared to the noneating group (7 percent vs 18 percent, respectively; p less than 0.05). The time between initial and delayed images and the incidence of exercise-induced ischemic ST-segment depression or pathologic Q waves on the electrocardiogram were not significantly different between the two groups. These data suggest that eating a high-carbohydrate meal between initial and delayed 201 Tl images causes increased 201 Tl myocardial clearance rates and may alter 201 Tl myocardial redistribution over time

  1. Dual-energy CT iodine maps as an alternative quantitative imaging biomarker to abdominal CT perfusion: determination of appropriate trigger delays for acquisition using bolus tracking.

    Science.gov (United States)

    Skornitzke, Stephan; Fritz, Franziska; Mayer, Philipp; Koell, Marco; Hansen, Jens; Pahn, Gregor; Hackert, Thilo; Kauczor, Hans-Ulrich; Stiller, Wolfram

    2018-05-01

    Quantitative evaluation of different bolus tracking trigger delays for acquisition of dual energy (DE) CT iodine maps as an alternative to CT perfusion. Prior to this retrospective analysis of prospectively acquired data, DECT perfusion sequences were dynamically acquired in 22 patients with pancreatic carcinoma using dual source CT at 80/140 kV p with tin filtration. After deformable motion-correction, perfusion maps of blood flow (BF) were calculated from 80 kV p image series of DECT, and iodine maps were calculated for each of the 34 DECT acquisitions per patient. BF and iodine concentrations were measured in healthy pancreatic tissue and carcinoma. To evaluate potential DECT acquisition triggered by bolus tracking, measured iodine concentrations from the 34 DECT acquisitions per patient corresponding to different trigger delays were assessed for correlation to BF and intergroup differences between tissue types depending on acquisition time. Average BF measured in healthy pancreatic tissue and carcinoma was 87.6 ± 28.4 and 38.6 ± 22.2 ml/100 ml min -1 , respectively. Correlation between iodine concentrations and BF was statistically significant for bolus tracking with trigger delay greater than 0 s (r max = 0.89; p alternative to CT perfusion measurements of BF. Advances in knowledge: After clinical validation, DECT iodine maps of pancreas acquired using bolus tracking with appropriate trigger delay as determined in this study could offer an alternative quantitative imaging biomarker providing functional information for tumor assessment at reduced patient radiation exposure compared to CT perfusion measurements of BF.

  2. Diagnostic accuracy of gadoxetic acid-enhanced MR for small hypervascular hepatocellular carcinoma and the concordance rate of Liver Imaging Reporting and Data System (LI-RADS).

    Science.gov (United States)

    Bae, Jae Seok; Kim, Jung Hoon; Yu, Mi Hye; Lee, Dong Ho; Kim, Hyo-Cheol; Chung, Jin Wook; Han, Joon Koo

    2017-01-01

    To assess diagnostic accuracy of gadoxetic acid-enhanced MR for small hypervascular hepatocellular carcinoma (HCC) detected by C-arm CT and concordance rate of Liver Imaging Reporting and Data System (LI-RADS). In this retrospective study, we recruited 4,544 patients suspected of having HCC underwent C-arm CT from November 2008 to May 2013. Among these patients, gadoxetic acid-enhanced MR was performed in 167 patients with HCC (n = 379; 257 > 1 cm, 122 ≤ 1 cm). HCC was confirmed by MR, CT, or follow-up images. Two radiologists graded likelihood of HCC and assessed MR features. Jackknife alternative free-response receiver operating characteristic (JAFROC) analysis was performed. All HCCs were evaluated concordance rate of LI-RADS. Mean JAFROC figure of merit for large (>1-cm) HCC was 0.948, while that for small HCC was 0.787 with fair agreement (κ = 0.409). Mean sensitivity and positive predictive value (PPV) were 91% and 90% for large HCC versus 63.0% and 79% for small HCC, respectively. Seventeen of 122 small HCCs (13.9%) were not visible on MR. Among 379 HCCs, 99 met LR-5, and 259 met LR-4. Common features for small HCC included arterial enhancement (81.9%), hepatobiliary phase hypointensity (80.3%), and delayed washout (72.9%). Diagnostic accuracy of gadoxetic acid-enhanced MR imaging for small, hypervascular HCCs (Mean figure of merit = 0.787) was still low compared with large HCC (Mean figure of merit = 0.948). LR-5 and LR-4 covered 94% (358/379) of the HCCs.

  3. Time Delay Measurements for the Cluster-lensed Sextuple Quasar SDSS J2222+2745

    Science.gov (United States)

    Dahle, H.; Gladders, M. D.; Sharon, K.; Bayliss, M. B.; Rigby, J. R.

    2015-11-01

    We report first results from an ongoing monitoring campaign to measure time delays between the six images of the quasar SDSS J2222+2745, gravitationally lensed by a galaxy cluster. The time delay between A and B, the two most highly magnified images, is measured to be {τ }{{AB}}=47.7+/- 6.0 days (95% confidence interval), consistent with previous model predictions for this lens system. The strong intrinsic variability of the quasar also allows us to derive a time delay value of {τ }{{CA}}=722+/- 24 days between image C and A, in spite of modest overlap between their light curves in the current data set. Image C, which is predicted to lead all the other lensed quasar images, has undergone a sharp, monotonic flux increase of 60%-75% during 2014. A corresponding brightening is firmly predicted to occur in images A and B during 2016. The amplitude of this rise indicates that time delays involving all six known images in this system, including those of the demagnified central images D-F, will be obtainable from further ground-based monitoring of this system during the next few years. Based on observations made with the Nordic Optical Telescope, operated on the island of La Palma jointly by Denmark, Finland, Iceland, Norway, and Sweden, in the Spanish Observatorio del Roque de los Muchachos of the Instituto de Astrofisica de Canarias, and including observations obtained at the Gemini Observatory, which is operated by the Association of Universities for Research in Astronomy, Inc., under a cooperative agreement with the NSF on behalf of the Gemini partnership: the National Science Foundation (United States), the National Research Council (Canada), CONICYT (Chile), the Australian Research Council (Australia), Ministério da Ciência, Tecnologia e Inovação (Brazil) and Ministerio de Ciencia, Tecnologi´a e Innovación Productiva (Argentina).

  4. Diagnostic Significance of the Blood Disappearance Rate of {sup 131}I-Rose Bengal and of {sup 198}Au colloid in Hepatobiliary Diseases

    Energy Technology Data Exchange (ETDEWEB)

    Chun, Young Kyoon; Hahn, Shim Suk; Koh, Chang Soon [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1971-09-15

    The liver function test was performed by means of two radioisotope tracer techniques in 20 normal subjects and in 63 patients with hepatobiliary diseases. The blood disappearance rates of {sup 131}I-rose bengal and of {sup 198}Au colloid were determined by external counting method. The hepatocellular function and the hepatic blood flow were estimated from the observed data and the results were compared with those of the conventional liver function tests. The results obtained were as follows: 1. The mean blood disappearance half time of {sup 131}I-rose bengal was 6.6+-0.63 minutes in normal control, 17.7+-6.93 in cirrhosis of the liver, 16.6+-4. 80 in acute hepatitis, and 14 7+-3.46 in obstructive jaundice. It was markedly prolonged in the hepatobiliary diseases as compared with the normal control, but there was no significant difference among the hepatobiliary diseases. 2.The mean blood disappearance half time of {sup 198}Au colloid was 4. 0+-0. 66 minutes in normal control, 9.8+-3.42 in cirrhosis of the liver, 4.4+-0.82 in acute hepatitis, and 5.0+-1.42 in obstructive jaundice. The difference between cirrhosis of the liver and normal control was statistically significant. However, there was no definite difference among acute hepatitis, obstructive jaundice, and normal control. The mean blood disappearance rate constant (K value) was 0.177+-0.028/minute in normal control, In cirrhosis of the liver, it was markedly decreased which was suggestive of the reduced hepatic blood flow. 3. The ratio of {sup 131}I-rose bengal blood disappearance half time to {sup 198}Au colloid disappearance half time was 1.68+-0.20 in normal control, 1.82+-0.31 in cirrhosis of the liver, 3.80+-0.82 in acute hepatitis, and 3.01+-0.54 in obstructive jaundice. The ratios in acute hepatitis and obstructive jaundice were remarkably higher than those in normal control and cirrhosis of the liver. 4. There was a significant correlation between the blood disappearance half time of {sup 131}I

  5. Hepato-biliary effects of mucoviscidosis: use of Mebrofenine scintigraphy

    International Nuclear Information System (INIS)

    Perrin-Fayolle, O.; Morelec, I.; Gilly, R.; Roche, S.; Sappey-Marinier, D.; Briere, J.; Bonmartin, A.; Bellon, G.

    1997-01-01

    The objective of this work is the scintigraphic profile of patients afflicted with mucoviscidosis with portal hypertension (PHT) and the questions whether there exists a criterion to characterized the first stage of fibrosis as well as whether exist in this stage lesions of hepato cellular insufficiency (HCI). The method of the work implied the study of the dynamics of 60 minutes after injecting 40 - 120 MBq of Mebrofenine in 18 patients, 9 presenting a certain PHT, and 9, signs of hepatobiliary affliction without genuine PHT. In the population with PHT, all patients presented a splenomegaly, a very heterogeneous fixation and a retention of the tracer in the intrahepatic-biliary tracts (IHBT) with augmentation of T 1/2 in 5 cases; 8 presented a diminution of the hepatic extraction fraction (HEF), serving as control of HCI. In the population without PHT 2 patients are normal. In the other seven, the most frequently found anomalies are the accumulation of tracer in the IHBT (5/7) and the hepatic heterogeneity (4/7). HEF is low in one case. No dilatation was visible by echography. In conclusion, the accumulation in the IHBT (14 patients, 9 PHT and 5 non PHT) expresses the presence of a functional stasis without organic effects (no echographic dilatation), consequence of a obstruction of biliary ducts by mucus plugs due to dehydration of the bile. The HEF, labeller of HCI, is low in 8 PHT and in one non-PHT, hence tardy in the evolution of the disease, the portal cirrhosis occurring at more on less long term. This parameter can not be considered as a labeller of fibrosis, on the contrary, the accumulation of this tracer in the IHBT and the hepatic heterogeneity seems more interesting for an early detection and start of a preventive treatment

  6. Regret Expression and Social Learning Increases Delay to Sexual Gratification.

    Directory of Open Access Journals (Sweden)

    Amanda J Quisenberry

    Full Text Available Modification and prevention of risky sexual behavior is important to individuals' health and public health policy. This study employed a novel sexual discounting task to elucidate the effects of social learning and regret expression on delay to sexual gratification in a behavioral task.Amazon Mechanical Turk Workers were assigned to hear one of three scenarios about a friend who engages in similar sexual behavior. The scenarios included a positive health consequence, a negative health consequence or a negative health consequence with the expression of regret. After reading one scenario, participants were asked to select from 60 images, those with whom they would have casual sex. Of the selected images, participants chose one image each for the person they most and least want to have sex with and person most and least likely to have a sexually transmitted infection. They then answered questions about engaging in unprotected sex now or waiting some delay for condom-protected sex in each partner condition.Results indicate that the negative health outcome scenario with regret expression resulted in delayed sexual gratification in the most attractive and least STI partner conditions, whereas in the least attractive and most STI partner conditions the negative health outcome with and without regret resulted in delayed sexual gratification.Results suggest that the sexual discounting task is a relevant laboratory measure and the framing of information to include regret expression may be relevant for prevention of risky sexual behavior.

  7. Effect of complete biliary-tract obstruction on serial hepatobiliary imaging in an experimental model: concise communication

    International Nuclear Information System (INIS)

    Klingensmith, W.C.; Whitney, W.P.; Spitzer, V.M.; Klintmalm, G.B.; Koep, L.M.; Kuni, C.C.

    1981-01-01

    In order to determine the effect of biliary obstruction on hepatocyte clearance and bile flow, five dogs were imaged before, and three times a week after, surgical ligation of the common bile duct. THe first postoperative study was performed 3 hr after surgery. Bile flow and duct function were evaluated from analog images; hepatocyte clearance (HC) was estimated in digital images from the ratio of liver to cardiac blood-pool counts at 3 min. Liver function tests were measured serially. 3 hr after surgery the HC index and liver function tests were still normal. Analog images showed no intestinal radioactivity, but accumulation was seen in the distending biliary tract. on the third postoperative day, all liver function tests were abnormal and the HC index was significantly decreased (p less than 0.01). The biliary tract was never seen beyond the first postoperative day. Thus, complete obstruction of the common bile duct does not stop bile flow or cause significant hepatocyte damage in the first few hours. By the third day of obstruction, however, no bile flow is detectible and significant hepatocyte damage has occurred

  8. Rational imaging of hepatocellular carcinoma. The challenge of multimodal diagnostic criteria; Rationale Schnittbildgebung des hepatozellulaeren Karzinoms. Die Herausforderung multimodaler Diagnosekriterien

    Energy Technology Data Exchange (ETDEWEB)

    Kircher, A.; Bongartz, G.; Merkle, E.M.; Zech, C.J. [Universitaetsspital Basel, Klinik fuer Radiologie und Nuklearmedizin, Basel (Switzerland)

    2014-07-15

    Both computed tomography (CT) and magnetic resonance imaging (MRI) constitute the gold standard in radiological imaging of hepatocellular carcinoma (HCC). In cases of typical contrast behavior each modality as a single dynamic technique allows the diagnosis of HCC. There is still a challenge in detection of small HCCs < 2 cm, in differentiating HCC and high-grade dysplasia from other benign liver lesions as well as the evaluation of hypovascular liver lesions in the cirrhotic liver. Nowadays, both modalities achieve high detection rates of 90-100 % for lesions > 2 cm. Regarding lesions between 1 and 2 cm there is a higher sensitivity for MRI ranging between 80 and 90 % compared to 60-75 % with CT. Besides the multimodal diagnostic criteria, MRI provides significant benefits with the use of hepatobiliary contrast. Especially in combination with diffusion- weighted imaging (DWI) increased sensitivity and diagnostic accuracy compared to CT has been described for lesions sized < 2 cm. Regarding the differentiation from other hepatic nodules in the cirrhotic liver there is strong evidence that the coexistence of arterial enhancement and hypointensity on hepatobiliary imaging is specific for HCC. Moreover, hypointensity on hepatobiliary imaging is associated with a high positive predictive value (PPV) of up to 100 % for the presence of high-grade dysplasia and HCC. The use of MRI including hepatobiliary imaging and DWI has to be regarded as the best non-invasive imaging modality for the detection of HCC and for the characterization of nodules in patients with liver cirrhosis. In comparison to CT there are benefits regarding detection of small lesions < 2 cm and evaluation of hypovascular liver lesions in the context of the hepatocarcinogenesis including prognostic values of premalignant lesions. Both MRI and CT provide a high diagnostic performance in evaluation of HCC in liver cirrhosis. With MRI there are considerable advantages regarding the detection rate and

  9. The value of delayed 18F-FDG PET/CT imaging for differentiating axillary lymph nodes in breast cancer

    International Nuclear Information System (INIS)

    Ji, Young Sik; Son, Ju Cheol; Park, Cheol Woo

    2013-01-01

    Positron emission tomography/computed tomography (PET/CT) imaging with fluorodeoxyglucose (FDG) have been used as a powerful fusion modality in nuclear medicine not only for detecting cancer but also for staging and therapy monitoring. Nevertheless, there are various causes of FDG uptake in normal and/or benign tissues. The purpose of present study was to investigate whether additional delayed imaging can improve the diagnosis to differentiate the rates of FDG uptake at axillary lymph nodes (ALN) between malignant and benign in breast cancer patients. 180 PET/CT images were obtained for 27 patients with ALN uptake. The patients who had radiotherapy and chemotherapy were excluded from the study. 18 F-FDG PET/CT scan at 50 min (early phase) and 90 min (delayed phase) after 18 F-FDG injection were included in this retrospective study. The staging of cancers was confirmed by final clinical according to radiologic follow-up and pathologic findings. The standardized uptake value (SUV) of ALN was measured at the Syngo Acquisition Workplace by Siemens. The 27 patients included 18 malignant and 9 ALN benign groups and the 18 malignant groups were classified into the 3 groups according to number of metastatic ALN in each patient. ALNs were categorized less than or equal 3 as N1, between 4 to 9 as N2 and more than 10 as N3 group. Results are expressed as the mean ± standard deviation (S.D.) and statistically analyzed by SPSS. As a result, Retention index (RI-SUV max) in metastasis was significantly higher than that in non-metastasis about 5 fold increased. On the other hand, RI-SUV max in N group tended to decrease gradually from N1 to N3. However, we could not prove significance statistically in malignant group with ANOVA. As a consequence, RI-SUV max was good indicator for differentiating ALN positive group from node negative group in breast cancer patients. These results show that dual-time-point scan appears to be useful in distinguishing malignant from benign

  10. Scintigraphic visualization of extrahepatic portal circulation in patients with portal hypertension using /sup 99m/Tc-tin-colloid and /sup 99m/Tc-HIDA

    Energy Technology Data Exchange (ETDEWEB)

    Al-Hussoni, M H; Jasim, M N; Shubbar, A H

    1985-01-01

    Rapid dynamic sequential scintigraphy of the abdomen with /sup 99m/Tc-tin-colloid and /sup 99m/Tc-HIDA has been used to evaluate two patients with portal hypertension. /sup 99m/Tc-tin-colloid was useful for visualization of diliated vessels in the abdomen. Radionuclide hepatobiliary imaging was useful in such cases in evaluation of the hepatobiliary system.

  11. Comparison of standard and delayed imaging to improve the detection rate of [{sup 68}Ga]PSMA I and T PET/CT in patients with biochemical recurrence or prostate-specific antigen persistence after primary therapy for prostate cancer

    Energy Technology Data Exchange (ETDEWEB)

    Schmuck, Sebastian; Nordlohne, Stefan; Sohns, Jan M.; Ross, Tobias L.; Bengel, Frank M.; Derlin, Thorsten [Hannover Medical School, Department of Nuclear Medicine, Hannover (Germany); Klot, Christoph A. von [Hannover Medical School, Department of Urology and Urologic Oncology, Hannover (Germany); Henkenberens, Christoph; Christiansen, Hans [Hannover Medical School, Department of Radiation Oncology, Hannover (Germany); Wester, Hans-Juergen [Technische Universitaet Muenchen, Pharmaceutical Radiochemistry, Garching (Germany)

    2017-06-15

    The aim of this study was to assess the value of dual-time point imaging in PET/CT for detection of biochemically recurrent or persistent prostate cancer, using the prostate-specific membrane antigen (PSMA) ligand [{sup 68}Ga]PSMA I and T. 240 patients who underwent a [{sup 68}Ga]PSMA I and T PET/CT in the context of biochemical relapse of prostate cancer were included in this retrospective analysis. Imaging consisted of a standard whole-body PET/CT (1 h p.i.), followed by delayed (3 h p.i.) imaging of the abdomen. PSA-stratified proportions of positive PET/CT results, standardized uptake values and target-to-background ratios were analyzed, and compared between standard and delayed imaging. The overall detection rates of [{sup 68}Ga]PSMA I and T PET/CT were 94.2, 71.8, 58.6, 55.9 and 38.9% for PSA levels of ≥2, 1 to <2, 0.5 to <1, >0.2 to <0.5, and 0.01 to 0.2 ng/mL, respectively. Although the target-to-background ratio improved significantly over time (P < 0.0001), the majority (96.6%) of all lesions suggestive of recurrent disease could already be detected in standard imaging. Delayed imaging at 3 h p.i. exclusively identified pathologic findings in 5.4% (10/184) of abnormal [{sup 68}Ga]PSMA I and T PET/CT scans, and exclusively detected 3.4% (38/1134) of all lesions suggestive of recurrent disease. [{sup 68}Ga]PSMA I and T PET/CT shows high detection rates in patients with prostate-specific antigen persistence or biochemical recurrence of prostate cancer. Delayed imaging can detect lesions with improved contrast compared to standard imaging. However, the impact on detection rates was limited in this study. (orig.)

  12. Comparison of standard and delayed imaging to improve the detection rate of ["6"8Ga]PSMA I and T PET/CT in patients with biochemical recurrence or prostate-specific antigen persistence after primary therapy for prostate cancer

    International Nuclear Information System (INIS)

    Schmuck, Sebastian; Nordlohne, Stefan; Sohns, Jan M.; Ross, Tobias L.; Bengel, Frank M.; Derlin, Thorsten; Klot, Christoph A. von; Henkenberens, Christoph; Christiansen, Hans; Wester, Hans-Juergen

    2017-01-01

    The aim of this study was to assess the value of dual-time point imaging in PET/CT for detection of biochemically recurrent or persistent prostate cancer, using the prostate-specific membrane antigen (PSMA) ligand ["6"8Ga]PSMA I and T. 240 patients who underwent a ["6"8Ga]PSMA I and T PET/CT in the context of biochemical relapse of prostate cancer were included in this retrospective analysis. Imaging consisted of a standard whole-body PET/CT (1 h p.i.), followed by delayed (3 h p.i.) imaging of the abdomen. PSA-stratified proportions of positive PET/CT results, standardized uptake values and target-to-background ratios were analyzed, and compared between standard and delayed imaging. The overall detection rates of ["6"8Ga]PSMA I and T PET/CT were 94.2, 71.8, 58.6, 55.9 and 38.9% for PSA levels of ≥2, 1 to 0.2 to <0.5, and 0.01 to 0.2 ng/mL, respectively. Although the target-to-background ratio improved significantly over time (P < 0.0001), the majority (96.6%) of all lesions suggestive of recurrent disease could already be detected in standard imaging. Delayed imaging at 3 h p.i. exclusively identified pathologic findings in 5.4% (10/184) of abnormal ["6"8Ga]PSMA I and T PET/CT scans, and exclusively detected 3.4% (38/1134) of all lesions suggestive of recurrent disease. ["6"8Ga]PSMA I and T PET/CT shows high detection rates in patients with prostate-specific antigen persistence or biochemical recurrence of prostate cancer. Delayed imaging can detect lesions with improved contrast compared to standard imaging. However, the impact on detection rates was limited in this study. (orig.)

  13. Characteristics of hypertrophic cardiomyopathy on delayed contrast-enhanced MRI

    International Nuclear Information System (INIS)

    Yan Chaowu; Zhao Shihua; Li Hua; Jiang Shiliang; Lu Minjie; Zhang Yan; Wei Yunqing; Ling Jian; Fang Wei

    2010-01-01

    Objective: To analyze the characteristics of hypertrophic cardiomyopathy (HCM) on delayed contrast-enhanced cardiac magnetic resonance imaging (CMRI). Methods: All patients underwent delayed contrast-enhanced CMRI. The left ventricle was divided into 9 segments to assess the location, extent and function of the hypertrophic segments. The t test was applied for the statistics. Results: Of 154 patients, delayed enhancement of' hypertrophic segment was found in 95 cases and non-delayed enhancement in 59 cases. The thickness and number of hypertrophic segment in patients with delayed enhancement were larger than those with non-delayed enhancement [(24.8±5.5) mm vs (20.4± 3.8) mm, t=3.82, P<0.05; (3.3±1.9) vs (2.4±1.7), t=2.26, P<0.05], and the age was younger [(46.0±15.2) years vs (55.0±11.9) years, t=-3.67, P<0.05]. The diffuse enhancement was found in 62 patients, and confluent enhancement in 33 patients. Confluent enhancement was found in all 14 patients after the alcohol ablation procedure. Conclusion: The age, thickness and number of hypertrophic segments in patients with delayed enhancement are different from those with non-delayed enhancement. (authors)

  14. Evaluation of reserved hepatic function in patients with hepatobiliary tumor by 99mTc-GSA. Effect of hyperbilirubinemia and usefulness of regional reserved hepatic functional imaging

    International Nuclear Information System (INIS)

    Jin Wu; Ishikawa, Nobuyoshi; Takeda, Tohoru; Sato, Motohiro; Todoroki, Takeshi; Itai, Yuji; Fukunaga, Kiyoshi; Okumura, Toshiyuki; Hatakeyama, Rokurou.

    1996-01-01

    The evaluation of the reserved hepatic function was performed by 99m Tc-galactosyl serum albumin ( 99m Tc-GSA) in 70 patients with hepatobiliary tumor. The dynamic study was performed to evaluate global reserved hepatic function following the intravenous bolus injection of 99m Tc-GSA, and the hepatic single photon emission computed tomography (SPECT) was obtained to assess the regional reserved hepatic function. The functional hepatic index (LHL 15 ) was derived from liver time-activity data, and it was compared with serum total-bilirubin level, serum albumin level and plasma disappearance rate of indocyanine green (ICG 15 ). In the patients with hepatocellular carcinoma, LHL 15 value agreed well with ICG 15 value, serum total-bilirubin level, and serum albumin level. Moderate or severe hepatic dysfunction was observed at 65.4% of these patients. In the patients with cholangiocellular carcinoma, a discrepancy of LHL 15 value and ICG 15 value was observed. Increment of the ICG 15 value was correlated with that of the serum total-bilirubin level, whereas the correlation was not observed between the LHL 15 value and the serum total-bilirubin level. These results indicate that 99m Tc-GSA scintigraphy can evaluate the reserved hepatic function without the embellishment of jaundice. This method is useful for assessing the global and regional reserved hepatic function. (author)

  15. The impact of processing delay on the exposure index value

    Science.gov (United States)

    Butler, M. L.; Brennan, P. C.; Last, J.; Rainford, L.

    2010-04-01

    Digital radiography poses the risk of unnoticed increases in patient dose. Manufacturers responded to this by offering an exposure index (EI) value to clinicians. Use of the EI value in clinical practice is encouraged by the American College of Radiology and American Association of Physicists in Medicine. This study assesses the impact of processing delay on the EI value. An anthropormorphic phantom was used to simulate three radiographic examinations; skull, pelvis and chest. For each examination, the phantom was placed in the optimal position and exposures were chosen in accordance with international guidelines. A Carestream (previously Kodak) computed radiography system was used. The imaging plate was exposed, and processing was delayed in various increments from 30 seconds to 24 hours, representing common delays in clinical practice. The EI value was recorded for each exposure. The EI value decreased considerably with increasing processing delay. The EI value decreased by 100 within 25 minutes delay for the chest, and 20 minutes for the skull and pelvis. Within 1 hour, the EI value had fallen by 180, 160 and 100 for the chest, skull and pelvis respectively. After 24 hours, the value had decreased by 370, 350 and 340 for the chest, skull and pelvis respectively, representing to the clinician more then a halving of exposure to the detector in Carestream systems. The assessment of images using EI values should be approached with caution in clinical practice when delays in processing occur. The use of EI values as a feedback mechanism is questioned.

  16. Building the Nonuniversity, Tertiary Care Center Hepatobiliary and Pancreatic Surgery Practice: Structural and Financial Considerations.

    Science.gov (United States)

    Baker, Erin H; Siddiqui, Imran; Vrochides, Dionisios; Iannitti, David A; Martinie, John B; Rorabaugh, Lauren; Jeyarajah, D Rohan; Swan, Ryan Z

    2016-12-01

    Early in their careers, many new surgeons lack the background and experience to understand essential components needed to build a surgical practice. Surgical resident education is often devoid of specific instruction on the business of medicine and practice management. In particular, hepatobiliary and pancreatic (HPB) surgeons require many key components to build a successful practice secondary to significant interdisciplinary coordination and a scope of complex surgery, which spans challenging benign and malignant disease processes. In the following, we describe the required clinical and financial components for developing a successful HPB surgery practice in the nonuniversity tertiary care center. We discuss significant financial considerations for understanding community need and hospital investment, contract establishment, billing, and coding. We summarize the structural elements and key personnel necessary for establishing an effectual HPB surgical team. This article provides useful, essential information for a new HPB surgeon looking to establish a surgical practice. It also provides insight for health-care administrators as to the value an HPB surgeon can bring to a hospital or health-care system.

  17. Biodistribution and dosimetry in humans of two inverse agonists to image cannabinoid CB1 receptors using positron emission tomography

    International Nuclear Information System (INIS)

    Terry, Garth E.; Hirvonen, Jussi; Liow, Jeih-San; Seneca, Nicholas; Morse, Cheryl L.; Pike, Victor W.; Innis, Robert B.; Tauscher, Johannes T.; Schaus, John M.; Phebus, Lee; Felder, Christian C.; Halldin, Christer

    2010-01-01

    Cannabinoid subtype 1 (CB 1 ) receptors are found in nearly every organ in the body, may be involved in several neuropsychiatric and metabolic disorders, and are therefore an active target for pharmacotherapy and biomarker development. We recently reported brain imaging of CB 1 receptors with two PET radioligands: 11 C-MePPEP and 18 F-FMPEP-d 2 . Here we describe the biodistribution and dosimetry estimates for these two radioligands. Seven healthy subjects (four men and three women) underwent whole-body PET scans for 120 min after injection with 11 C-MePPEP. Another seven healthy subjects (two men and five women) underwent whole-body PET scans for 300 min after injection with 18 F-FMPEP-d 2 . Residence times were acquired from regions of interest drawn on tomographic images of visually identifiable organs for both radioligands and from radioactivity excreted in urine for 18 F-FMPEP-d 2 . The effective doses of 11 C-MePPEP and 18 F-FMPEP-d 2 are 4.6 and 19.7 μSv/MBq, respectively. Both radioligands demonstrated high uptake of radioactivity in liver, lung, and brain shortly after injection and accumulated radioactivity in bone marrow towards the end of the scan. After injection of 11 C-MePPEP, radioactivity apparently underwent hepatobiliary excretion only, while radioactivity from 18 F-FMPEP-d 2 showed both hepatobiliary and urinary excretion. 11 C-MePPEP and 18 F-FMPEP-d 2 yield an effective dose similar to other PET radioligands labeled with either 11 C or 18 F. The high uptake in brain confirms the utility of these two radioligands to image CB 1 receptors in brain, and both may also be useful to image CB 1 receptors in the periphery. (orig.)

  18. Three-Dimensional Photoacoustic Tomography using Delay Multiply and Sum Beamforming Algorithm

    OpenAIRE

    Paridar, Roya; Mozaffarzadeh, Moein; Mahloojifar, Ali; Nasiriavanaki, Mohammadreza; Orooji, Mahdi

    2018-01-01

    Photoacoustic imaging (PAI), is a promising medical imaging technique that provides the high contrast of the optical imaging and the resolution of ultrasound (US) imaging. Among all the methods, Three-dimensional (3D) PAI provides a high resolution and accuracy. One of the most common algorithms for 3D PA image reconstruction is delay-and-sum (DAS). However, the quality of the reconstructed image obtained from this algorithm is not satisfying, having high level of sidelobes and a wide mainlob...

  19. Comparison of CT during arterial portography, delayed iodine CT, and MR imaging for the preoperative evaluation of hepatic tumors

    International Nuclear Information System (INIS)

    Nelson, R.C.; Chezmar, J.L.; Sugarbaker, P.H.; Bernardino, M.E.

    1988-01-01

    Twenty-eight patients with neoplastic involvement of the liver were studied with CT during arterial portography, delayed iodine CT, and MR imaging, to determine the number, size, and location of focal hepatic lesions prior to hepatic tumor surgery. The MR pulse-sequences used included T1- and T2-weighted spin-echo (SE) sequences and inversion-recovery (IR) sequences at 0.5 T, 1.5 T, or both. Results were compared with operative and pathologic findings. The sensitivities for the detection of individual focal lesions are as follows: CT during arterial portography, delayed iodine CT, 77%, IR at 0.5 T, 74%; T1-weighted SE at 0.5 T, 69%; T2-weighted SE at 1.5 T, 55%, IR at 1.5 T, 50%; T2-weighted SE at 0.5 T, 48%, and T1-weighted SE at 1.5 T, 31%. The positive predictive values ranged from 88% to 100% for all techniques. The authors' data suggest that CT during arterial portography is a superior technique for evaluating patients prior to hepatic tumor surgery

  20. Hepatobiliary gammagraphy and its importance for differential diagnosis of mechanic and hepatocellular jaundice

    International Nuclear Information System (INIS)

    Takacs, J.

    1983-01-01

    The reliability of hepatobiliary gammagraphy following sup(99m)Tc-EHIDA administration and its variations with the concentration of the total plasma bilirubin were assessed in 155 hepatitis patients in whom differential diagnosis was performed for mechanical or hepatocellular jaundice. In mechanical jaundice (28 patients), sensitivity of the method was 75.8%, specificity 95.9%, diagnostic accuracy 90.9%. In hepatocellular jaundice (127 patients) the respective values were 95.9%, 90.3%, 94.8%. The differential diagnosis reliability was found to decrease with the increasing level of total bilirubin. For a level of up to 21.5 μmol/l, diagnostic accuracy was 93.6%, for a level between 21.6 and 85.5 μmol/l it was 91.0%, from 85.6 to 171.0 μmol/l it was 66.6%, from 171.1 to 242.0 μmol/l it was 50.0%, and above 242.0 μmol/l, diagnostic accuracy was 28.5%. At the same time, the sensitivity and specificity of examination decreased with increasing bilirubin level. In respect of differential diagnosis of jaundice, a concentration of the total plasma bilirubin of 242.O μmol/l is considered to be the limit concentration. (author)

  1. Cytologic diagnosis of hepatobiliary cystadenoma with mesenchymal stroma during intraoperative consultation: a case report.

    Science.gov (United States)

    Voltaggio, Lysandra; Szeto, Oliver J; Tabbara, Sana O

    2010-01-01

    Hepatobiliary cystadenoma with mesenchymal stroma (HCMS) is a rare cystic tumor characterized by a layer of mucinous cuboidal to columnar epithelium situated on top of a basement membrane resting on an ovarian-like stroma. Cytologic features of this entity have not been extensively studied. We present a case of HCMS with emphasis on cytologic material obtained at the time of intraoperative consultation (IOC). A 51-year-old woman had partial resection of a liver cyst. Seven months later she sought further medical attention and presented for surgical reevaluation and reexcision of the same lesion. Initial computed tomography revealed a multiloculated liver cyst. Five months after reexcision the lesion recurred and was again excised. During IOC, scrape cytology revealed both biliary epithelial and mesenchymal stromal cells in a cystic background. Permanent sections showed histologic features of HCMS. To the best of our knowledge, this is the first cytologic description of such a neoplasm to include both epithelial and mesenchymal stromal elements. The use of scrape cytology during IOC can be a fast and effective way of identifying both the epithelium and mesenchymal stroma when HCMS is in the differential diagnosis of a cystic liver lesion.

  2. [CHANGES OF CAROTID AND VERTEBRAL ARTERIES IN PATENTS WITH ARTERIAL HYPERTENSION AND HEPATOBILIARY PATHOLOGY].

    Science.gov (United States)

    Polyakov, V Ya; Nikolaev, Yu A; Pegova, S V; Matsievskaya, T R; Obukhov, I V

    2016-01-01

    The study included 1172 patients (410 men and 762 women) at the mean age of 60.3 ± 10.4 years with grade I-II (stage I-II) arterial hypertension (AH) admitted to the clinic of Institute of Experimental Medicine. The patients were divided into 2 groups based on the results of clinical and laboratory diagnostics. Group 1 (n = 525) included patients with AH and hepatobiliary system (HBS) diseases, group 2 (n = 647) patients with AH without HBS diseases. The patients group 1 had a thicker intima-media complex of carotid arteries, higher peak systolic bloodflow rate in the internal and vertebral carotid arteries, more pronounced coiling of internal carotid arteries than patients of group 2. Patients with AH and HBS diseases exhibited correlation between bloodflow rate in external carotid arteries and atherogenicity coefficient. Duplex scanning of neck vessels of in patients with AH without HBS diseases revealed peculiar changes of the intima-media thickness and hemodynamically significant changes of the blood flow in the internal carotid arteries that may be of prognostic value in this nosological syntropy and require the personified approach to diagnostics, treatment, and prevention of these conditions.

  3. The clinical value of 99Tcm-N-NOET exercise and delayed myocardial perfusion imaging in patients with hypertension

    International Nuclear Information System (INIS)

    Wei Hua; Li Sijin; Liu Jianzhong; Wu Zhifang; Liu Haiyan; Hu Guang; Wang Jin; Li Qing

    2010-01-01

    Objective: To investigate clinical significance of the 99 Tc m -bis (N-ethoxy-N-ethyl-dithiocar-bamato) nitridotechnetium ( 99 Tc m -N-NOET) exercise and delayed myocardial perfusion imaging (MPI) in hypertensive patients. Methods: Sixty patients with hypertension and 19 normal subjects were carried out 99 Tc m -N-NOET exercise and delayed MPI, and analyzed the results of MPI, exercise electrocardiography (ECG), cardiac function parameters end-diastolic volume (EDV), end-systolic volume (ESV), left ventricular ejection fraction (LVEF), triangle open LVEF (LVEF exercis-LVEF delay) and coronary angiography (CAG). Results: 1) Sixty patients with hypertension, 22 cases (36.7%) of exercise ECG were abnormal, 16 cases (26.7%) were the chest tightness in exercise, 13 cases (21.7%) were blood pressure excessive reaction in exercise; control group, 2 cases (10.5%) of exercise ECG were abnormal, 1 case (5.3%, 1/19) was chest tightness in exercise, no person was blood pressure response in excessive. 2) The positive rate of myocardial perfusion in hypertensive group was significantly higher than the control group (31.75%vs. 5.30%, P 0.05), triangle open LVEF 2 =4.501, P 2 =0.25, P>0.05). The sensitivity, specificity and accuracy of 99 Tc m -N-NOET MPI were 72.7%, 87.5% and 78.9%. Conclusions: 1) 99 Tc m -N-NOET exercise and delayde MPI can diagnose whether hypertension patients with myocardial ischemia or not. 2) triangle open LVEF of hypertensive patients reduced, triangle open LVEF is lower in hypertensive patients of MPI-positive. (authors)

  4. Design and Optimization of Gadolinium Based Contrast Agents for Magnetic Resonance Imaging

    International Nuclear Information System (INIS)

    Pereira, G.A.; Geraldes, C.F.G.C.; University of Coimbra

    2007-01-01

    The role of Gd 3+ chelates as contrast agents in Magnetic Resonance Imaging is discussed. The theory describing the different contributions to paramagnetic relaxation relevant to the understanding of the molecular parameters determining the relativity of those Gd 3+ chelates, is presented. The experimental techniques used to obtain those parameters are also described. Then, the various approaches taken to optimize those parameters, leading to maximum relativity (efficiency) of the contrast agents, are also illustrated with relevant examples taken from the literature. The various types of Gd 3+ -based agents, besides non-specific and hepatobiliary agents, are also discussed, namely blood pool, targeting, responsive and paramagnetic chemical shift saturation transfer (PARACEST) agents. Finally, a perspective is presented of some of the challenges lying ahead in the optimization of MRI contrast agents to be useful in Molecular Imaging. (author)

  5. Lens Model and Time Delay Predictions for the Sextuply Lensed Quasar SDSS J2222+2745*

    Science.gov (United States)

    Sharon, Keren; Bayliss, Matthew B.; Dahle, Hakon; Florian, Michael K.; Gladders, Michael D.; Johnson, Traci L.; Paterno-Mahler, Rachel; Rigby, Jane R.; Whitaker, Katherine E.; Wuyts, Eva

    2017-01-01

    SDSS J2222+2745 is a galaxy cluster at z = 0.49, strongly lensing a quasar at z = 2.805 into six widely separated images. In recent Hubble Space Telescope imaging of the field, we identify additional multiply lensed galaxies and confirm the sixth quasar image that was identified by Dahle et al. We used the Gemini-North telescope to measure a spectroscopic redshift of z = 4.56 of one of the lensed galaxies. These data are used to refine the lens model of SDSS J2222+2745, compute the time delay and magnifications of the lensed quasar images, and reconstruct the source image of the quasar host and a lensed galaxy at z = 2.3. This galaxy also appears in absorption in our Gemini spectra of the lensed quasar, at a projected distance of 34 kpc. Our model is in agreement with the recent time delay measurements of Dahle et al., who found T(sub AB) = 47.7 +/- 6.0 days and T(sub AC) = 722 +/- 24 days. We use the observed time delays to further constrain the model, and find that the model-predicted time delays of the three faint images of the quasar are T(sub AD) = 502+/- 68 days, T( sub AE) = 611 +/- 75 days, and T(sub AF) = 415 +/- 72 days. We have initiated a follow-up campaign to measure these time delays with Gemini North. Finally, we present initial results from an X-ray monitoring program with Swift, indicating the presence of hard X-ray emission from the lensed quasar, as well as extended X-ray emission from the cluster itself, which is consistent with the lensing mass measurement and the cluster velocity dispersion.

  6. LENS MODEL AND TIME DELAY PREDICTIONS FOR THE SEXTUPLY LENSED QUASAR SDSS J2222+2745

    Energy Technology Data Exchange (ETDEWEB)

    Sharon, Keren; Johnson, Traci L.; Paterno-Mahler, Rachel [Department of Astronomy, University of Michigan, 1085 S. University Avenue, Ann Arbor, MI 48109 (United States); Bayliss, Matthew B. [Colby College, 5800 Mayflower Hill, Waterville, 04901, Maine (United States); Dahle, Håkon [Institute of Theoretical Astrophysics, University of Oslo, P.O. Box 1029, Blindern, NO-0315 Oslo (Norway); Florian, Michael K.; Gladders, Michael D. [Department of Astronomy and Astrophysics, University of Chicago, 5640 South Ellis Avenue, Chicago, IL 60637 (United States); Rigby, Jane R. [Astrophysics Science Division, Goddard Space Flight Center, 8800 Greenbelt Road, Greenbelt, MD 20771 (United States); Whitaker, Katherine E. [Department of Astronomy, University of Massachusetts-Amherst, Amherst, MA 01003 (United States); Wuyts, Eva, E-mail: kerens@umich.edu [Max-Planck-Institut für extraterrestrische Physik, Giessenbachstr. 1, D-85741 Garching (Germany)

    2017-01-20

    SDSS J2222+2745 is a galaxy cluster at z = 0.49, strongly lensing a quasar at z = 2.805 into six widely separated images. In recent Hubble Space Telescope imaging of the field, we identify additional multiply lensed galaxies and confirm the sixth quasar image that was identified by Dahle et al. We used the Gemini-North telescope to measure a spectroscopic redshift of z = 4.56 of one of the lensed galaxies. These data are used to refine the lens model of SDSS J2222+2745, compute the time delay and magnifications of the lensed quasar images, and reconstruct the source image of the quasar host and a lensed galaxy at z = 2.3. This galaxy also appears in absorption in our Gemini spectra of the lensed quasar, at a projected distance of 34 kpc. Our model is in agreement with the recent time delay measurements of Dahle et al., who found τ {sub AB} = 47.7 ± 6.0 days and τ {sub AC} = −722 ± 24 days. We use the observed time delays to further constrain the model, and find that the model-predicted time delays of the three faint images of the quasar are τ {sub AD} = 502 ± 68 days, τ {sub AE} = 611 ± 75 days, and τ {sub AF} = 415 ± 72 days. We have initiated a follow-up campaign to measure these time delays with Gemini North. Finally, we present initial results from an X-ray monitoring program with Swift , indicating the presence of hard X-ray emission from the lensed quasar, as well as extended X-ray emission from the cluster itself, which is consistent with the lensing mass measurement and the cluster velocity dispersion.

  7. Modeling delay in genetic networks: from delay birth-death processes to delay stochastic differential equations.

    Science.gov (United States)

    Gupta, Chinmaya; López, José Manuel; Azencott, Robert; Bennett, Matthew R; Josić, Krešimir; Ott, William

    2014-05-28

    Delay is an important and ubiquitous aspect of many biochemical processes. For example, delay plays a central role in the dynamics of genetic regulatory networks as it stems from the sequential assembly of first mRNA and then protein. Genetic regulatory networks are therefore frequently modeled as stochastic birth-death processes with delay. Here, we examine the relationship between delay birth-death processes and their appropriate approximating delay chemical Langevin equations. We prove a quantitative bound on the error between the pathwise realizations of these two processes. Our results hold for both fixed delay and distributed delay. Simulations demonstrate that the delay chemical Langevin approximation is accurate even at moderate system sizes. It captures dynamical features such as the oscillatory behavior in negative feedback circuits, cross-correlations between nodes in a network, and spatial and temporal information in two commonly studied motifs of metastability in biochemical systems. Overall, these results provide a foundation for using delay stochastic differential equations to approximate the dynamics of birth-death processes with delay.

  8. Modeling delay in genetic networks: From delay birth-death processes to delay stochastic differential equations

    Energy Technology Data Exchange (ETDEWEB)

    Gupta, Chinmaya; López, José Manuel; Azencott, Robert; Ott, William [Department of Mathematics, University of Houston, Houston, Texas 77004 (United States); Bennett, Matthew R. [Department of Biochemistry and Cell Biology, Rice University, Houston, Texas 77204, USA and Institute of Biosciences and Bioengineering, Rice University, Houston, Texas 77005 (United States); Josić, Krešimir [Department of Mathematics, University of Houston, Houston, Texas 77004 (United States); Department of Biology and Biochemistry, University of Houston, Houston, Texas 77204 (United States)

    2014-05-28

    Delay is an important and ubiquitous aspect of many biochemical processes. For example, delay plays a central role in the dynamics of genetic regulatory networks as it stems from the sequential assembly of first mRNA and then protein. Genetic regulatory networks are therefore frequently modeled as stochastic birth-death processes with delay. Here, we examine the relationship between delay birth-death processes and their appropriate approximating delay chemical Langevin equations. We prove a quantitative bound on the error between the pathwise realizations of these two processes. Our results hold for both fixed delay and distributed delay. Simulations demonstrate that the delay chemical Langevin approximation is accurate even at moderate system sizes. It captures dynamical features such as the oscillatory behavior in negative feedback circuits, cross-correlations between nodes in a network, and spatial and temporal information in two commonly studied motifs of metastability in biochemical systems. Overall, these results provide a foundation for using delay stochastic differential equations to approximate the dynamics of birth-death processes with delay.

  9. Modeling delay in genetic networks: From delay birth-death processes to delay stochastic differential equations

    International Nuclear Information System (INIS)

    Gupta, Chinmaya; López, José Manuel; Azencott, Robert; Ott, William; Bennett, Matthew R.; Josić, Krešimir

    2014-01-01

    Delay is an important and ubiquitous aspect of many biochemical processes. For example, delay plays a central role in the dynamics of genetic regulatory networks as it stems from the sequential assembly of first mRNA and then protein. Genetic regulatory networks are therefore frequently modeled as stochastic birth-death processes with delay. Here, we examine the relationship between delay birth-death processes and their appropriate approximating delay chemical Langevin equations. We prove a quantitative bound on the error between the pathwise realizations of these two processes. Our results hold for both fixed delay and distributed delay. Simulations demonstrate that the delay chemical Langevin approximation is accurate even at moderate system sizes. It captures dynamical features such as the oscillatory behavior in negative feedback circuits, cross-correlations between nodes in a network, and spatial and temporal information in two commonly studied motifs of metastability in biochemical systems. Overall, these results provide a foundation for using delay stochastic differential equations to approximate the dynamics of birth-death processes with delay

  10. Eigenspace-Based Minimum Variance Adaptive Beamformer Combined with Delay Multiply and Sum: Experimental Study

    OpenAIRE

    Mozaffarzadeh, Moein; Mahloojifar, Ali; Nasiriavanaki, Mohammadreza; Orooji, Mahdi

    2017-01-01

    Delay and sum (DAS) is the most common beamforming algorithm in linear-array photoacoustic imaging (PAI) as a result of its simple implementation. However, it leads to a low resolution and high sidelobes. Delay multiply and sum (DMAS) was used to address the incapabilities of DAS, providing a higher image quality. However, the resolution improvement is not well enough compared to eigenspace-based minimum variance (EIBMV). In this paper, the EIBMV beamformer has been combined with DMAS algebra...

  11. Biodistribution and dosimetry in humans of two inverse agonists to image cannabinoid CB{sub 1} receptors using positron emission tomography

    Energy Technology Data Exchange (ETDEWEB)

    Terry, Garth E. [National Institute of Mental Health, Molecular Imaging Branch, Bethesda, MD (United States); Karolinska Institutet, Department of Clinical Neuroscience, Psychiatry Section, Stockholm (Sweden); Hirvonen, Jussi; Liow, Jeih-San; Seneca, Nicholas; Morse, Cheryl L.; Pike, Victor W.; Innis, Robert B. [National Institute of Mental Health, Molecular Imaging Branch, Bethesda, MD (United States); Tauscher, Johannes T.; Schaus, John M.; Phebus, Lee; Felder, Christian C. [Lilly Research Laboratories, Lilly Corporate Center, Indianapolis, IN (United States); Halldin, Christer [Karolinska Institutet, Department of Clinical Neuroscience, Psychiatry Section, Stockholm (Sweden)

    2010-08-15

    Cannabinoid subtype 1 (CB{sub 1}) receptors are found in nearly every organ in the body, may be involved in several neuropsychiatric and metabolic disorders, and are therefore an active target for pharmacotherapy and biomarker development. We recently reported brain imaging of CB{sub 1} receptors with two PET radioligands: {sup 11}C-MePPEP and {sup 18}F-FMPEP-d{sub 2}. Here we describe the biodistribution and dosimetry estimates for these two radioligands. Seven healthy subjects (four men and three women) underwent whole-body PET scans for 120 min after injection with {sup 11}C-MePPEP. Another seven healthy subjects (two men and five women) underwent whole-body PET scans for 300 min after injection with {sup 18}F-FMPEP-d{sub 2}. Residence times were acquired from regions of interest drawn on tomographic images of visually identifiable organs for both radioligands and from radioactivity excreted in urine for {sup 18}F-FMPEP-d{sub 2}. The effective doses of {sup 11}C-MePPEP and {sup 18}F-FMPEP-d{sub 2} are 4.6 and 19.7 {mu}Sv/MBq, respectively. Both radioligands demonstrated high uptake of radioactivity in liver, lung, and brain shortly after injection and accumulated radioactivity in bone marrow towards the end of the scan. After injection of {sup 11}C-MePPEP, radioactivity apparently underwent hepatobiliary excretion only, while radioactivity from {sup 18}F-FMPEP-d{sub 2} showed both hepatobiliary and urinary excretion. {sup 11}C-MePPEP and {sup 18}F-FMPEP-d{sub 2} yield an effective dose similar to other PET radioligands labeled with either {sup 11}C or {sup 18}F. The high uptake in brain confirms the utility of these two radioligands to image CB{sub 1} receptors in brain, and both may also be useful to image CB{sub 1} receptors in the periphery. (orig.)

  12. Myocardial delayed-enhancement CT: initial experience in children and young adults

    Energy Technology Data Exchange (ETDEWEB)

    Goo, Hyun Woo [University of Ulsan College of Medicine, Department of Radiology and Research Institute of Radiology, Asan Medical Center, Seoul (Korea, Republic of)

    2017-10-15

    Clinical utility of myocardial delayed enhancement CT has not been reported in children and young adults. To describe initial experience of myocardial delayed enhancement CT regarding image quality, radiation dose and identification of myocardial lesions in children and young adults. Between August 2013 and November 2016, 29 consecutive children and young adults (median age 16 months) with suspected coronary artery or myocardial abnormality underwent arterial- and delayed-phase cardiac CT at our institution. We measured CT densities in normal myocardium, left ventricular cavity, and arterial and delayed hypo-enhancing and delayed hyperenhancing myocardial lesions. We then compared the extent of delayed hyperenhancing lesions with delayed-enhancement MRI or thallium single-photon emission CT. Normal myocardium and left ventricular cavity showed significantly higher CT numbers on arterial-phase CT than on delayed-phase CT (t-test, P<0.0001). Contrast-to-noise ratios of the arterial and delayed hypo-enhancing and delayed hyperenhancing lesions on CT were 26.7, 17.6 and 18.7, respectively. Delayed-phase CT findings were equivalent to those of delayed-enhancement MRI in all cases (7/7) and to those of thallium single-photon emission CT in 70% (7/10). Myocardial delayed-enhancement CT can be added to evaluate myocardial lesions in select children and young adults with suspected coronary artery or myocardial abnormality. (orig.)

  13. Myocardial delayed-enhancement CT: initial experience in children and young adults

    International Nuclear Information System (INIS)

    Goo, Hyun Woo

    2017-01-01

    Clinical utility of myocardial delayed enhancement CT has not been reported in children and young adults. To describe initial experience of myocardial delayed enhancement CT regarding image quality, radiation dose and identification of myocardial lesions in children and young adults. Between August 2013 and November 2016, 29 consecutive children and young adults (median age 16 months) with suspected coronary artery or myocardial abnormality underwent arterial- and delayed-phase cardiac CT at our institution. We measured CT densities in normal myocardium, left ventricular cavity, and arterial and delayed hypo-enhancing and delayed hyperenhancing myocardial lesions. We then compared the extent of delayed hyperenhancing lesions with delayed-enhancement MRI or thallium single-photon emission CT. Normal myocardium and left ventricular cavity showed significantly higher CT numbers on arterial-phase CT than on delayed-phase CT (t-test, P<0.0001). Contrast-to-noise ratios of the arterial and delayed hypo-enhancing and delayed hyperenhancing lesions on CT were 26.7, 17.6 and 18.7, respectively. Delayed-phase CT findings were equivalent to those of delayed-enhancement MRI in all cases (7/7) and to those of thallium single-photon emission CT in 70% (7/10). Myocardial delayed-enhancement CT can be added to evaluate myocardial lesions in select children and young adults with suspected coronary artery or myocardial abnormality. (orig.)

  14. Interpreting the Strongly Lensed Supernova iPTF16geu: Time Delay Predictions, Microlensing, and Lensing Rates

    Energy Technology Data Exchange (ETDEWEB)

    More, Anupreeta; Oguri, Masamune; More, Surhud [Kavli Institute for the Physics and Mathematics of the Universe (Kavli IPMU, WPI), University of Tokyo, Chiba 277-8583 (Japan); Suyu, Sherry H. [Max-Planck-Institut für Astrophysik, Karl-Schwarzschild-Str. 1, D-85748 Garching (Germany); Lee, Chien-Hsiu, E-mail: anupreeta.more@ipmu.jp [Subaru Telescope, National Astronomical Observatory of Japan, 650 North Aohoku Place, Hilo, HI 96720 (United States)

    2017-02-01

    We present predictions for time delays between multiple images of the gravitationally lensed supernova, iPTF16geu, which was recently discovered from the intermediate Palomar Transient Factory (iPTF). As the supernova is of Type Ia where the intrinsic luminosity is usually well known, accurately measured time delays of the multiple images could provide tight constraints on the Hubble constant. According to our lens mass models constrained by the Hubble Space Telescope F814W image, we expect the maximum relative time delay to be less than a day, which is consistent with the maximum of 100 hr reported by Goobar et al. but places a stringent upper limit. Furthermore, the fluxes of most of the supernova images depart from expected values suggesting that they are affected by microlensing. The microlensing timescales are small enough that they may pose significant problems to measure the time delays reliably. Our lensing rate calculation indicates that the occurrence of a lensed SN in iPTF is likely. However, the observed total magnification of iPTF16geu is larger than expected, given its redshift. This may be a further indication of ongoing microlensing in this system.

  15. Delayed-onset dementia after stroke or transient ischemic attack.

    Science.gov (United States)

    Mok, Vincent C T; Lam, Bonnie Y K; Wang, Zhaolu; Liu, Wenyan; Au, Lisa; Leung, Eric Y L; Chen, Sirong; Yang, Jie; Chu, Winnie C W; Lau, Alexander Y L; Chan, Anne Y Y; Shi, Lin; Fan, Florence; Ma, Sze H; Ip, Vincent; Soo, Yannie O Y; Leung, Thomas W H; Kwok, Timothy C Y; Ho, Chi L; Wong, Lawrence K S; Wong, Adrian

    2016-11-01

    Patients surviving stroke without immediate dementia are at high risk of delayed-onset dementia. Mechanisms underlying delayed-onset dementia are complex and may involve vascular and/or neurodegenerative diseases. Dementia-free patients with stroke and/or transient ischemic attack (TIA; n = 919) were studied for 3 years prospectively, excluding those who developed dementia 3 to 6 months after stroke and/or TIA. Forty subjects (4.4%) developed dementia during the study period. Imaging markers of severe small vessel disease (SVD), namely presence of ≥3 lacunes and confluent white matter changes; history of hypertension and diabetes mellitus independently predicted delayed-onset dementia after adjustment for age, gender, and education. Only 6 of 31 (19.4%) subjects with delayed cognitive decline harbored Alzheimer's disease-like Pittsburg compound B (PiB) retention. Most PiB cases (16/25, 64%) had evidence of severe SVD. Severe SVD contributes importantly to delayed-onset dementia after stroke and/or TIA. Future clinical trials aiming to prevent delayed-onset dementia after stroke and/or TIA should target this high-risk group. Copyright © 2016 The Alzheimer's Association. Published by Elsevier Inc. All rights reserved.

  16. The value of delayed {sup 18}F-FDG PET/CT imaging for differentiating axillary lymph nodes in breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Ji, Young Sik; Son, Ju Cheol [Dept. of Nuclear Medicine, Dongnam Institute of Radiological and Medical Sciences Cancer Center, Busan (Korea, Republic of); Park, Cheol Woo [Dept. of Radiological Technology Dong-Eui Institute of Technology, Busan (Korea, Republic of)

    2013-12-15

    Positron emission tomography/computed tomography (PET/CT) imaging with fluorodeoxyglucose (FDG) have been used as a powerful fusion modality in nuclear medicine not only for detecting cancer but also for staging and therapy monitoring. Nevertheless, there are various causes of FDG uptake in normal and/or benign tissues. The purpose of present study was to investigate whether additional delayed imaging can improve the diagnosis to differentiate the rates of FDG uptake at axillary lymph nodes (ALN) between malignant and benign in breast cancer patients. 180 PET/CT images were obtained for 27 patients with ALN uptake. The patients who had radiotherapy and chemotherapy were excluded from the study. {sup 18}F-FDG PET/CT scan at 50 min (early phase) and 90 min (delayed phase) after {sup 18}F-FDG injection were included in this retrospective study. The staging of cancers was confirmed by final clinical according to radiologic follow-up and pathologic findings. The standardized uptake value (SUV) of ALN was measured at the Syngo Acquisition Workplace by Siemens. The 27 patients included 18 malignant and 9 ALN benign groups and the 18 malignant groups were classified into the 3 groups according to number of metastatic ALN in each patient. ALNs were categorized less than or equal 3 as N1, between 4 to 9 as N2 and more than 10 as N3 group. Results are expressed as the mean ± standard deviation (S.D.) and statistically analyzed by SPSS. As a result, Retention index (RI-SUV max) in metastasis was significantly higher than that in non-metastasis about 5 fold increased. On the other hand, RI-SUV max in N group tended to decrease gradually from N1 to N3. However, we could not prove significance statistically in malignant group with ANOVA. As a consequence, RI-SUV max was good indicator for differentiating ALN positive group from node negative group in breast cancer patients. These results show that dual-time-point scan appears to be useful in distinguishing malignant from benign.

  17. Multiple FNH-Like Lesions in a Patient with Chronic Budd-Chiari Syndrome: Gd-EOB-Enhanced MRI and BR1 CEUS Findings

    Directory of Open Access Journals (Sweden)

    Caroline Newerla

    2012-01-01

    Full Text Available A-26-year old female patient with chronic Budd-Chiari syndrome due to different underlying blood disorders applied for a two-year followup of the liver with Gadolinium-ethoxybenzyl-diethylenetriaminepentaacetic-acid-(Gd-EOB-DTPA- enhanced MRI. The liver function tests were raised. Besides showing a progressive hepatosplenomegaly and a cirrhotic liver alteration, the MRI revealed multiple new nodular lesions in all liver segments. These lesions showed typical patterns in the precontrast images, while there was an arterial and a persistent portal venous enhancement. In the hepatobiliary liver-specific late phase, a central “washout” and a persistent rim enhancement were observed (target sign. The additionally performed contrast-enhanced ultrasonography showed a strong zentrifugal arterial enhancement of the lesions followed by an isoechoic enhancement in the portal venous and delayed liver phase. Histologically these lesions turned out as focal nodular hyperplasias (FNH or FNH-like lesions, also known as large regenerative nodules (LRNs. Differentiation between regenerative nodules like LRN and hepatocellular carcinoma (HCC in cirrhotic livers is crucial, and the target sign in the hepatobiliary phase of Gd-EOB-DTPA as well as the centrifugal arterial enhancement followed by an isoenhancement during a CEUS might be useful for establishing the correct diagnosis of such hypervascular lesions with proliferated and likely aberrant bile ducts.

  18. Magnetic Resonance Elastography and Other Magnetic Resonance Imaging Techniques in Chronic Liver Disease: Current Status and Future Directions

    Science.gov (United States)

    Tan, Cher Heng; Venkatesh, Sudhakar Kundapur

    2016-01-01

    Recent advances in the noninvasive imaging of chronic liver disease have led to improvements in diagnosis, particularly with magnetic resonance imaging (MRI). A comprehensive evaluation of the liver may be performed with the quantification of the degree of hepatic steatosis, liver iron concentration, and liver fibrosis. In addition, MRI of the liver may be used to identify complications of cirrhosis, including portal hypertension, ascites, and the development of hepatocellular carcinoma. In this review article, we discuss the state of the art techniques in liver MRI, namely, magnetic resonance elastography, hepatobiliary phase MRI, and liver fat and iron quantification MRI. The use of these advanced techniques in the management of chronic liver diseases, including non-alcoholic fatty liver disease, will be elaborated. PMID:27563019

  19. High-speed Imaging of Vocal Fold Vibration Onset Delay: Normal Versus Abnormal.

    Science.gov (United States)

    Woo, Peak

    2017-05-01

    Vocal fold vibration onset delay (VFVOD) is heard frequently in spasmodic dysphonia and in muscle tension dysphonia. VFVOD changes due to other vocal pathologies have not been investigated. VFVOD during sustained vowel production was estimated with high-speed video in 10 normal and 40 pathologic subjects (scars, vocal fold paralysis, vocal fold nodules, and polyps). Analysis of high-speed video was done using digital kymography. VFVOD can be divided into two portions. Pre-phonation delay (PPD) is the duration when the vocal folds are nearly approximated to the time of first observed oscillation. Steady state delay (SSD) is the time when vocal folds are observed to come into oscillation until steady state of oscillation is observed. Normal subjects have almost zero PPD with vocal fold oscillation observed before full vocal fold adduction. Pathologic cases showed prolonged PPD because of (1) false cord adduction, (2) prolonged true vocal fold adduction, and (3) delay to onset of vocal fold vibration. Normal subjects have SSD of three to five cycles before steady state. Pathologic states result in increased SSD. Causes for increased SSD include (1) slow ramping up to steady state, (2) partial vibration of vocal folds, and (3) diplophonia with alternating beats before achieving steady state. There are significant differences between normal and pathology groups in both PPD and SSD. VFVOD is elevated in pathologic states. This can be due to increase in PPD or SSD. VFVOD is an under-recognized phenomenon that may contribute to complaints of vocal fatigue and dysphonia. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  20. Effect of complete biliary-tract obstruction on serial hepatobiliary imaging in an experimental model: concise communication. [Dogs

    Energy Technology Data Exchange (ETDEWEB)

    Klingensmith, W.C.; Whitney, W.P.; Spitzer, V.M.; Klintmalm, G.B.; Koep, L.M.; Kuni, C.C.

    1981-01-01

    In order to determine the effect of biliary obstruction on hepatocyte clearance and bile flow, five dogs were imaged before, and three times a week after, surgical ligation of the common bile duct. THe first postoperative study was performed 3 hr after surgery. Bile flow and duct function were evaluated from analog images; hepatocyte clearance (HC) was estimated in digital images from the ratio of liver to cardiac blood-pool counts at 3 min. Liver function tests were measured serially. 3 hr after surgery the HC index and liver function tests were still normal. Analog images showed no intestinal radioactivity, but accumulation was seen in the distending biliary tract. on the third postoperative day, all liver function tests were abnormal and the HC index was significantly decreased (p less than 0.01). The biliary tract was never seen beyond the first postoperative day. Thus, complete obstruction of the common bile duct does not stop bile flow or cause significant hepatocyte damage in the first few hours. By the third day of obstruction, however, no bile flow is detectible and significant hepatocyte damage has occurred.

  1. Altered intestinal bile salt biotransformation in a cystic fibrosis (Cftr-/-) mouse model with hepato-biliary pathology.

    Science.gov (United States)

    Bodewes, Frank A J A; van der Wulp, Mariëtte Y M; Beharry, Satti; Doktorova, Marcela; Havinga, Rick; Boverhof, Renze; James Phillips, M; Durie, Peter R; Verkade, Henkjan J

    2015-07-01

    Cftr(-/-tm1Unc) mice develop progressive hepato-biliary pathology. We hypothesize that this liver pathology is related to alterations in biliary bile hydrophobicity and bile salt metabolism in Cftr(-/-tm1Unc) mice. We determined bile production, biliary and fecal bile salt- and lipid compositions and fecal bacterial composition of C57BL/6J Cftr(-/-tm1Unc) and control mice. We found no differences between the total biliary bile salt or lipid concentrations of Cftr(-/-) and controls. Compared to controls, Cftr(-/-) mice had a ~30% higher bile production and a low bile hydrophobicity, related to a ~7 fold higher concentration of the choleretic and hydrophilic bile salt ursocholate. These findings coexisted with a significantly smaller quantity of fecal Bacteroides bacteria. Liver pathology in Cftr(-/-tm1Unc) is not related to increased bile hydrophobicity. Cftr(-/-) mice do however display a biliary phenotype characterized by increased bile production and decreased biliary hydrophobicity. Our findings suggest Cftr dependent, alterations in intestinal bacterial biotransformation of bile salts. Copyright © 2014. Published by Elsevier B.V.

  2. Enterogastroesophageal reflux detected on 99m-technetium sestamibi cardiac imaging as a cause of chest pain

    International Nuclear Information System (INIS)

    Erdogan, Zeynep; Silov, Güler; Özdal, Aysegül; Turhal, Özgül

    2013-01-01

    Myocardial perfusion imaging (MPI) with technetium-99m sestamibi ( 99m Tc MIBI) is considered a diagnostic technique that is widely used for the investigation of suspected coronary artery disease. Incidental inspection of an extracardiac activity is indirect, but important marker, which can identify a potentially treatable non-coronary cause for chest pain that may mimic cardiac symptoms. Here, we present an illustrative case in which significant enterogastroesophageal reflux of 99m Tc MIBI occurred during the cardiac imaging following prompt hepatobiliary clearance. Because, there was normal myocardial perfusion on MPI, presence of gastroesophageal reflux (GER) on GER scintigraphy and detection of mild inflammation with pathologically confirmed hyperplastic polyp by endoscopy, in view of the above findings we concluded that the probable cause of chest pain was reflux. (author)

  3. The Hubble constant estimation using 18 gravitational lensing time delays

    Science.gov (United States)

    Jaelani, Anton T.; Premadi, Premana W.

    2014-03-01

    Gravitational lens time delay method has been used to estimate the rate of cosmological expansion, called the Hubble constant, H0, independently of the standard candle method. This gravitational lensing method requires a good knowledge of the lens mass distribution, reconstructed using the lens image properties. The observed positions of the images, and the redshifts of the lens and the images serve as strong constraints to the lens equations, which are then solved as a set of simultaneous linear equations. Here we made use of a non-parametric technique to reconstruct the lens mass distribution, which is manifested in a linear equations solver named PixeLens. Input for the calculation is chosen based on prior known parameters obtained from analyzed result of the lens case observations, including time-delay, position angles of the images and the lens, and their redshifts. In this project, 18 fairly well studied lens cases are further grouped according to a number of common properties to examine how each property affects the character of the data, and therefore affects the calculation of H0. The considered lens case properties are lens morphology, number of image, completeness of time delays, and symmetry of lens mass distribution. Analysis of simulation shows that paucity of constraints on mass distribution of a lens yields wide range value of H0, which reflects the uniqueness of each lens system. Nonetheless, gravitational lens method still yields H0 within an acceptable range of value when compared to those determined by many other methods. Grouping the cases in the above manner allowed us to assess the robustness of PixeLens and thereby use it selectively. In addition, we use glafic, a parametric mass reconstruction solver, to refine the mass distribution of one lens case, as a comparison.

  4. Optimal Joint Expected Delay Forwarding in Delay Tolerant Networks

    OpenAIRE

    Jia Xu; Xin Feng; Wen Jun Yang; Ru Chuan Wang; Bing Qing Han

    2013-01-01

    Multicopy forwarding schemes have been employed in delay tolerant network (DTN) to improve the delivery delay and delivery rate. Much effort has been focused on reducing the routing cost while retaining high performance. This paper aims to provide an optimal joint expected delay forwarding (OJEDF) protocol which minimizes the expected delay while satisfying a certain constant on the number of forwardings per message. We propose a comprehensive forwarding metric called joint expected delay (JE...

  5. MR imaging of skeletal muscle injury in rabbit : comparison between diffusion and T2-weighted MR images

    International Nuclear Information System (INIS)

    Kim, Ki Jun; Lee, Sung Yong; Lee, Jae Hee; Kwon Oh Han; Lee, Jae Mun; Lim, Yeon Soo

    2000-01-01

    The purpose of this study was to apply the diffusion-weighted MR imaging technique to the early detection of skeletal muscle injury and to evaluate the usefulness of this imaging sequence. Thirty rabbits, divided into two groups, were included in this study . Skeletal muscle injury was experimentally induced in the right thigh muscles of each rabbit by clamping with a hemostat for one minute. Four-stage clamping was applied to the rabbits in group I, but for group II there was only one stage. Diffusion and T2-weighted MR images were obtained using a 1.5T MR unit. Serial 5-and 30-minute, and 2-, 24-, and 48- hour delayed images were obtained after injury. The initial time of signal intensity change was recorded and the signal intensities of the injured sites and corresponding normal sites were measured and compared. On 5-minute delayed images in group I, diffusion-weighted MR images showed signal intensity changes in injured muscle in all 15 cases, but on T2-weighted images, change was not detected in three cases. In group II, 5-minute delayed T2-weighted images failed to depict the lesion in six cases, but on diffusion-weighted images, all lesions were detected. In addition, one lesion was not detected on 30-minute delayed T2-weighted images. In group II, the sensitivity of lesion detection was significantly higher on diffusion-weighted than on T2-weighted images (p=3D0.0169). Diffusion-weighted MR imaging was shown to be more sensitive than T2-weighted imaging for the detection of signal intensity changes immediately after artificial injury, especially when this was of a lesser degree. These results suggest that diffusion-weighted MR imaging may be useful for the detection of early stage skeletal muscle injury. (author)

  6. Detection and characterization of Budd-Chiari syndrome with inferior vena cava obstruction: Comparison of fixed and flexible delayed scan time of computed tomography venography.

    Science.gov (United States)

    Zhou, Peng-Li; Wu, Gang; Han, Xin-Wei; Bi, Yong-Hua; Zhang, Wen-Guang; Wu, Zheng-Yang

    2017-06-01

    To compare the results of computed tomography venography (CTV) with a fixed and a flexible delayed scan time for Budd-Chiari syndrome (BCS) with inferior vena cava (IVC) obstruction. A total of 209 consecutive BCS patients with IVC obstruction underwent either a CTV with a fixed delayed scan time of 180s (n=87) or a flexible delayed scan time for good image quality according to IVC blood flow in color Doppler ultrasonography (n=122). The IVC blood flow velocity was measured using a color Doppler ultrasound prior to CT scan. Image quality was classified as either good, moderate, or poor. Image quality, surrounding structures and the morphology of the IVC obstruction were compared between the two groups using a χ 2 -test or paired or unpaired t-tests as appropriate. Inter-observer agreement was assessed using Kappa statistics. There was no significant difference in IVC blood flow velocity between the two groups. Overall image quality, surrounding structures and IVC obstruction morphology delineation on the flexible delayed scan time of CTV images were rated better relative to those obtained by fixed delayed scan time of CTV images (ptime of CTV. There were no significant differences in Kappa statistics between Group A and Group B. The flexible delayed scan time of CTV was associated with better detection and more reliable characterization of BCS with IVC obstruction compared to a fixed delayed scan time. Copyright © 2017 Elsevier B.V. All rights reserved.

  7. Dose and batch-dependent hepatobiliary toxicity of 10 nm silver nanoparticles

    Directory of Open Access Journals (Sweden)

    Marcella De Maglie

    2015-07-01

    Full Text Available Silver nanoparticles (AgNPs are widely used because of their antimicrobial properties in medical devices and in a variety of consumer products. The extensive use of AgNPs raises concerns about their potential toxicity, although it is still difficult to draw definite conclusions about their toxicity based on published data. Our preliminary studies performed to compare the effect of the AgNPs size (10-40-100 nm on toxicity, demonstrated that the smallest AgNPs determine the most severe toxicological effects. In order to best investigate the impact of physicochemical characteristics of 10 nm AgNPs on toxicity, we compare three different batches of 10 nm AgNPs slightly different in size distribution (Batch A: 8.8±1.7 nm; Batch B: 9.4±1.7 nm; Batch C: 10.0±1.8 nm. Mice were intravenously treated with two doses (5 and 10 mg/kg of the 3 AgNPs. 24 hours after the treatment, mice were euthanized and underwent complete necropsy. Tissues were collected for histopathological examination and total silver content was determined in tissues by inductively coupled plasma mass spectrometry (ICP-MS. All batches induced severe hepatobiliary lesions, i.e. marked hepatocellular necrosis and massive hemorrhage of the gall bladder. The toxicity was dose-dependent and interestingly, the toxic effects were more severe in mice treated with batches A and B that contained smaller AgNPs. Since the total silver mass concentration was similar, the observed batch-dependent toxicity suggest that even subtle differences in size may contribute to relevant changes in the toxicological outcomes, confirming the fundamental involvement of physicochemical features with respect to toxicity.

  8. Delayed contrast-enhanced MRI: use in myocardial viability assessment and other cardiac pathology

    International Nuclear Information System (INIS)

    Bogaert, J.; Dymarkowski, S.

    2005-01-01

    As in other organs, tissue characterization is important for many cardiac diseases. For example, in ischemic heart disease, differentiation between reversibly and irreversibly damaged myocardium in patients with a prior myocardial infarction is crucial in determining disease severity, functional recovery and patient outcome. With the recent advent of the single inversion-recovery contrast-enhanced magnetic resonance imaging (MRI) sequence (delayed contrast-enhanced MRI), contrast between normal and abnormal tissues could be significantly enhanced compared with the conventional cardiac MRI sequences, enabling even subtle abnormalities to be visualized. Together with other advances in cardiac MRI (e.g. functional imaging, coronary artery imaging), MRI has become one of the preferred non-invasive modalities to study cardiac diseases. In this paper an overview of the versatility of delayed contrast-enhanced MRI for investigating cardiac diseases is given. (orig.)

  9. Micromachined silicon acoustic delay line with 3D-printed micro linkers and tapered input for improved structural stability and acoustic directivity

    International Nuclear Information System (INIS)

    Cho, Y; Kumar, A; Xu, S; Zou, J

    2016-01-01

    Recent studies have shown that micromachined silicon acoustic delay lines can provide a promising solution to achieve real-time photoacoustic tomography without the need for complex transducer arrays and data acquisition electronics. To achieve deeper imaging depth and wider field of view, a longer delay time and therefore delay length are required. However, as the length of the delay line increases, it becomes more vulnerable to structural instability due to reduced mechanical stiffness. In this paper, we report the design, fabrication, and testing of a new silicon acoustic delay line enhanced with 3D printed polymer micro linker structures. First, mechanical deformation of the silicon acoustic delay line (with and without linker structures) under gravity was simulated by using finite element method. Second, the acoustic crosstalk and acoustic attenuation caused by the polymer micro linker structures were evaluated with both numerical simulation and ultrasound transmission testing. The result shows that the use of the polymer micro linker structures significantly improves the structural stability of the silicon acoustic delay lines without creating additional acoustic attenuation and crosstalk. In addition, the improvement of the acoustic acceptance angle of the silicon acoustic delay lines was also investigated to better suppress the reception of unwanted ultrasound signals outside of the imaging plane. These two improvements are expected to provide an effective solution to eliminate current limitations on the achievable acoustic delay time and out-of-plane imaging resolution of micromachined silicon acoustic delay line arrays. (paper)

  10. Hepatobiliary function assessed by {sup 99m}Tc-mebrofenin cholescintigraphy in the evaluation of severity of steatosis in a rat model

    Energy Technology Data Exchange (ETDEWEB)

    Vetelaeinen, Reeta L.; Vliet, Arlene van; Gulik, Thomas M. van [Academic Medical Center, Department of Surgery, Amsterdam (Netherlands); Bennink, Roelof J.; Bruin, Kora de [Academic Medical Center, Department of Nuclear Medicine, Amsterdam (Netherlands)

    2006-10-15

    This study evaluated the utility of non-invasive assessment of hepatobiliary function by {sup 99m}Tc-mebrofenin cholescintigraphy in a rat model of diet-induced steatosis. Male Wistar rats (250-300 g) were fed a standard methionine- and choline-deficient (MCD) diet for up to 5 weeks, thereby inducing hepatic fat accumulation, progressive inflammation and fibrogenesis corresponding with clinical steatosis. {sup 99m}Tc-mebrofenin pinhole scintigraphy was used to evaluate the hepatocyte mebrofenin uptake rate, the time of maximum hepatic uptake (T{sub peak}) and the time required for peak activity to decrease by 50% (T{sub 1/2peak}). Scintigraphic parameters were correlated with biochemical and serological parameters and with liver histopathology. MCD diet induced mild steatosis after 1 week and severe steatosis with prominent inflammation after 5 weeks. T{sub peak}, T{sub 1/2peak} prolonged and the uptake rate decreased significantly, while the severity of steatosis increased (p<0.05). There was a strong, significant correlation between the severity of steatosis (histopathology, hepatic triglyceride content) and the {sup 99m}Tc-mebrofenin uptake rate (r {sup 2}=0.83, p<0.0001 and r {sup 2}=0.82, p<0.0001, respectively). In addition, the uptake rate correlated significantly with the increased inflammation (plasma and hepatic TNF-{alpha}, r {sup 2}=0.72, p<0.0001 and r {sup 2}=0.52, p=0.001, respectively). The correlation of the uptake rate with hepatocellular damage was weak (AST and ALT, r {sup 2}=0.29 and 0.32, respectively), but correlation with synthetic function was strong (prothrombin time, r {sup 2}=0.70, p<0.001). Hepatobiliary function assessed by {sup 99m}Tc-mebrofenin scintigraphy correlates with the extent and progression of steatosis. These results suggest a potential role for mebrofenin scintigraphy as a non-invasive functional follow-up method for disease progression in steatotic patients. (orig.)

  11. Memory retrieval of smoking-related images induce greater insula activation as revealed by an fMRI-based delayed matching to sample task.

    Science.gov (United States)

    Janes, Amy C; Ross, Robert S; Farmer, Stacey; Frederick, Blaise B; Nickerson, Lisa D; Lukas, Scott E; Stern, Chantal E

    2015-03-01

    Nicotine dependence is a chronic and difficult to treat disorder. While environmental stimuli associated with smoking precipitate craving and relapse, it is unknown whether smoking cues are cognitively processed differently than neutral stimuli. To evaluate working memory differences between smoking-related and neutral stimuli, we conducted a delay-match-to-sample (DMS) task concurrently with functional magnetic resonance imaging (fMRI) in nicotine-dependent participants. The DMS task evaluates brain activation during the encoding, maintenance and retrieval phases of working memory. Smoking images induced significantly more subjective craving, and greater midline cortical activation during encoding in comparison to neutral stimuli that were similar in content yet lacked a smoking component. The insula, which is involved in maintaining nicotine dependence, was active during the successful retrieval of previously viewed smoking versus neutral images. In contrast, neutral images required more prefrontal cortex-mediated active maintenance during the maintenance period. These findings indicate that distinct brain regions are involved in the different phases of working memory for smoking-related versus neutral images. Importantly, the results implicate the insula in the retrieval of smoking-related stimuli, which is relevant given the insula's emerging role in addiction. © 2013 Society for the Study of Addiction.

  12. Evaluation of reserved hepatic function in patients with hepatobiliary tumor by {sup 99m}Tc-GSA. Effect of hyperbilirubinemia and usefulness of regional reserved hepatic functional imaging

    Energy Technology Data Exchange (ETDEWEB)

    Jin Wu; Ishikawa, Nobuyoshi; Takeda, Tohoru; Sato, Motohiro; Todoroki, Takeshi; Itai, Yuji [Tsukuba Univ., Ibaraki (Japan). Inst. of Clinical Medicine; Fukunaga, Kiyoshi; Okumura, Toshiyuki; Hatakeyama, Rokurou

    1996-02-01

    The evaluation of the reserved hepatic function was performed by {sup 99m}Tc-galactosyl serum albumin ({sup 99m}Tc-GSA) in 70 patients with hepatobiliary tumor. The dynamic study was performed to evaluate global reserved hepatic function following the intravenous bolus injection of {sup 99m}Tc-GSA, and the hepatic single photon emission computed tomography (SPECT) was obtained to assess the regional reserved hepatic function. The functional hepatic index (LHL{sub 15}) was derived from liver time-activity data, and it was compared with serum total-bilirubin level, serum albumin level and plasma disappearance rate of indocyanine green (ICG{sub 15}). In the patients with hepatocellular carcinoma, LHL{sub 15} value agreed well with ICG{sub 15} value, serum total-bilirubin level, and serum albumin level. Moderate or severe hepatic dysfunction was observed at 65.4% of these patients. In the patients with cholangiocellular carcinoma, a discrepancy of LHL{sub 15} value and ICG{sub 15} value was observed. Increment of the ICG{sub 15} value was correlated with that of the serum total-bilirubin level, whereas the correlation was not observed between the LHL{sub 15} value and the serum total-bilirubin level. These results indicate that {sup 99m}Tc-GSA scintigraphy can evaluate the reserved hepatic function without the embellishment of jaundice. This method is useful for assessing the global and regional reserved hepatic function. (author).

  13. The Strong Lensing Time Delay Challenge (2014)

    Science.gov (United States)

    Liao, Kai; Dobler, G.; Fassnacht, C. D.; Treu, T.; Marshall, P. J.; Rumbaugh, N.; Linder, E.; Hojjati, A.

    2014-01-01

    Time delays between multiple images in strong lensing systems are a powerful probe of cosmology. At the moment the application of this technique is limited by the number of lensed quasars with measured time delays. However, the number of such systems is expected to increase dramatically in the next few years. Hundred such systems are expected within this decade, while the Large Synoptic Survey Telescope (LSST) is expected to deliver of order 1000 time delays in the 2020 decade. In order to exploit this bounty of lenses we needed to make sure the time delay determination algorithms have sufficiently high precision and accuracy. As a first step to test current algorithms and identify potential areas for improvement we have started a "Time Delay Challenge" (TDC). An "evil" team has created realistic simulated light curves, to be analyzed blindly by "good" teams. The challenge is open to all interested parties. The initial challenge consists of two steps (TDC0 and TDC1). TDC0 consists of a small number of datasets to be used as a training template. The non-mandatory deadline is December 1 2013. The "good" teams that complete TDC0 will be given access to TDC1. TDC1 consists of thousands of lightcurves, a number sufficient to test precision and accuracy at the subpercent level, necessary for time-delay cosmography. The deadline for responding to TDC1 is July 1 2014. Submissions will be analyzed and compared in terms of predefined metrics to establish the goodness-of-fit, efficiency, precision and accuracy of current algorithms. This poster describes the challenge in detail and gives instructions for participation.

  14. Type a niemann-pick disease. Description of three cases with delayed myelination.

    Science.gov (United States)

    D'Amico, A; Sibilio, M; Caranci, F; Bartiromo, F; Taurisano, R; Balivo, F; Melis, D; Parenti, G; Cirillo, S; Elefante, R; Brunetti, A

    2008-06-03

    We describe three patients with type A Niemann-Pick disease (NPD-A). NPD-A is an autosomal recessive neuronal storage disease classified among the sphingolipidoses, characterized by accumulation of sphingomyelin in various tissues and in the brain. Magnetic Resonance imaging (MRI) of our three patients showed a marked delay of myelination with frontal atrophy. Few descriptions of this MRI pattern of delayed myelination have been published to date.

  15. Indocyanine green labeled with /sup 123/I for dynamic studies of the hepato-biliary system. [/sup 131/I, /sup 125/I

    Energy Technology Data Exchange (ETDEWEB)

    Lambrecht, R.M.; Ansari, A.N.; Wolf, A.P.; Atkins, H.L.

    1975-01-01

    This report summarizes the results to develop an iodine-123 labeled agent for dynamic studies of the hepato-biliary system. Iodine-123 is an ideal nuclide for radiopharmaceuticals, because of its short half-life (T/sub /sup 1///sub 2// = 13.3 hr); its decay with a high abundance (83%) of 159 keV photons; and the reduced patient radiation exposure (a factor of 100 less than iodine-131). Indocyanine green, a tricarbanocyanine dye, was introduced by Heseltine and co-workers in 1956, has several characteristics which suggested that iodine-123 labeled ICG might be potentially useful for hepatic functional evaluation. The plasma clearance and biliary excretion kinetics of /sup 123/I-ICG (in dogs) will be compared to /sup 131/I-rose bengal and bromosulphalein labeled with iodine-125.

  16. Effect of delayed film processing and milliamperage changes on ...

    African Journals Online (AJOL)

    Effect of delayed film processing and milliamperage changes on image quality. NO Egbe, BF Olisemeke, DU Uduwen. Abstract. No Abstract. West African Journal of Radiology Vol. 11(1) 2004: 8-13. Full Text: EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT.

  17. DELAYED FDG-PET/CT IMAGES IN PATIENTS WITH BRAIN TUMORS - IMPACT ON VISUAL AND SEMIQUANTITATIVE ASSESSMENT

    Directory of Open Access Journals (Sweden)

    Pavel H. Bochev

    2013-01-01

    Full Text Available Background: Despite the extensive use of FDG-PET/CT its role in brain tumor assessment remains controversial mostly because of the physiologically high brain uptake which easily obscures pathological processes. The wide availability of FDG, however, maintains the interest in FDG neuro-oncological applications. Objective: to evaluate the use of a late registration at 180min in patients with brain tumors, studied with FDG-PET/CT based on visual and semiquantitative analysis. Materials and methods: 38 patients with brain neoplasms and non-tumor structural lesions underwent a selective brain 18F-FDG PET/CT at two time points at 60 and 180 minutes after administration. Visual assessment was made by two readers with interobserver agreement calculation. Region ratio comparison with three different reference regions - the contralateral one, the white matter, and the cerebellum was used as a base for semiquantitative analysis. Results: Visual analysis showed better delineation of malignant lesion on late registrations with higher inter/intraobserver agreement as compared to the early images. Semiquantitative analysis demonstrated significant differences in early and late indices of metastases and gliomas, but failed in distinguishing gliomas from metastatic lesions and benign lesions.Conclusion: Delayed brain images with FDG-PET/CT at 180 min after injection provide better tumor delineation, higher accuracy, lower interobserver variations. The use of semiquantitative indices, irrespective of the reference region used, is of limited value

  18. Stability and delay sensitivity of neutral fractional-delay systems.

    Science.gov (United States)

    Xu, Qi; Shi, Min; Wang, Zaihua

    2016-08-01

    This paper generalizes the stability test method via integral estimation for integer-order neutral time-delay systems to neutral fractional-delay systems. The key step in stability test is the calculation of the number of unstable characteristic roots that is described by a definite integral over an interval from zero to a sufficient large upper limit. Algorithms for correctly estimating the upper limits of the integral are given in two concise ways, parameter dependent or independent. A special feature of the proposed method is that it judges the stability of fractional-delay systems simply by using rough integral estimation. Meanwhile, the paper shows that for some neutral fractional-delay systems, the stability is extremely sensitive to the change of time delays. Examples are given for demonstrating the proposed method as well as the delay sensitivity.

  19. Magnetic resonance cholangiography in the assessment and management of biliary complications after OLT.

    Science.gov (United States)

    Girometti, Rossano; Cereser, Lorenzo; Bazzocchi, Massimo; Zuiani, Chiara

    2014-07-28

    Despite advances in patient and graft management, biliary complications (BC) still represent a challenge both in the early and delayed period after orthotopic liver transplantation (OLT). Because of unspecific clinical presentation, imaging is often mandatory in order to diagnose BC. Among imaging modalities, magnetic resonance cholangiography (MRC) has gained widespread acceptance as a tool to represent the reconstructed biliary tree noninvasively, using both the conventional technique (based on heavily T2-weighted sequences) and contrast-enhanced MRC (based on the acquisition of T1-weighted sequences after the administration of hepatobiliary contrast agents). On this basis, MRC is generally indicated to: (1) avoid unnecessary procedures of direct cholangiography in patients with a negative examination and/or identify alternative complications; and (2) provide a road map for interventional procedures or surgery. As illustrated in the review, MRC is accurate in the diagnosis of different types of biliary complications, including anastomotic strictures, non-anastomotic strictures, leakage and stones.

  20. Fundamental and clinical studies on simultaneous, quantitative analysis of hepatobiliary and gastrointestinal scintigrams using double isotope method

    Energy Technology Data Exchange (ETDEWEB)

    Aoki, Y; Kakihara, M; Sasaki, M; Tabuse, Y; Takei, N [Wakayama Medical Coll. (Japan)

    1981-04-01

    Double isotope method was applied to carry out simultaneous and quantitative analysis of hepatobiliary and gastrointestinal scintigrams. A scinticamera with parallel collimator for medium energy was connected to a computer to distinguish the two isotopes at a time. 4mCi of sup(99m)Tc-(Sn)-pyridoxylideneisoleucine (Tc-PI) and 200 ..mu..Ci of /sup 111/In-diethylenetriaminepentaacetic acid (In-DTPA) were administrated by i.v. injection and per oral, respectively. Three normal (two women and a man) and 16 patients after the operation of gastric cancer (10 recovered by Roux-en Y method after the total gastrectomy, and 6 recovered after the operation replacing the jejunum between the esophagus and duodenum) were investigated. The process of bile secretion and its mixing with food were followed by the scanning quantitatively. The analysis of time-activity variation at each organ indicated that the replacing operation gave more physiological recovery than that by Roux-en Y method. This method is noninvasive to patients and is promising to follow the process or activity of digestion in any digestive organ after surgery.

  1. Prehospital and hospital delays after stroke onset--United States, 2005-2006.

    Science.gov (United States)

    2007-05-18

    Each year approximately 700,000 persons in the United States have a new or recurrent stroke; of these persons, 15%-30% become permanently disabled, and 20% require institutionalization during the first 3 months after the stroke. The severity of stroke-related disability can be reduced if timely and appropriate treatment is received. Patients with ischemic stroke may be eligible for treatment with intravenous thrombolytic (i.e., tissue plasminogen activator [t-PA]) therapy within 3 hours of symptom onset. Receipt of this treatment usually requires patients to recognize stroke symptoms and receive prompt transport to a hospital emergency department (ED), where timely evaluation and brain imaging (i.e., computed tomography or magnetic resonance imaging) can take place. For patients eligible for t-PA, evidence suggests that the earlier patients are treated after the onset of symptoms the greater the likelihood of a more favorable outcome. In 2001, Congress established the Paul Coverdell National Acute Stroke Registry to measure and track the quality of care provided to acute stroke patients. To assess prehospital delays from onset of stroke symptoms to ED arrival and hospital delays from ED arrival to receipt of brain imaging, CDC analyzed data from the four states participating in the national stroke registry. The results of that analysis indicated that fewer than half (48.0%) of stroke patients for whom onset data were available arrived at the ED within 2 hours of symptom onset, and prehospital delays were shorter for persons transported to the ED by ambulance (i.e., emergency medical services) than for persons who did not receive ambulance transport. The interval between ED arrival and brain imaging also was significantly reduced for those arriving by ambulance. More extensive public education is needed regarding early recognition of stroke and the urgency of telephoning 9-1-1 to receive ambulance transport. Shortening prehospital and hospital delays will increase

  2. Liver Imaging Reporting and Data System on CT and gadoxetic acid-enhanced MRI with diffusion-weighted imaging

    Energy Technology Data Exchange (ETDEWEB)

    Cha, Dong Ik; Jang, Kyung Mi; Kim, Seong Hyun; Kang, Tae Wook; Song, Kyoung Doo [Sungkyunkwan University School of Medicine, Department of Radiology and Center for Imaging Science, Samsung Medical Center, Seoul (Korea, Republic of)

    2017-10-15

    To assess major imaging features of Liver Imaging Reporting and Data System (LI-RADS) on contrast-enhanced CT and gadoxetic acid-enhanced MRI and to estimate whether the combination of signal intensity favouring HCC on hepatobiliary phase (HBP) and diffusion-weighted images (DWI) can act as a major feature in LI-RADS. Four hundred twenty one patients with 445 observations were included. Major features of LI-RADS on CT and MRI as well as HBP and DWI features were assessed. Diagnostic performances of LR-5 according to LI-RADS v2014 and modified LI-RADS which incorporate combination of HBP and DWI were assessed. Pairwise comparisons of the receiver operating characteristic (ROC) curves were performed. For HCCs, capsule appearance had the highest rate of discordance between CT and MRI (32.7%), followed by washout appearance (22.2%). Specificity (75%) of LR-5 of LI-RADS v2014 was lower than that (77.1-79.2%) of modified LI-RADS. Area under the ROC curve of modified LI-RADS (0.755-0.775) was not significantly different from that of LI-RADS v 2014 (0.709) (p > 0.05). There were substantial discordances between CT and MRI for capsule and washout appearances in hepatic observations, and combination of gadoxetic acid-enhanced MRI and DWI might be able to be incorporated as a major feature of LI-RADS. (orig.)

  3. Delayed-enhancement magnetic resonance imaging in patients with clinically suspected stress cardiomyopathy (Tako-Tsubo)

    International Nuclear Information System (INIS)

    Muellerleile, K.; Sultan, A.; Willems, S.; Lund, G.; Groth, M.; Adam, G.; Barmeyer, A.; Meinertz, T.; Koester, R.; Heitzer, T.

    2010-01-01

    To compare the ability of delayed-enhancement magnetic resonance imaging (DE-MRI) and other MRI and clinical parameters to identify diseases mimicking stress cardiomyopathy (SCM). The study included 14 consecutive patients fulfilling the American Heart Association (AHA) criteria for SCM with acute left ventricular dysfunction in the absence of coronary artery disease, triggered by psychological stress. The MRI protocol consisted of cine, T 2-weighted, first-pass-perfusion (FPP) and DE-MRI. Six patients with DE were classified as mimicking SCM (non-SCM) and 8 patients without DE as SCM. FPP defects were found in 4 patients with non-SCM and in none with SCM (p < 0.05). Myocardial edema was found in 5 patients with non-SCM and in 2 patients with SCM (p = ns). No significant differences in clinical findings such as ECG, cardiac markers and echocardiographic recovery of left ventricular function were found between patients with non-SCM and SCM. Non-SCM defined by DE-MRI is a frequent finding in patients fulfilling the AHA criteria for SCM. Clinical findings seem to be of limited value to differentiate between non-SCM and SCM. (orig.)

  4. Brain imaging

    International Nuclear Information System (INIS)

    Mishkin, F.S.

    1978-01-01

    The techniques of brain imaging and results in perfusion studies and delayed images are outlined. An analysis of the advantages and disadvantages of the brain scan in a variety of common problems is discussed, especially as compared with other available procedures. Both nonneoplastic and neoplastic lesions are considered. (Auth/C.F.)

  5. ''In vitro'' and ''in vivo'' studies 2,6 - diisopropyl-fenil-carboilmethyl iminodiacetic acid labeled with99mTc (Disida -99mTc)

    International Nuclear Information System (INIS)

    Martinez, D.Y.F.; Barbosa, M.R.F.F. de; Muramoto, E.; Achando, S.S.; Silva, C.P.G. da.

    1988-07-01

    The ''in vivo'' and ''in vitro'' studies on DISIDA - 99m Tc at the hepatobiliary level were made. The binding of DISIDA - 99m Tc to plasmatic proteins and the fraction at which this binding occurs were determined. The distribution coefficient in n-octanol/saline solution was 0.41 showing the lipophilicity of the compound. The images in rats show the biological distribution as well as the hepatobiliary clearance of the radiopharmaceutical under its unmetabolized form. (author) [pt

  6. Delayed Gadolinium-Enhanced Magnetic Resonance Imaging (dGEMRIC) of Hip Joint Cartilage: Better Cartilage Delineation after Intra-Articular than Intravenous Gadolinium Injection

    DEFF Research Database (Denmark)

    Boesen, M.; Jensen, K.E.; Quistgaard, E.

    2006-01-01

    years) with clinical and radiographic hip osteoarthritis (OA; Kellgren score II-III), MRI of the hip was performed twice on a clinical 1.5T MR scanner: On day 1, before and 90-180 min after 0.3 mmol/kg body weight i.v. Gd-DTPA and, on day 8, 90-180 min after ultrasound-guided i.a. injection of a 4 mmol......PURPOSE: To investigate and compare delayed gadolinium (Gd-DTPA)-enhanced magnetic resonance imaging (MRI) of cartilage (dGEMRIC) in the hip joint using intravenous (i.v.) or ultrasound-guided intra-articular (i.a.) Gd-DTPA injection. MATERIAL AND METHODS: In 10 patients (50% males, mean age 58......) in the joint cartilage compared to the non-enhanced images (P I.a. Gd-DTPA provided significantly higher SNR and CNR compared to i.v. Gd-DTPA (P

  7. Scattering and; Delay, Scale, and Sum Migration

    Energy Technology Data Exchange (ETDEWEB)

    Lehman, S K

    2011-07-06

    How do we see? What is the mechanism? Consider standing in an open field on a clear sunny day. In the field are a yellow dog and a blue ball. From a wave-based remote sensing point of view the sun is a source of radiation. It is a broadband electromagnetic source which, for the purposes of this introduction, only the visible spectrum is considered (approximately 390 to 750 nanometers or 400 to 769 TeraHertz). The source emits an incident field into the known background environment which, for this example, is free space. The incident field propagates until it strikes an object or target, either the yellow dog or the blue ball. The interaction of the incident field with an object results in a scattered field. The scattered field arises from a mis-match between the background refractive index, considered to be unity, and the scattering object refractive index ('yellow' for the case of the dog, and 'blue' for the ball). This is also known as an impedance mis-match. The scattering objects are referred to as secondary sources of radiation, that radiation being the scattered field which propagates until it is measured by the two receivers known as 'eyes'. The eyes focus the measured scattered field to form images which are processed by the 'wetware' of the brain for detection, identification, and localization. When time series representations of the measured scattered field are available, the image forming focusing process can be mathematically modeled by delayed, scaled, and summed migration. This concept of optical propagation, scattering, and focusing have one-to-one equivalents in the acoustic realm. This document is intended to present the basic concepts of scalar scattering and migration used in wide band wave-based remote sensing and imaging. The terms beamforming and (delayed, scaled, and summed) migration are used interchangeably but are to be distinguished from the narrow band (frequency domain) beamforming to determine

  8. Age dependence of spleen- and muscle-corrected hepatic signal enhancement on hepatobiliary phase gadoxetate MRI

    Energy Technology Data Exchange (ETDEWEB)

    Matoori, Simon [Paracelsus Medical University Salzburg, Department of Radiology, Salzburg (Austria); Hirslanden Clinic St. Anna, Clinical Research Group, Lucerne (Switzerland); Froehlich, Johannes M. [Hirslanden Clinic St. Anna, Clinical Research Group, Lucerne (Switzerland); ETH Zurich, Department of Chemistry and Applied Biosciences, Institute of Pharmaceutical Sciences, Zurich (Switzerland); Cantonal Hospital Winterthur, Department of Radiology, Winterthur (Switzerland); Breitenstein, Stefan [Cantonal Hospital Winterthur, Department of Surgery, Clinic for Visceral and Thoracic Surgery, Winterthur (Switzerland); Doert, Aleksis [Cantonal Hospital Winterthur, Department of Radiology, Winterthur (Switzerland); Pozdniakova, Viktoria [Stavanger University Hospital, Department of Radiology, Stavanger (Norway); Koh, Dow-Mu [Royal Marsden Hospital, Department of Radiology, Surrey, England (United Kingdom); Gutzeit, Andreas [Paracelsus Medical University Salzburg, Department of Radiology, Salzburg (Austria); Hirslanden Clinic St. Anna, Clinical Research Group, Lucerne (Switzerland); Cantonal Hospital Winterthur, Department of Radiology, Winterthur (Switzerland)

    2016-06-15

    To identify correlations of signal enhancements (SE) and SE normalized to reference tissues of the spleen, kidney, liver, musculus erector spinae (MES) and ductus hepatocholedochus (DHC) on hepatobiliary phase gadoxetate-enhanced MRI with patient age in non-cirrhotic patients. A heterogeneous cohort of 131 patients with different clinical backgrounds underwent a standardized 3.0-T gadoxetate-enhanced liver MRI between November 2008 and June 2013. After exclusion of cirrhotic patients, a cohort of 75 patients with no diagnosed diffuse liver disease was selected. The ratio of signal intensity 20 min post- to pre-contrast administration (SE) in the spleen, kidney, liver, MES and DHC, and the SE of the kidney, liver and DHC normalized to the reference tissues spleen or MES were compared to patient age. Patient age was inversely correlated with the liver SE normalized to the spleen and MES SE (both p < 0.001) and proportionally with the SE of the spleen (p = 0.043), the MES (p = 0.030) and the kidney (p = 0.022). No significant correlations were observed for the DHC (p = 0.347) and liver SE (p = 0.606). The age dependence of hepatic SE normalized to the enhancement in the spleen and MES calls for a cautious interpretation of these quantification methods. (orig.)

  9. Age dependence of spleen- and muscle-corrected hepatic signal enhancement on hepatobiliary phase gadoxetate MRI

    International Nuclear Information System (INIS)

    Matoori, Simon; Froehlich, Johannes M.; Breitenstein, Stefan; Doert, Aleksis; Pozdniakova, Viktoria; Koh, Dow-Mu; Gutzeit, Andreas

    2016-01-01

    To identify correlations of signal enhancements (SE) and SE normalized to reference tissues of the spleen, kidney, liver, musculus erector spinae (MES) and ductus hepatocholedochus (DHC) on hepatobiliary phase gadoxetate-enhanced MRI with patient age in non-cirrhotic patients. A heterogeneous cohort of 131 patients with different clinical backgrounds underwent a standardized 3.0-T gadoxetate-enhanced liver MRI between November 2008 and June 2013. After exclusion of cirrhotic patients, a cohort of 75 patients with no diagnosed diffuse liver disease was selected. The ratio of signal intensity 20 min post- to pre-contrast administration (SE) in the spleen, kidney, liver, MES and DHC, and the SE of the kidney, liver and DHC normalized to the reference tissues spleen or MES were compared to patient age. Patient age was inversely correlated with the liver SE normalized to the spleen and MES SE (both p < 0.001) and proportionally with the SE of the spleen (p = 0.043), the MES (p = 0.030) and the kidney (p = 0.022). No significant correlations were observed for the DHC (p = 0.347) and liver SE (p = 0.606). The age dependence of hepatic SE normalized to the enhancement in the spleen and MES calls for a cautious interpretation of these quantification methods. (orig.)

  10. Simultaneous auto-calibration and gradient delays estimation (SAGE) in non-Cartesian parallel MRI using low-rank constraints.

    Science.gov (United States)

    Jiang, Wenwen; Larson, Peder E Z; Lustig, Michael

    2018-03-09

    To correct gradient timing delays in non-Cartesian MRI while simultaneously recovering corruption-free auto-calibration data for parallel imaging, without additional calibration scans. The calibration matrix constructed from multi-channel k-space data should be inherently low-rank. This property is used to construct reconstruction kernels or sensitivity maps. Delays between the gradient hardware across different axes and RF receive chain, which are relatively benign in Cartesian MRI (excluding EPI), lead to trajectory deviations and hence data inconsistencies for non-Cartesian trajectories. These in turn lead to higher rank and corrupted calibration information which hampers the reconstruction. Here, a method named Simultaneous Auto-calibration and Gradient delays Estimation (SAGE) is proposed that estimates the actual k-space trajectory while simultaneously recovering the uncorrupted auto-calibration data. This is done by estimating the gradient delays that result in the lowest rank of the calibration matrix. The Gauss-Newton method is used to solve the non-linear problem. The method is validated in simulations using center-out radial, projection reconstruction and spiral trajectories. Feasibility is demonstrated on phantom and in vivo scans with center-out radial and projection reconstruction trajectories. SAGE is able to estimate gradient timing delays with high accuracy at a signal to noise ratio level as low as 5. The method is able to effectively remove artifacts resulting from gradient timing delays and restore image quality in center-out radial, projection reconstruction, and spiral trajectories. The low-rank based method introduced simultaneously estimates gradient timing delays and provides accurate auto-calibration data for improved image quality, without any additional calibration scans. © 2018 International Society for Magnetic Resonance in Medicine.

  11. Delayed-onset Reversible Cortical Blindness after Resuscitation from Cardiac Arrest

    Science.gov (United States)

    de Souza, Aaron; de Souza, Rainha J.; Pai Kakode, Varun R.

    2017-01-01

    We present a patient who presented with cortical blindness (CB) 1 week after repeated cardiac arrest while undergoing treatment for an acute myocardial infarction. He had been revived within 5 min in each instance and was apparently neurologically normal until presentation. Magnetic resonance imaging showed subtle hyperintensities on fluid-attenuated inversion recovery and diffusion-weighted imaging in both temporooccipital cortices. A rapid recovery over the next 2 weeks was remarkable for the appearance of metamorphopsia. CB may present even days to weeks after hypoxic-ischemic encephalopathy following cardiac arrest, even in patients apparently without immediate neurological sequelae. The pathogenesis of this phenomenon remains to be fully elucidated, but is likely to be due to delayed effects of anoxia on the occipital cortex and may be analogous to the previously described syndrome of delayed posthypoxic leukoencephalopathy. Prognosis for visual recovery appears to be good. PMID:28936091

  12. Delayed gastric emptying in children with chronic constipation and fecal impaction

    International Nuclear Information System (INIS)

    Baracat, M.L.C.M.; Daher, S.F.; Brunetto, S.Q.; Etchebehere, E.C.S.C.; Santos, A.O.; Ramos, C.D.; Camargo, E.E.; Pinto, E.A.L.C.; Silva, J.M.B.

    2002-01-01

    Post-prandial upper abdominal symptoms such as nausea, fullness and early satiety in constipated children may be associated with delayed gastric emptying. Aim: To evaluate the gastric emptying in children with post-prandial upper abdominal symptoms. Materials and Methods: Gastric emptying studies were performed in 12 children with functional constipation (mean age 9 years; mean duration of symptoms: 5.5 years), fecal impaction and soiling. In 12 of them the studies were performed only before fecal impaction removal and in 7 of them the study was repeated after impaction removal and recovery from constipation. After an overnight fast, the patients received 300 ml/m 2 of water added to 37 MBq of 99m Tc-sulfur colloid. Images were acquired in a camera-computer system with a low energy all purpose collimator. Images were acquired at 1 minute per frame for 30 minutes. When gastric emptying was delayed for more than 30 minutes, additional static images with 500,000 counts were performed for no more than 1 hour until a T1/2 was obtained. Results: Gastric emptying was delayed (21.4 ± 7 minutes; normal 12 ± 3 minutes) in 10/12 patients studied prior to fecal impaction removal. In the group of seven patients who repeated the study after fecal impaction removal, gastric emptying remained prolonged (22 ±7.9 minutes). There was no statistically significant difference between the gastric emptying time before and after fecal impaction removal (p 0,612; Wilcoxon test). Conclusion: The gastric emptying time of a liquid test meal was delayed in constipated children before and after fecal impaction removal. Maintenance of prolonged emptying time after impaction removal and recovery from constipation may indicate an alteration in gastrointestinal motility

  13. Atmospheric Phase Delay in Sentinel SAR Interferometry

    Science.gov (United States)

    Krishnakumar, V.; Monserrat, O.; Crosetto, M.; Crippa, B.

    2018-04-01

    The repeat-pass Synthetic Aperture Radio Detection and Ranging (RADAR) Interferometry (InSAR) has been a widely used geodetic technique for observing the Earth's surface, especially for mapping the Earth's topography and deformations. However, InSAR measurements are prone to atmospheric errors. RADAR waves traverse the Earth's atmosphere twice and experience a delay due to atmospheric refraction. The two major layers of the atmosphere (troposphere and ionosphere) are mainly responsible for this delay in the propagating RADAR wave. Previous studies have shown that water vapour and clouds present in the troposphere and the Total Electron Content (TEC) of the ionosphere are responsible for the additional path delay in the RADAR wave. The tropospheric refractivity is mainly dependent on pressure, temperature and partial pressure of water vapour. The tropospheric refractivity leads to an increase in the observed range. These induced propagation delays affect the quality of phase measurement and introduce errors in the topography and deformation fields. The effect of this delay was studied on a differential interferogram (DInSAR). To calculate the amount of tropospheric delay occurred, the meteorological data collected from the Spanish Agencia Estatal de Meteorología (AEMET) and MODIS were used. The interferograms generated from Sentinel-1 carrying C-band Synthetic Aperture RADAR Single Look Complex (SLC) images acquired on the study area are used. The study area consists of different types of scatterers exhibiting different coherence. The existing Saastamoinen model was used to perform a quantitative evaluation of the phase changes caused by pressure, temperature and humidity of the troposphere during the study. Unless the phase values due to atmospheric disturbances are not corrected, it is difficult to obtain accurate measurements. Thus, the atmospheric error correction is essential for all practical applications of DInSAR to avoid inaccurate height and deformation

  14. ATMOSPHERIC PHASE DELAY IN SENTINEL SAR INTERFEROMETRY

    Directory of Open Access Journals (Sweden)

    V. Krishnakumar

    2018-04-01

    Full Text Available The repeat-pass Synthetic Aperture Radio Detection and Ranging (RADAR Interferometry (InSAR has been a widely used geodetic technique for observing the Earth’s surface, especially for mapping the Earth’s topography and deformations. However, InSAR measurements are prone to atmospheric errors. RADAR waves traverse the Earth’s atmosphere twice and experience a delay due to atmospheric refraction. The two major layers of the atmosphere (troposphere and ionosphere are mainly responsible for this delay in the propagating RADAR wave. Previous studies have shown that water vapour and clouds present in the troposphere and the Total Electron Content (TEC of the ionosphere are responsible for the additional path delay in the RADAR wave. The tropospheric refractivity is mainly dependent on pressure, temperature and partial pressure of water vapour. The tropospheric refractivity leads to an increase in the observed range. These induced propagation delays affect the quality of phase measurement and introduce errors in the topography and deformation fields. The effect of this delay was studied on a differential interferogram (DInSAR. To calculate the amount of tropospheric delay occurred, the meteorological data collected from the Spanish Agencia Estatal de Meteorología (AEMET and MODIS were used. The interferograms generated from Sentinel-1 carrying C-band Synthetic Aperture RADAR Single Look Complex (SLC images acquired on the study area are used. The study area consists of different types of scatterers exhibiting different coherence. The existing Saastamoinen model was used to perform a quantitative evaluation of the phase changes caused by pressure, temperature and humidity of the troposphere during the study. Unless the phase values due to atmospheric disturbances are not corrected, it is difficult to obtain accurate measurements. Thus, the atmospheric error correction is essential for all practical applications of DInSAR to avoid inaccurate

  15. Primed infusion with delayed equilibrium of Gd.DTPA for enhanced imaging of small pulmonary metastases.

    Science.gov (United States)

    Kalber, Tammy L; Campbell-Washburn, Adrienne E; Siow, Bernard M; Sage, Elizabeth; Price, Anthony N; Ordidge, Katherine L; Walker-Samuel, Simon; Janes, Sam M; Lythgoe, Mark F

    2013-01-01

    To use primed infusions of the magnetic resonance imaging (MRI) contrast agent Gd.DTPA (Magnevist), to achieve an equilibrium between blood and tissue (eqMRI). This may increase tumor Gd concentrations as a novel cancer imaging methodology for the enhancement of small tumor nodules within the low signal-to-noise background of the lung. A primed infusion with a delay before equilibrium (eqMRI) of the Gd(III) chelator Gd.DTPA, via the intraperitoneal route, was used to evaluate gadolinium tumor enhancement as a function of a bolus injection, which is applied routinely in the clinic, compared to gadolinium maintained at equilibrium. A double gated (respiration and cardiac) spin-echo sequence at 9.4T was used to evaluate whole lungs pre contrast and then at 15 (representative of bolus enhancement), 25 and 35 minutes (representative of eqMRI). This was carried out in two lung metastasis models representative of high and low tumor cell seeding. Lungs containing discrete tumor nodes where inflation fixed and taken for haematoxylin and eosin staining as well as CD34 staining for correlation to MRI. We demonstrate that sustained Gd enhancement, afforded by Gd equilibrium, increases the detection of pulmonary metastases compared to bolus enhancement and those tumors which enhance at equilibrium are sub-millimetre in size (<0.7 mm(2)) with a similar morphology to early bronchoalveolar cell carcinomas. As Gd-chelates are routinely used in the clinic for detecting tumors by MRI, this methodology is readily transferable to the clinic and advances MRI as a methodology for the detection of small pulmonary tumors.

  16. On the choice of lens density profile in time delay cosmography

    Science.gov (United States)

    Sonnenfeld, Alessandro

    2018-03-01

    Time delay lensing is a mature and competitive cosmological probe. However, it is limited in accuracy by the well-known problem of the mass-sheet degeneracy: too rigid assumptions on the density profile of the lens can potentially bias the inference on cosmological parameters. I investigate the degeneracy between the choice of the lens density profile and the inference on the Hubble constant, focusing on double image systems. By expanding lensing observables in terms of the local derivatives of the lens potential around the Einstein radius, and assuming circular symmetry, I show that 3 degrees of freedom in the radial direction are necessary to achieve a few per cent accuracy in the time-delay distance. Additionally, while the time delay is strongly dependent on the second derivative of the potential, observables typically used to constrain lens models in time-delay studies, such as image position and radial magnification information, are mostly sensitive to the first and third derivatives, making it very challenging to accurately determine time-delay distances with lensing data alone. Tests on mock observations show that the assumption of a power-law density profile results in a 5 per cent average bias on H0, with a 6 per cent scatter. Using a more flexible model and adding unbiased velocity dispersion constraints allows me to obtain an inference with 1 per cent accuracy. A power-law model can still provide 3 per cent accuracy if velocity dispersion measurements are used to constrain its slope. Although this study is based on the assumption of axisymmetry, its main findings can be generalized to cases with moderate ellipticity.

  17. Chaotic Image Encryption Algorithm Based on Circulant Operation

    Directory of Open Access Journals (Sweden)

    Xiaoling Huang

    2013-01-01

    Full Text Available A novel chaotic image encryption scheme based on the time-delay Lorenz system is presented in this paper with the description of Circulant matrix. Making use of the chaotic sequence generated by the time-delay Lorenz system, the pixel permutation is carried out in diagonal and antidiagonal directions according to the first and second components. Then, a pseudorandom chaotic sequence is generated again from time-delay Lorenz system using all components. Modular operation is further employed for diffusion by blocks, in which the control parameter is generated depending on the plain-image. Numerical experiments show that the proposed scheme possesses the properties of a large key space to resist brute-force attack, sensitive dependence on secret keys, uniform distribution of gray values in the cipher-image, and zero correlation between two adjacent cipher-image pixels. Therefore, it can be adopted as an effective and fast image encryption algorithm.

  18. Tc-99m labeled Sparfloxacin: A specific infection imaging agent

    International Nuclear Information System (INIS)

    Singh, A.K.; Verma, J.; Bhatnagar, A.; Ali, A.

    2003-01-01

    Radiolabeled antibiotics are being used for the specific diagnosis of infection by exploiting their specific binding properties to the bacterial component, thereby making it possible to differentiate infection from sterile lesions. A new radiopharmaceutical, Tc-99m Sparfloxacin has been developed for infection imaging. Sparfloxacin is a quinolone based broad-spectrum antibiotic, which is more potent than Ciprofloxacin. Radiolabeling of Sparfloxacin with Tc-99m was standardized using direct labeling protocol. Labeling efficiency, in-vitro and in-vivo stability, blood kinetics and organ distribution studies (in balb/c mice and New Zealand White Rabbits at different time interval up to 24hrs) were carried out. Biological activity of Sparfloxacin after its labeling with Tc-99m was evaluated with S.aureus using Peptone water (DIFCO) as media. Turpentine oil (100 μl) in left thigh and S.aureus (100μl of 3x10 7 cells) in right thigh were injected intramuscularly to create sterile and infective inflammation respectively in six New Zealand white rabbits. The localization kinetics of the radiolabeled complex were studied in the animal model by injecting 70-75MBq of Tc-99m Sparfloxacin intravenously in the ear of rabbit and the images were taken with a Gamma-camera (ECIL) at different post-injection time intervals. Standardized protocol produced >95% labeled complex. About 8% of tracer leached out at 24 hrs when incubated in serum at 37 0 C, confirming high stability of the complex. Blood clearance in rabbit revealed biphasic pattern and 50% of the complex clears from the blood within 5 min. Biodistribution studies in balb/c mice showed hepatobiliary route of excretion. Presence of insignificant amount of tracer at 24 hrs in the stomach confirmed high in vivo stability of the complex. Imaging in rabbits showed significant concentration of tracer in lesions with infection. Typical imaging patterns revealed initial accumulation of radiotracer in both sterile inflammatory

  19. Fuzzy delay model based fault simulator for crosstalk delay fault test ...

    Indian Academy of Sciences (India)

    In this paper, a fuzzy delay model based crosstalk delay fault simulator is proposed. As design trends move towards nanometer technologies, more number of new parameters affects the delay of the component. Fuzzy delay models are ideal for modelling the uncertainty found in the design and manufacturing steps.

  20. Delayed Radiation-Induced Vasculitic Leukoencephalopathy

    Energy Technology Data Exchange (ETDEWEB)

    Rauch, Philipp J. [Departments of Pathology and Neurosurgery, Yale University School of Medicine, New Haven, Connecticut (United States); Faculty of Medicine, University of Heidelberg, Heidelberg (Germany); Park, Henry S. [Departments of Pathology and Neurosurgery, Yale University School of Medicine, New Haven, Connecticut (United States); Knisely, Jonathan P.S. [Department of Radiation Medicine, North Shore University Hospital, Manhasset, New York (United States); Chiang, Veronica L. [Departments of Pathology and Neurosurgery, Yale University School of Medicine, New Haven, Connecticut (United States); Vortmeyer, Alexander O., E-mail: alexander.vortmeyer@yale.edu [Departments of Pathology and Neurosurgery, Yale University School of Medicine, New Haven, Connecticut (United States)

    2012-05-01

    Purpose: Recently, single-fraction, high-dosed focused radiation therapy such as that administered by Gamma Knife radiosurgery has been used increasingly for the treatment of metastatic brain cancer. Radiation therapy to the brain can cause delayed leukoencephalopathy, which carries its own significant morbidity and mortality. While radiosurgery-induced leukoencephalopathy is known to be clinically different from that following fractionated radiation, pathological differences are not well characterized. In this study, we aimed to integrate novel radiographic and histopathologic observations to gain a conceptual understanding of radiosurgery-induced leukoencephalopathy. Methods and Materials: We examined resected tissues of 10 patients treated at Yale New Haven Hospital between January 1, 2009, and June 30, 2010, for brain metastases that had been previously treated with Gamma Knife radiosurgery, who subsequently required surgical management of a symptomatic regrowing lesion. None of the patients showed pathological evidence of tumor recurrence. Clinical and magnetic resonance imaging data for each of the 10 patients were then studied retrospectively. Results: We provide evidence to show that radiosurgery-induced leukoencephalopathy may present as an advancing process that extends beyond the original high-dose radiation field. Neuropathologic examination of the resected tissue revealed traditionally known leukoencephalopathic changes including demyelination, coagulation necrosis, and vascular sclerosis. Unexpectedly, small and medium-sized vessels revealed transmural T-cell infiltration indicative of active vasculitis. Conclusions: We propose that the presence of a vasculitic component in association with radiation-induced leukoencephalopathy may facilitate the progressive nature of the condition. It may also explain the resemblance of delayed leukoencephalopathy with recurring tumor on virtually all imaging modalities used for posttreatment follow-up.

  1. Flash trajectory imaging of target 3D motion

    Science.gov (United States)

    Wang, Xinwei; Zhou, Yan; Fan, Songtao; He, Jun; Liu, Yuliang

    2011-03-01

    We present a flash trajectory imaging technique which can directly obtain target trajectory and realize non-contact measurement of motion parameters by range-gated imaging and time delay integration. Range-gated imaging gives the range of targets and realizes silhouette detection which can directly extract targets from complex background and decrease the complexity of moving target image processing. Time delay integration increases information of one single frame of image so that one can directly gain the moving trajectory. In this paper, we have studied the algorithm about flash trajectory imaging and performed initial experiments which successfully obtained the trajectory of a falling badminton. Our research demonstrates that flash trajectory imaging is an effective approach to imaging target trajectory and can give motion parameters of moving targets.

  2. Usefulness of liposomes carrying losefamate for CT opacification of liver and spleen

    International Nuclear Information System (INIS)

    Seltzer, S.E.; Shulkin, P.M.; Adams, D.F.; Davis, M.A.; Hoey, G.B.; Hopkins, R.M.; Bosworth, M.E.

    1984-01-01

    Iosefamate, a hepatobiliary contrast agent, was encapsulated into liposomes to increase its ability to opacify the liver and spleen on computed tomographic (CT) images. Multilamellar lipid vesicles containing iosefamate in their aqueous phase were prepared. Seven dogs received intravenous injections of 100-300 mg l/kg in one of three forms; encapsulated, unencapsulated, or a mixture of the two in equal parts. Animals that received the opaque vesicles had marked opacification of their livers, bile ducts, gallbladders, spleens and gastrointestinal tracts. At the high-dose level, liver upake of the encapsulated materials was also greater. Liposome-encapsulated hepatobiliary contrast agents are effective liver and spleen opacifiers for CT imaging in the dog

  3. On the cost/delay tradeoff of wireless delay tolerant geographic routing

    OpenAIRE

    Tasiopoulos, Argyrios; Tsiaras, Christos; Toumpis, Stavros

    2012-01-01

    In Delay Tolerant Networks (DTNs), there is a fundamental tradeoff between the aggregate transport cost of a packet and the delay in its delivery. We study this tradeoff in the context of geographical routing in wireless DTNs.We ?rst specify the optimal cost/delay tradeoff, i.e., the tradeoff under optimal network operation, using a dynamic network construction termed the Cost/Delay Evolving Graph (C/DEG) and the Optimal Cost/Delay Curve (OC/DC), a function that gives the minimum possible agg...

  4. Leveraging delay discounting for health: Can time delays influence food choice?

    Science.gov (United States)

    Appelhans, Bradley M; French, Simone A; Olinger, Tamara; Bogucki, Michael; Janssen, Imke; Avery-Mamer, Elizabeth F; Powell, Lisa M

    2018-03-15

    Delay discounting, the tendency to choose smaller immediate rewards over larger delayed rewards, is theorized to promote consumption of immediately rewarding but unhealthy foods at the expense of long-term weight maintenance and nutritional health. An untested implication of delay discounting models of decision-making is that selectively delaying access to less healthy foods may promote selection of healthier (immediately available) alternatives, even if they may be less desirable. The current study tested this hypothesis by measuring healthy versus regular vending machine snack purchasing before and during the implementation of a 25-s time delay on the delivery of regular snacks. Purchasing was also examined under a $0.25 discount on healthy snacks, a $0.25 tax on regular snacks, and the combination of both pricing interventions with the 25-s time delay. Across 32,019 vending sales from three separate vending locations, the 25-s time delay increased healthy snack purchasing from 40.1% to 42.5%, which was comparable to the impact of a $0.25 discount (43.0%). Combining the delay and the discount had a roughly additive effect (46.0%). However, the strongest effects were seen under the $0.25 tax on regular snacks (53.7%) and the combination of the delay and the tax (50.2%). Intervention effects varied substantially between vending locations. Importantly, time delays did not harm overall vending sales or revenue, which is relevant to the real-world feasibility of this intervention. More investigation is needed to better understand how the impact of time delays on food choice varies across populations, evaluate the effects of time delays on beverage vending choices, and extend this approach to food choices in contexts other than vending machines. ClinicalTrials.gov, NCT02359916. Copyright © 2018 Elsevier Ltd. All rights reserved.

  5. Advanced gastric cancer. The findings of delayed phase dynamic CT and radiologic-histopathologic correlation

    International Nuclear Information System (INIS)

    Monzawa, Shuichi; Omata, Kosaku; Nakazima, Hiroto; Yokosuka, Noriko; Ito, Atuko; Araki, Tsutomu

    2000-01-01

    The aim of this study was to describe delayed phase dynamic CT findings of advanced (T2-T4) gastric cancer and to correlate with histopathologic findings. Quadruple phase dynamic CT including delayed imaging taken five minutes after the start of injection of contrast material was performed in 43 patients with 45 advanced gastric cancer and 20 control subjects with no gastric lesions. On delayed phase CT scans, the attenuation of the gastric wall was equal to or lower than that of the liver parenchyma in the control subjects, therefore, the presence of higher attenuation in the gastric wall was considered to be abnormal and defined as delayed enhancement. Histopathologic findings in the tumors showing delayed enhancement were compared with those in the tumors without this feature. Delayed enhancement was seen in 26 (57%) of the 45 tumors. Eleven of 25 differentiated-type tumors and 15 of 20 undifferentiated-type tumors showed delayed enhancement (p<.05). Delayed enhancement was seen in one of five medullary type tumors, in 11 of 25 intermediate-type tumors, and in 14 of 15 scirrhous-type tumors (p<.005). Delayed enhancement was frequently seen in the tumors with abundant fibrous tissue stroma. Delayed phase dynamic CT may be useful for the characterization of advanced gastric cancer. (author)

  6. Preclinical evaluation of severely defective manganese-based nanocrystal as a liver-specific contrast media for MR imaging: comparison with Gd-EOB-DTPA and MnDPDP

    Science.gov (United States)

    Zhang, Yu; Xiao, Xiao-ping; Shu, Ting; Cai, Jing; Xiao, Xin-lan; Li, Yan-shu; Zhang, Zhong-wei; Tang, Qun

    2018-06-01

    Manganese-based (chemically formulated of KMnF3) nanocrystal was evaluated as a liver-specific contrast agent for MR imaging and its imaging performance was also compared with those of two commercial hepatobiliary contrast media (Gd-EOB-DTPA and MnDPDP). KMnF3 nanocrystal was post-treated using a plasma technique to cause severe defects, leading to appropriate water dispersibility and high relaxivity. Severely defective KMnF3 nanocrystal (SD-KMnF3) has characteristic high tolerance, as evidenced by cytotoxicity on the macrophage cell, and acute and subchronic toxicity on the healthy mouse. SD-KMnF3 showed better hepatic MR imaging as the T 1 relaxation time of the liver decreased to only 17% of the control group, compared to 22% of the control group for Gd-EOB-DTPA (P hepatocarcinoma or metastatic lesions.

  7. Representing delayed force feedback as a combination of current and delayed states.

    Science.gov (United States)

    Avraham, Guy; Mawase, Firas; Karniel, Amir; Shmuelof, Lior; Donchin, Opher; Mussa-Ivaldi, Ferdinando A; Nisky, Ilana

    2017-10-01

    To adapt to deterministic force perturbations that depend on the current state of the hand, internal representations are formed to capture the relationships between forces experienced and motion. However, information from multiple modalities travels at different rates, resulting in intermodal delays that require compensation for these internal representations to develop. To understand how these delays are represented by the brain, we presented participants with delayed velocity-dependent force fields, i.e., forces that depend on hand velocity either 70 or 100 ms beforehand. We probed the internal representation of these delayed forces by examining the forces the participants applied to cope with the perturbations. The findings showed that for both delayed forces, the best model of internal representation consisted of a delayed velocity and current position and velocity. We show that participants relied initially on the current state, but with adaptation, the contribution of the delayed representation to adaptation increased. After adaptation, when the participants were asked to make movements with a higher velocity for which they had not previously experienced with the delayed force field, they applied forces that were consistent with current position and velocity as well as delayed velocity representations. This suggests that the sensorimotor system represents delayed force feedback using current and delayed state information and that it uses this representation when generalizing to faster movements. NEW & NOTEWORTHY The brain compensates for forces in the body and the environment to control movements, but it is unclear how it does so given the inherent delays in information transmission and processing. We examined how participants cope with delayed forces that depend on their arm velocity 70 or 100 ms beforehand. After adaptation, participants applied opposing forces that revealed a partially correct representation of the perturbation using the current and the

  8. Imaging findings in congenital hepatic fibrosis

    International Nuclear Information System (INIS)

    Akhan, Okan; Karaosmanoglu, Ali Devrim; Ergen, Bilge

    2007-01-01

    Congenital hepatic fibrosis (CHF) is a rare congenital multisystemic disorder, mostly inherited in autosomal recessive fashion, primarily affecting renal and hepatobiliary systems. Main underlying process of the disease is the malformation of the ductal plate, the embryological precursor of the biliary system, and secondary biliary strictures and periportal fibrosis ultimately leading to portal hypertension. The natural course of the disease is highly variable ranging from minimally symptomatic disease to true cirrhosis of the liver. However, in most patients the most common manifestations of the diseases that are related to portal hypertension, particularly splenomegaly and bleeding varices. Many other disease processes may co-exist with the disease including Caroli's disease, choledochal cysts and autosomal recessive polycystic kidney disease (ARPKD) reflecting the mulstisystemic nature of the disease. The associating biliary ductal disease led the authors to think that all these entities are a continuum and different reflections of the same underlying pathophysiological process. Although, conventional method of diagnosis of CHF is the liver biopsy the advent of imaging technologies and modalities, today, may permit the correct diagnosis in a non-invasive manner. Characteristic imaging features are generally present and recognition of these findings may obviate liver biopsy while preserving the diagnostic accuracy. In this article, it is aimed to increase the awareness of the practising radiologists to the imaging findings of this uncommon clinical disorder and trail the blaze for future articles relating to this issue

  9. Imaging findings in congenital hepatic fibrosis

    Energy Technology Data Exchange (ETDEWEB)

    Akhan, Okan [Department of Radiology, Hacettepe University, School of Medicine, 06100 Ankara (Turkey)]. E-mail: akhano@tr.net; Karaosmanoglu, Ali Devrim [Department of Radiology, Hacettepe University, School of Medicine, 06100 Ankara (Turkey); Ergen, Bilge [Department of Radiology, Hacettepe University, School of Medicine, 06100 Ankara (Turkey)

    2007-01-15

    Congenital hepatic fibrosis (CHF) is a rare congenital multisystemic disorder, mostly inherited in autosomal recessive fashion, primarily affecting renal and hepatobiliary systems. Main underlying process of the disease is the malformation of the ductal plate, the embryological precursor of the biliary system, and secondary biliary strictures and periportal fibrosis ultimately leading to portal hypertension. The natural course of the disease is highly variable ranging from minimally symptomatic disease to true cirrhosis of the liver. However, in most patients the most common manifestations of the diseases that are related to portal hypertension, particularly splenomegaly and bleeding varices. Many other disease processes may co-exist with the disease including Caroli's disease, choledochal cysts and autosomal recessive polycystic kidney disease (ARPKD) reflecting the mulstisystemic nature of the disease. The associating biliary ductal disease led the authors to think that all these entities are a continuum and different reflections of the same underlying pathophysiological process. Although, conventional method of diagnosis of CHF is the liver biopsy the advent of imaging technologies and modalities, today, may permit the correct diagnosis in a non-invasive manner. Characteristic imaging features are generally present and recognition of these findings may obviate liver biopsy while preserving the diagnostic accuracy. In this article, it is aimed to increase the awareness of the practising radiologists to the imaging findings of this uncommon clinical disorder and trail the blaze for future articles relating to this issue.

  10. Asymptotic Delay Analysis for Cross-Layer Delay-Based Routing in Ad Hoc Networks

    Directory of Open Access Journals (Sweden)

    Philippe Jacquet

    2007-01-01

    Full Text Available This paper addresses the problem of the evaluation of the delay distribution via analytical means in IEEE 802.11 wireless ad hoc networks. We show that the asymptotic delay distribution can be expressed as a power law. Based on the latter result, we present a cross-layer delay estimation protocol and we derive new delay-distribution-based routing algorithms, which are well adapted to the QoS requirements of real-time multimedia applications. In fact, multimedia services are not sensitive to average delays, but rather to the asymptotic delay distributions. Indeed, video streaming applications drop frames when they are received beyond a delay threshold, determined by the buffer size. Although delay-distribution-based routing is an NP-hard problem, we show that it can be solved in polynomial time when the delay threshold is large, because of the asymptotic power law distribution of the link delays.

  11. Space-Time Quantum Imaging

    Directory of Open Access Journals (Sweden)

    Ronald E. Meyers

    2015-03-01

    Full Text Available We report on an experimental and theoretical investigation of quantum imaging where the images are stored in both space and time. Ghost images of remote objects are produced with either one or two beams of chaotic laser light generated by a rotating ground glass and two sensors measuring the reference field and bucket field at different space-time points. We further observe that the ghost images translate depending on the time delay between the sensor measurements. The ghost imaging experiments are performed both with and without turbulence. A discussion of the physics of the space-time imaging is presented in terms of quantum nonlocal two-photon analysis to support the experimental results. The theoretical model includes certain phase factors of the rotating ground glass. These experiments demonstrated a means to investigate the time and space aspects of ghost imaging and showed that ghost imaging contains more information per measured photon than was previously recognized where multiple ghost images are stored within the same ghost imaging data sets. This suggests new pathways to explore quantum information stored not only in multi-photon coincidence information but also in time delayed multi-photon interference. The research is applicable to making enhanced space-time quantum images and videos of moving objects where the images are stored in both space and time.

  12. Evaluation of the Effect of Light and Scanning Time Delay on The Image Quality of Intra Oral Photostimulable Phosphor Plates.

    Science.gov (United States)

    Eskandarloo, Amir; Yousefi, Arman; Soheili, Setareh; Ghazikhanloo, Karim; Amini, Payam; Mohammadpoor, Haniyeh

    2017-01-01

    Nowadays, digital radiography is widely used in dental practice. One of the most common types is Photo Stimulated Phosphor Plate (PSP). The aims of this experimental study were to evaluate the impacts of different combinations of storage conditions and varying delays in reading of digital images captured using PSPs. Standardized images of a step wedges were obtained using PSPs from the Digora digital systems. Plates were exposed and immediately scanned to produce the baseline gold standard. The plates were re-exposed and stored in four different storage conditions: white light, yellow light, natural light environment and dark room, then scanned after 10 and 30 minutes and 4 and 8 hours. Objective analysis was conducted by density measurements and the data were analyzed statistically using GEE test. Subjective analysis was performed by two oral and maxillofacial radiologists and the results were analyzed using McNemar's test. The results from GEE analysis show that in the natural light environment, the densities in 10 minutes did not differ from the baseline. The mean densities decreased significantly during the time in all environments. The mean densities in step 2 for the dark room environment decreased with a slighter slope in comparison to yellow environment significantly. PSP images showed significant decrease in the density in plates scanned for 10 minutes or longer after exposure which may not be detected clinically. The yellow light environment had a different impact on the quality of PSP images. The spatial resolution did not change significantly with time.

  13. Imprints of the quasar structure in time-delay light curves: Microlensing-aided reverberation mapping

    Science.gov (United States)

    Sluse, D.; Tewes, M.

    2014-11-01

    The advent of large area photometric surveys has raised a great deal of interest in the possibility of using broadband photometric data, instead of spectra, to measure the size of the broad line region of active galactic nuclei. We describe here a new method that uses time-delay lensed quasars where one or several images are affected by microlensing due to stars in the lensing galaxy. Because microlensing decreases (or increases) the flux of the continuum compared to the broad line region, it changes the contrast between these two emission components. We show that this effect can be used to effectively disentangle the intrinsic variability of those two regions, offering the opportunity to perform reverberation mapping based on single-band photometric data. Based on simulated light curves generated using a damped random walk model of quasar variability, we show that measurement of the size of the broad line region can be achieved using this method, provided one spectrum has been obtained independently during the monitoring. This method is complementary to photometric reverberation mapping and could also be extended to multi-band data. Because the effect described above produces a variability pattern in difference light curves between pairs of lensed images that is correlated with the time-lagged continuum variability, it can potentially produce systematic errors in measurement of time delays between pairs of lensed images. Simple simulations indicate that time-delay measurement techniques that use a sufficiently flexible model for the extrinsic variability are not affected by this effect and produce accurate time delays.

  14. Delayed Gadolinium-Enhanced Magnetic Resonance Imaging (dGEMRIC) of Hip Joint Cartilage: Better Cartilage Delineation after Intra-Articular than Intravenous Gadolinium Injection

    DEFF Research Database (Denmark)

    Boesen, M.; Jensen, K.E.; Quistgaard, E.

    2006-01-01

    PURPOSE: To investigate and compare delayed gadolinium (Gd-DTPA)-enhanced magnetic resonance imaging (MRI) of cartilage (dGEMRIC) in the hip joint using intravenous (i.v.) or ultrasound-guided intra-articular (i.a.) Gd-DTPA injection. MATERIAL AND METHODS: In 10 patients (50% males, mean age 58...... years) with clinical and radiographic hip osteoarthritis (OA; Kellgren score II-III), MRI of the hip was performed twice on a clinical 1.5T MR scanner: On day 1, before and 90-180 min after 0.3 mmol/kg body weight i.v. Gd-DTPA and, on day 8, 90-180 min after ultrasound-guided i.a. injection of a 4 mmol....../l Gd-DTPA solution. Coronal STIR, coronal T1 fat-saturated spin-echo, and a cartilage-sensitive gradient-echo sequence (3D T1 SPGR) in the sagittal plane were applied. RESULTS Both the post-i.v. and post-i.a. Gd-DTPA images showed significantly higher signal-to-noise (SNR) and contrast-to-noise (CNR...

  15. HAMLET treatment delays bladder cancer development.

    Science.gov (United States)

    Mossberg, Ann-Kristin; Hou, Yuchuan; Svensson, Majlis; Holmqvist, Bo; Svanborg, Catharina

    2010-04-01

    HAMLET is a protein-lipid complex that kills different types of cancer cells. Recently we observed a rapid reduction in human bladder cancer size after intravesical HAMLET treatment. In this study we evaluated the therapeutic effect of HAMLET in the mouse MB49 bladder carcinoma model. Bladder tumors were established by intravesical injection of MB49 cells into poly L-lysine treated bladders of C57BL/6 mice. Treatment groups received repeat intravesical HAMLET instillations and controls received alpha-lactalbumin or phosphate buffer. Effects of HAMLET on tumor size and putative apoptotic effects were analyzed in bladder tissue sections. Whole body imaging was used to study HAMLET distribution in tumor bearing mice compared to healthy bladder tissue. HAMLET caused a dose dependent decrease in MB49 cell viability in vitro. Five intravesical HAMLET instillations significantly decreased tumor size and delayed development in vivo compared to controls. TUNEL staining revealed selective apoptotic effects in tumor areas but not in adjacent healthy bladder tissue. On in vivo imaging Alexa-HAMLET was retained for more than 24 hours in the bladder of tumor bearing mice but not in tumor-free bladders or in tumor bearing mice that received Alexa-alpha-lactalbumin. Results show that HAMLET is active as a tumoricidal agent and suggest that topical HAMLET administration may delay bladder cancer development. Copyright (c) 2010 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  16. Delayed diagnosis of sarcoidosis is common in Brazil

    Directory of Open Access Journals (Sweden)

    Mauri Monteiro Rodrigues

    2013-09-01

    Full Text Available OBJECTIVE: To determine the frequency of and the factors related to delayed diagnosis of sarcoidosis in Brazil. METHODS: We evaluated patients with a biopsy-proven diagnosis of sarcoidosis, using a questionnaire that addressed the following: time since symptom onset and since the first medical visit; and the number and specialty of the physicians visited. We divided the patients by the timeliness of the diagnosis-timely (< 6 months and delayed (≥ 6 months-comparing the two groups in terms of systemic and pulmonary symptoms; extrathoracic involvement; spirometric data; radiological staging; level of education; income; and tuberculosis (diagnosis and treatment. RESULTS: We evaluated 100 patients. The median number of physicians consulted was 3 (range, 1-14. In 11 cases, sarcoidosis was diagnosed at the first visit. In 54, the first physician seen was a general practitioner. The diagnosis of sarcoidosis was timely in 41 patients and delayed in 59. The groups did not differ in terms of gender; race; type of health insurance; level of education; income; respiratory/systemic symptoms; extrathoracic involvement; and radiological staging. In the delayed diagnosis group, FVC was lower (80.3 ± 20.4% vs. 90.5 ± 17.1%; p = 0.010, as was FEV1 (77.3 ± 19.9% vs. 86.4 ± 19.5%; p = 0.024, misdiagnosis with and treatment for tuberculosis (≥ 3 months also being more common (24% vs. 7%, p = 0.032, and 20% vs. 0%; p = 0.002, respectively. CONCLUSIONS: The diagnosis of sarcoidosis is often delayed, even when the imaging is suggestive of sarcoidosis. Delayed diagnosis is associated with impaired lung function at the time of diagnosis. Many sarcoidosis patients are misdiagnosed with and treated for tuberculosis.

  17. Lesions Responsible for Delayed Oral Transit Time in Post-stroke Dysphagia.

    Science.gov (United States)

    Moon, Hyun Im; Yoon, Seo Yeon; Yi, Tae Im; Jeong, Yoon Jeong; Cho, Tae Hwan

    2017-10-11

    Some stroke patients show oral phase dysphagia, characterized by a markedly prolonged oral transit time that hinders oral feeding. The aim of this study was to clarify the clinical characteristics and lesions responsible for delayed swallowing. We reviewed 90 patients with stroke. The oral processing time plus the postfaucial aggregation time required to swallow semisolid food was assessed. The patients were divided into two groups according to oral transit time, and we analyzed the differences in characteristics such as demographic factors, lesion factors, and cognitive function. Logistic regression analyses were performed to examine the predictors of delayed oral transit time. Lesion location and volume were measured on brain magnetic resonance images. We generated statistic maps of lesions related to delayed oral phase in swallowing using voxel-based lesion symptom mapping (VLSM). The group of patients who showed delayed oral transit time had significantly low cognitive function. Also, in a regression model, delayed oral phase was predicted with low K-MMSE (Korean version of the Mini Mental Status Exam). Using VLSM, we found the lesion location to be associated with delayed oral phase after adjusting for K-MMSE score. Although these results did not reach statistical significance, they showed the lesion pattern with predominant distribution in the left frontal lobe. Delayed oral phase in post-stroke patients was not negligible clinically. Patients' cognitive impairments affect the oral transit time. When adjusting it, we found a trend that the lesion responsible for delayed oral phase was located in the left frontal lobe, though the association did not reach significance. The delay might be related to praxis function.

  18. Delayed fission

    Energy Technology Data Exchange (ETDEWEB)

    Hatsukawa, Yuichi [Japan Atomic Energy Research Inst., Tokai, Ibaraki (Japan). Tokai Research Establishment

    1997-07-01

    Delayed fission is a nuclear decay process that couples {beta} decay and fission. In the delayed fission process, a parent nucleus undergoes {beta} decay and thereby populates excited states in the daughter. If these states are of energies comparable to or greater than the fission barrier of the daughter, then fission may compete with other decay modes of the excited states in the daughter. In this paper, mechanism and some experiments of the delayed fission will be discussed. (author)

  19. Nuclear imaging in reflux diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Bares, R.

    1988-12-01

    Duodenogastric and gastroesophageal refluxes can be accurately detected by hepatobiliary and gastroesophageal scintigraphy. These procedures are non-invasive and easy to perform. Practical details and evaluation are described. Subsequent to a review of diagnostic results, indications are discussed. Both techniques should be applied in cases where morphological examinations did not yield any pathologic result and clinical symptoms are suggestive for functional disturbances.

  20. Fuzzy delay model based fault simulator for crosstalk delay fault test ...

    Indian Academy of Sciences (India)

    In this paper, a fuzzy delay model based crosstalk delay fault simulator is proposed. As design .... To find the quality of non-robust tests, a fuzzy delay ..... Dubois D and Prade H 1989 Processing Fuzzy temporal knowledge. IEEE Transactions ...

  1. Delayed power analysis

    International Nuclear Information System (INIS)

    Adamovich, L.A.; Azarov, V.V.

    1999-01-01

    Time dependent core power behavior in a nuclear reactor is described with well-known neutron kinetics equations. At the same time, two portions are distinguished in energy released from uranium nuclei fission; one released directly at fission and another delayed (residual) portion produced during radioactive decay of fission products. While prompt power is definitely described with kinetics equations, the delayed power presentation still remains outstanding. Since in operation the delayed power part is relatively small (about 6%) operation, it can be neglected for small reactivity disturbances assuming that entire power obeys neutron kinetics equations. In case of a high negative reactivity rapidly inserted in core (e.g. reactor scram initiation) the prompt and delayed components can be calculated separately with practically no impact on each other, employing kinetics equations for prompt power and known approximation formulas for delayed portion, named residual in this specific case. Under substantial disturbances the prompt component in the dynamic process becomes commensurable with delayed portion, thus making necessary to take into account their cross impact. A system of differential equations to describe time-dependent behavior of delayed power is presented. Specific NPP analysis shows a way to significantly simplify the task formulation. (author)

  2. A feasibility study evaluating the relationship between dose and focal liver reaction in stereotactic ablative radiotherapy for liver cancer based on intensity change of Gd-EOB-DTPA-enhanced magnetic resonance images

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Sang Hoon; Yu, Jeong Il; Park, Hee Chul; Lim, Do Hoon; Han, Young Yih [Dept. of Radiation Oncology, amsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2016-03-15

    In order to evaluate the relationship between the dose to the liver parenchyma and focal liver reaction (FLR) after stereotactic ablative body radiotherapy (SABR), we suggest a novel method using a three-dimensional dose distribution and change in signal intensity of gadoxetate disodium-gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) hepatobiliary phase images. In our method, change of the signal intensity between the pretreatment and follow-up hepatobiliary phase images of Gd-EOB-DTPA-enhanced MRI was calculated and then threshold dose (TD) for developing FLR was obtained from correlation of dose with the change of the signal intensity. For validation of the method, TDs for six patients, who had been treated for liver cancer with SABR with 45-60 Gy in 3 fractions, were calculated using the method, and we evaluated concordance between volume enclosed by isodose of TD by the method and volume identified as FLR by a physician. The dose to normal liver was correlated with change in signal intensity between pretreatment and follow-up MRI with a median R{sup 2} of 0.935 (range, 0.748 to 0.985). The median TD by the method was 23.5 Gy (range, 18.3 to 39.4 Gy). The median value of concordance was 84.5% (range, 44.7% to 95.9%). Our method is capable of providing a quantitative evaluation of the relationship between dose and intensity changes on follow-up MRI, as well as determining individual TD for developing FLR. We expect our method to provide better information about the individual relationship between dose and FLR in radiotherapy for liver cancer.

  3. A feasibility study evaluating the relationship between dose and focal liver reaction in stereotactic ablative radiotherapy for liver cancer based on intensity change of Gd-EOB-DTPA-enhanced magnetic resonance images

    International Nuclear Information System (INIS)

    Jung, Sang Hoon; Yu, Jeong Il; Park, Hee Chul; Lim, Do Hoon; Han, Young Yih

    2016-01-01

    In order to evaluate the relationship between the dose to the liver parenchyma and focal liver reaction (FLR) after stereotactic ablative body radiotherapy (SABR), we suggest a novel method using a three-dimensional dose distribution and change in signal intensity of gadoxetate disodium-gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) hepatobiliary phase images. In our method, change of the signal intensity between the pretreatment and follow-up hepatobiliary phase images of Gd-EOB-DTPA-enhanced MRI was calculated and then threshold dose (TD) for developing FLR was obtained from correlation of dose with the change of the signal intensity. For validation of the method, TDs for six patients, who had been treated for liver cancer with SABR with 45-60 Gy in 3 fractions, were calculated using the method, and we evaluated concordance between volume enclosed by isodose of TD by the method and volume identified as FLR by a physician. The dose to normal liver was correlated with change in signal intensity between pretreatment and follow-up MRI with a median R 2 of 0.935 (range, 0.748 to 0.985). The median TD by the method was 23.5 Gy (range, 18.3 to 39.4 Gy). The median value of concordance was 84.5% (range, 44.7% to 95.9%). Our method is capable of providing a quantitative evaluation of the relationship between dose and intensity changes on follow-up MRI, as well as determining individual TD for developing FLR. We expect our method to provide better information about the individual relationship between dose and FLR in radiotherapy for liver cancer

  4. Gadolinium-ethoxybenzyl-DTPA as a hepatobiliary contrast agent for use in MR cholangiography: results of an in vivo phase-I clinical evaluation

    International Nuclear Information System (INIS)

    Bollow, M.; Taupitz, M.; Hamm, B.; Staks, T.; Wolf, K.J.; Weinmann, H.J.

    1997-01-01

    The purpose of this study was to investigate the time course of contrast enhancement in bile ducts and the gallbladder (GB) after injection of gadolinium-ethoxybenzyl-DTPA (Gd-EOB-DTPA). In a clinical phase-I study, MR imaging at 1.5T was performed in 16 healthy volunteers with four different doses of Gd-EOB-DTPA (10, 25, 50, and 100 μmol/kg b. w., four volunteers per dosage). The study protocol comprised a heavily T1-weighted fast multiplanar gradient-echo (GE) sequence before and at increasing intervals for up to 360 min after injection of Gd-EOB-DTPA. The signal enhancement was evaluated in extra-and intrahepatic bile ducts as well as in the GB. In all 16 volunteers the common bile duct showed intense signal enhancement beginning 5-16 min after injection (mean 10 min) and persisting for at least 120 min in 4 subjects and for 360 min in 12 subjects. The duration of signal enhancement was significantly (p < 0.05) longer for higher doses (50, 100 μmol/kg) than for lower doses (10, 25 μmol/kg). Intrahepatic bile ducts were hyperintense as compared with liver parenchyma in all subjects receiving 10 μmol/kg from approximately 50-120 min after contrast agent application. Intrahepatic bile ducts were not displayed using the higher doses, probably because of the strong enhancement of the liver parenchyma. Gallbladder contrasting was achieved in all cases beginning 7-33 min after injection (mean 19 min) and remained visible for up to 360 min in 94 %. Hyperintense visualization of normal extrahepatic bile ducts as well as the GB is regularly achieved with the hepatobiliary contrast agent Gd-EOB-DTPA. The dosage for hyperintense visualization of intrahepatic bile ducts is 10 μmol/kg. (orig.). With 8 figs., 2 tabs

  5. ATMOSPHERIC PHASE DELAY CORRECTION OF D-INSAR BASED ON SENTINEL-1A

    Directory of Open Access Journals (Sweden)

    X. Li

    2018-04-01

    Full Text Available In this paper, we used the Generic Atmospheric Correction Online Service for InSAR (GACOS tropospheric delay maps to correct the atmospheric phase delay of the differential interferometric synthetic aperture radar (D-InSAR monitoring, and we improved the accuracy of subsidence monitoring using D-InSAR technology. Atmospheric phase delay, as one of the most important errors that limit the monitoring accuracy of InSAR, would lead to the masking of true phase in subsidence monitoring. For the problem, this paper used the Sentinel-1A images and the tropospheric delay maps got from GACOS to monitor the subsidence of the Yellow River Delta in Shandong Province. The conventional D-InSAR processing was performed using the GAMMA software. The MATLAB codes were used to correct the atmospheric delay of the D-InSAR results. The results before and after the atmospheric phase delay correction were verified and analyzed in the main subsidence area. The experimental results show that atmospheric phase influences the deformation results to a certain extent. After the correction, the measurement error of vertical deformation is reduced by about 18 mm, which proves that the removal of atmospheric effects can improve the accuracy of the D-InSAR monitoring.

  6. Patient Delay, Diagnosis Delay and Treatment Delay for Breast Cancer: Comparison of the Pattern between Patients in Public and Private Health Sectors

    Directory of Open Access Journals (Sweden)

    Iraj Harirchi

    2015-05-01

    Full Text Available Background: The purpose of this study was to compare patient delay, diagnosis delay and treatment delay in breast cancer patients of selected public and private health centers in Tehran, Iran.Methods: In this cross-sectional study, female patients with newly diagnosed breast cancer in a public medical complex and a private breast clinic within one year were included. Patient delay was considered positive, if the interval between the detection of the first symptom by the patient and the first visit to a health care provider took longer than one month. Delay in diagnosis was defined as the period of more than one week between the first medical visit for the symptoms and the diagnosis of breast cancer. Following the confirmed diagnosis of breast malignancy, if the medical treatment was initiated later than one week, treatment delay had occurred. The potential reasons for patient, diagnosis and treatment delay according to the patients’ reports were also recorded.Results: Overall, 385 patients were included of whom 52.7% were recruited from the public hospitals and 47.3% from a private clinic. The prevalence of patient delay, diagnosis delay and treatment delay were 31.7%, 17.9% and 28.3%, respectively. Patient delay was significantly more common among patients with lower socio-economic status and those recruited from the public hospitals. All the patients with diagnosis delay were in the group recruited from the public hospitals.Conclusions: Gaps between women of different socio-economic levels of the society need to be addressed in order to decrease patient, diagnosis and treatment delay.

  7. Speech and Language Delay

    Science.gov (United States)

    ... OTC Relief for Diarrhea Home Diseases and Conditions Speech and Language Delay Condition Speech and Language Delay Share Print Table of Contents1. ... Treatment6. Everyday Life7. Questions8. Resources What is a speech and language delay? A speech and language delay ...

  8. MR appearance of normal and abnormal bile: Correlation with imaging and endoscopic finding

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Nam Kyung [Department of Radiology, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Pusan National University, Busan 602-739 (Korea, Republic of); Kim, Suk, E-mail: kimsuk@medimail.co.kr [Department of Radiology, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Pusan National University, Busan 602-739 (Korea, Republic of); Lee, Jun Woo; Lee, Suk Hong [Department of Radiology, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Pusan National University, Busan 602-739 (Korea, Republic of); Kang, Dae Hwan; Kim, Dong Uk; Kim, Gwang Ha [Department of Internal Medicine, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Pusan National University, Busan 602-739 (Korea, Republic of); Seo, Hyung Il [Department of Surgery, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Pusan National University, Busan 602-739 (Korea, Republic of)

    2010-11-15

    Identification of abnormal bile related to various pathological processes in the pancreaticobiliary tract can be important in the diagnosis of disease and the determination of appropriate treatment. Magnetic resonance (MR) imaging can allow comprehensive evaluation of abnormal bile because MR usually provides better tissue characterization than other imaging modalities. A high-intensity signal from bile is frequently encountered on T1-weighted images and can be seen in concentrated bile, sludge, stones, or hemobilia. Contrast-enhanced MR features, such as inhomogeneous hepatic enhancement in the arterial phase and papillitis or mild-to-moderate bile duct wall thickening with enhancement, along with clinical characteristics, may suggest clinically significant bile, such as sludge or purulent bile, rather than merely concentrated bile. A history of trauma and appropriate imaging findings in the hepatobiliary tract can support a diagnosis of hemobilia. MR imaging may assist in diagnosing intraductal papillary mucinous neoplasm of the bile duct via detection of an intraductal mass or several indirect signs, suggesting a large amount of mucin. Additionally, Gd-EOB-DTPA-enhanced MR may delineate mucin as a filling defect surrounding hyperintense bile. A floating filling defect on all MR sequences is helpful in discriminating pneumobilia from other intraluminal filling defects. Familiarity with the various different MR features of abnormal bile signals can therefore facilitate accurate diagnosis and treatment.

  9. MR appearance of normal and abnormal bile: Correlation with imaging and endoscopic finding

    International Nuclear Information System (INIS)

    Lee, Nam Kyung; Kim, Suk; Lee, Jun Woo; Lee, Suk Hong; Kang, Dae Hwan; Kim, Dong Uk; Kim, Gwang Ha; Seo, Hyung Il

    2010-01-01

    Identification of abnormal bile related to various pathological processes in the pancreaticobiliary tract can be important in the diagnosis of disease and the determination of appropriate treatment. Magnetic resonance (MR) imaging can allow comprehensive evaluation of abnormal bile because MR usually provides better tissue characterization than other imaging modalities. A high-intensity signal from bile is frequently encountered on T1-weighted images and can be seen in concentrated bile, sludge, stones, or hemobilia. Contrast-enhanced MR features, such as inhomogeneous hepatic enhancement in the arterial phase and papillitis or mild-to-moderate bile duct wall thickening with enhancement, along with clinical characteristics, may suggest clinically significant bile, such as sludge or purulent bile, rather than merely concentrated bile. A history of trauma and appropriate imaging findings in the hepatobiliary tract can support a diagnosis of hemobilia. MR imaging may assist in diagnosing intraductal papillary mucinous neoplasm of the bile duct via detection of an intraductal mass or several indirect signs, suggesting a large amount of mucin. Additionally, Gd-EOB-DTPA-enhanced MR may delineate mucin as a filling defect surrounding hyperintense bile. A floating filling defect on all MR sequences is helpful in discriminating pneumobilia from other intraluminal filling defects. Familiarity with the various different MR features of abnormal bile signals can therefore facilitate accurate diagnosis and treatment.

  10. A model for integrating elementary neural functions into delayed-response behavior.

    Directory of Open Access Journals (Sweden)

    Thomas Gisiger

    2006-04-01

    Full Text Available It is well established that various cortical regions can implement a wide array of neural processes, yet the mechanisms which integrate these processes into behavior-producing, brain-scale activity remain elusive. We propose that an important role in this respect might be played by executive structures controlling the traffic of information between the cortical regions involved. To illustrate this hypothesis, we present a neural network model comprising a set of interconnected structures harboring stimulus-related activity (visual representation, working memory, and planning, and a group of executive units with task-related activity patterns that manage the information flowing between them. The resulting dynamics allows the network to perform the dual task of either retaining an image during a delay (delayed-matching to sample task, or recalling from this image another one that has been associated with it during training (delayed-pair association task. The model reproduces behavioral and electrophysiological data gathered on the inferior temporal and prefrontal cortices of primates performing these same tasks. It also makes predictions on how neural activity coding for the recall of the image associated with the sample emerges and becomes prospective during the training phase. The network dynamics proves to be very stable against perturbations, and it exhibits signs of scale-invariant organization and cooperativity. The present network represents a possible neural implementation for active, top-down, prospective memory retrieval in primates. The model suggests that brain activity leading to performance of cognitive tasks might be organized in modular fashion, simple neural functions becoming integrated into more complex behavior by executive structures harbored in prefrontal cortex and/or basal ganglia.

  11. A model for integrating elementary neural functions into delayed-response behavior.

    Science.gov (United States)

    Gisiger, Thomas; Kerszberg, Michel

    2006-04-01

    It is well established that various cortical regions can implement a wide array of neural processes, yet the mechanisms which integrate these processes into behavior-producing, brain-scale activity remain elusive. We propose that an important role in this respect might be played by executive structures controlling the traffic of information between the cortical regions involved. To illustrate this hypothesis, we present a neural network model comprising a set of interconnected structures harboring stimulus-related activity (visual representation, working memory, and planning), and a group of executive units with task-related activity patterns that manage the information flowing between them. The resulting dynamics allows the network to perform the dual task of either retaining an image during a delay (delayed-matching to sample task), or recalling from this image another one that has been associated with it during training (delayed-pair association task). The model reproduces behavioral and electrophysiological data gathered on the inferior temporal and prefrontal cortices of primates performing these same tasks. It also makes predictions on how neural activity coding for the recall of the image associated with the sample emerges and becomes prospective during the training phase. The network dynamics proves to be very stable against perturbations, and it exhibits signs of scale-invariant organization and cooperativity. The present network represents a possible neural implementation for active, top-down, prospective memory retrieval in primates. The model suggests that brain activity leading to performance of cognitive tasks might be organized in modular fashion, simple neural functions becoming integrated into more complex behavior by executive structures harbored in prefrontal cortex and/or basal ganglia.

  12. Contrast enhanced liver MRI in patients with primary sclerosing cholangitis: inverse appearance of focal confluent fibrosis on delayed phase MR images with hepatocyte specific versus extracellular gadolinium based contrast agents.

    Science.gov (United States)

    Husarik, Daniela B; Gupta, Rajan T; Ringe, Kristina I; Boll, Daniel T; Merkle, Elmar M

    2011-12-01

    To assess the enhancement pattern of focal confluent fibrosis (FCF) on contrast-enhanced hepatic magnetic resonance imaging (MRI) using hepatocyte-specific (Gd-EOB-DTPA) and extracellular (ECA) gadolinium-based contrast agents in patients with primary sclerosing cholangitis (PSC). After institutional review board approval, 10 patients with PSC (6 male, 4 female; 33-61 years) with 13 FCF were included in this retrospective study. All patients had a Gd-EOB-DTPA-enhanced liver MRI exam, and a comparison ECA-enhanced MRI. On each T1-weighted dynamic dataset, the signal intensity (SI) of FCF and the surrounding liver as well as the paraspinal muscle (M) were measured. In the Gd-EOB-DTPA group, hepatocyte phase images were also included. SI FCF/SI M, SI liver/SI M, and [(SI liver - SI FCF)/SI liver] were compared between the different contrast agents for each dynamic phase using the paired Student's t-test. There was no significant difference in SI FCF/SI M in all imaging phases. SI liver/SI M was significantly higher for the Gd-EOB-DTPA group in the delayed phase (P DTPA group, mean [(SI liver - SI FCF)/SI liver] were as follows (values for ECA group in parentheses): unenhanced phase: 0.26 (0.26); arterial phase: 0.01 (-0.31); portal venous phase (PVP): -0.05 (-0.26); delayed phase (DP): 0.14 (-0.54); and hepatocyte phase: 0.26. Differences were significant for the DP (P DTPA-enhanced images. Copyright © 2011 AUR. Published by Elsevier Inc. All rights reserved.

  13. Differentiation of intrahepatic mass-forming cholangiocarcinoma from hepatocellular carcinoma on gadoxetic acid-enhanced liver MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Rihyeon; Shin, Cheong-Il; Yoon, Jeong Hee; Joo, Ijin; Kim, Seong Ho; Hwang, Inpyeong [Seoul National University Hospital, Department of Radiology, Seoul (Korea, Republic of); Lee, Jeong Min; Han, Joon Koo [Seoul National University Hospital, Department of Radiology, Seoul (Korea, Republic of); Seoul National University Hospital, Institute of Radiation Medicine, Seoul (Korea, Republic of); Lee, Eun Sun; Choi, Byung Ihn [Chung-Ang University Hospital, Department of Radiology, Seoul (Korea, Republic of)

    2016-06-15

    To determine the different imaging features of intrahepatic mass-forming cholangiocarcinoma (IMCC) from hepatocellular carcinoma (HCC) on gadoxetic acid-enhanced magnetic resonance imaging (MRI). This retrospective study was institutional review board approved and the requirement for informed consent was waived. Patients who underwent gadoxetic acid-enhanced MRI with histologically confirmed IMCCs (n = 46) or HCCs (n = 58) were included. Imaging features of IMCCs and HCCs on gadoxetic acid-enhanced MRI including T2- and T1-weighted, diffusion weighted images, dynamic study and hepatobiliary phase (HBP) images were analyzed. Univariate and multivariate logistic regression analyses were performed to identify relevant differentiating features between IMCCs and HCCs. Multivariate analysis revealed heterogeneous T2 signal intensity and a hypointense rim on the HBP as suggestive findings of IMCCs and the wash-in and ''portal wash-out'' enhancement pattern as well as focal T1 high signal intensity foci as indicative of HCCs (all, p < 0.05). When we combined any three of the above four imaging features, we were able to diagnose IMCCs with 94 % (43/46) sensitivity and 86 % (50/58) specificity. Combined interpretation of enhancement characteristics including HBP images, morphologic features, and strict application of the ''portal wash-out'' pattern helped more accurate discrimination of IMCCs from HCCs. (orig.)

  14. The present status in the clinical development of MR contrast media

    International Nuclear Information System (INIS)

    Laniado, M.; Kopp, A.F.

    1997-01-01

    The paramagnetic extracellular Gd contrast media (Gd-CM) Magnevist, Dotarem, Omniscan, and ProHance are on the market, whereas Gadovist, Optimark, and MultiHance (also used as a hepatobiliary CM) are undergoing clinical trials (phase III). Among other indications, Gd-CM are applied in tumours, inflammation, vascular pathologies, and MR-angiography. The paramagnetic hepatobiliary CM Teslascan, Eovist and MultiHance are in clinical trials (phase II and III). They improve tumour detection and characterisation. The Mn-CM Teslascan is also suited for pancreatic imaging, the Gd-CM MultiHance for imaging of myocardial infarction and the brain, and the Gd-CM Eovist has been used in liver CT. The superparamagnetic reticuloendothelial CM Endorem is on the market whereas Resovist is undergoing phase-III trials. Both agents have the same indications as the hepatobiliary CM. Sinerem is another superparamagnetic CM. However, it acts as a blood pool agent and accumulates in lymph nodes (MR lymphography). Gastrointestinal CM are divided into paramagnetic, superparamagnetic and diamagnetic agents acting either as positive or negative CM. Some are on the market, but their clinical value is limited. (orig.) [de

  15. Synchronization of delayed systems in the presence of delay time modulation

    International Nuclear Information System (INIS)

    Kye, Won-Ho; Choi, Muhan; Kim, Myung-Woon; Lee, Soo-Young; Rim, Sunghwan; Kim, Chil-Min; Park, Young-Jai

    2004-01-01

    We investigate synchronization in the presence of delay time modulation for application to communication. We have observed that the robust synchronization is established by a common delay signal and its threshold is presented using Lyapunov exponents analysis. The influence of the delay time modulation in chaotic oscillators is also discussed

  16. Phenolic aminocarboxylic acids as gallium-binding radiopharmaceuticals

    International Nuclear Information System (INIS)

    Hunt, F.C.

    1984-01-01

    The phenolic aminocarboxylic acids ethylenediamine di [o-hydroxyphenylacetic acid] (EDDHA) and N,N'-bis [2-hydroxybenzyl] ethylenediamine N,N'-diacetic acid (HBED) form gallium complexes having high stability constants which enable them to resist exchange of gallium with plasma transferrin. 67 Ga complexes were synthesized with these ligands, placing substituent groups in the phenolic ring to direct excretion via the renal or hepatobiliary route. The amount of 67 Ga-Br-EDDHA excreted via the hepatobiliary route was comparable with that of some of the sup(99m)Tc agents. Excretion of 67 Ga-Br-HBED was similar but with delayed transit from the liver. 67 Ga COOH-EDDHA was excreted exclusively via the renal route. These findings provide a basis for developing new 67 Ga or 68 Ga radiopharmaceuticals, the latter for use in positron emission tomography, using these phenolic aminocarboxylates. (orig.) [de

  17. Phenolic aminocarboxylic acids as gallium-binding radiopharmaceuticals.

    Science.gov (United States)

    Hunt, F C

    1984-06-01

    The phenolic aminocarboxylic acids ethylenediamine di [o-hydroxyphenylacetic acid] (EDDHA) and N,N'-bis [2-hydroxybenzyl] ethylenediamine N,N'-diacetic acid (HBED) form gallium complexes having high stability constants which enable them to resist exchange of gallium with plasma transferrin. 67Ga complexes were synthesized with these ligands, placing substituent groups in the phenolic ring to direct excretion via the renal or hepatobiliary route. The amount of 67Ga-Br-EDDHA excreted via the hepatobiliary route was comparable with that of some of the 99mTc agents. Excretion of 67Ga-Br-HBED was similar but with delayed transit from the liver. 67Ga COOH-EDDHA was excreted exclusively via the renal route. These findings provide a basis for developing new 67Ga or 68Ga radiopharmaceuticals, the latter for use in positron emission tomography, using these phenolic aminocarboxylates.

  18. Chaos synchronization in time-delayed systems with parameter mismatches and variable delay times

    International Nuclear Information System (INIS)

    Shahverdiev, E.M.; Nuriev, R.A.; Hashimov, R.H.; Shore, K.A.

    2004-06-01

    We investigate synchronization between two undirectionally linearly coupled chaotic nonidentical time-delayed systems and show that parameter mismatches are of crucial importance to achieve synchronization. We establish that independent of the relation between the delay time in the coupled systems and the coupling delay time, only retarded synchronization with the coupling delay time is obtained. We show that with parameter mismatch or without it neither complete nor anticipating synchronization occurs. We derive existence and stability conditions for the retarded synchronization manifold. We demonstrate our approach using examples of the Ikeda and Mackey Glass models. Also for the first time we investigate chaos synchronization in time-delayed systems with variable delay time and find both existence and sufficient stability conditions for the retarded synchronization manifold with the coupling-delay lag time. (author)

  19. Increase in Operator's Sympathetic Nerve Activity during Complicated Hepatobiliary Surgery: Evidence for Surgeons' Mental Stress.

    Science.gov (United States)

    Yamanouchi, Kosho; Hayashida, Naomi; Kuba, Sayaka; Sakimura, Chika; Kuroki, Tamotsu; Togo, Michita; Katayama, Noritada; Takamura, Noboru; Eguchi, Susumu

    2015-11-01

    Surgeons often experience stress during operations. The heart rate variability (HRV) is the variability in the beat-to-beat interval, which has been used as parameters of stress. The purpose of this study was to evaluate mental stress of surgeons before, during and after operations, especially during pancreaticoduodenectomy (PD) and living donor liver transplantation (LDLT). Additionally, the parameters were compared in various procedures during the operations. By frequency domain method using electrocardiograph, we measured the high frequency (HF) component, representing the parasympathetic activity, and the low frequency (LF)/HF ratio, representing the sympathetic activity. In all 5 cases of PD, the surgeon showed significantly lower HF component and higher LF/HF during operation, indicating predominance of sympathetic nervous system and increased stress, than those before the operation (p operation. Out of the 4 LDLT cases, the value of HF was decreased in two and the LF/HF increased in three cases (p operation compared to those before the operation. In all cases, the value of HF was decreased and/or the LF/HF increased significantly during the reconstruction of the vessels or bile ducts than during the removal of the liver. Thus, sympathetic nerve activity increased during hepatobiliary surgery compared with the level before the operation, and various procedures during the operations induced diverse changes in the autonomic nervous activities. The HRV analysis could assess the chronological changes of mental stress by measuring the autonomic nervous balances.

  20. Hepatobiliary scintigraphy in the assessment of biliary obstruction after hepatic resection with biliary-enteric anastomosis

    Energy Technology Data Exchange (ETDEWEB)

    Kim, J.S.; Moon, D.H.; Shin, J.W.; Ryu, J.S.; Lee, H.K. [Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea); Lee, S.G.; Lee, Y.J.; Park, K.M. [Department of General Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea)

    2000-02-01

    We investigated the usefulness of hepatobiliary scintigraphy (HBS) for diagnosing biliary obstruction after curative hepatic resection with biliary-enteric anastomosis. The study population consisted of 54 patients who underwent surgery for benign (n=18) or malignant (n=36) biliary disease. We analysed 68 technetium-99m DISIDA scintigrams which were performed at least 1 month after the surgery (median: 9 months). Final diagnosis was made by operative exploration, other invasive radiological studies or clinical and radiological follow-up for at least 6 months after the surgery. Diagnostic accuracy was analysed according to the pretest likelihood of biliary obstruction. There were two total and 15 segmental biliary obstructions. In patients with symptoms of biliary obstruction and abnormal liver function, HBS always allowed correct diagnosis (two instances of total obstruction, seven of segmental obstruction and seven of non-obstruction). Among the patients with non-specific symptoms or isolated elevation of serum alkaline phosphatase, HBS diagnosed segmental biliary obstruction in seven of the eight instances, and non-obstruction in 22 of 23 instances. There were no cases of biliary obstruction and no false-positive results of HBS in 21 instances with no clinical signs or symptoms of biliary obstruction. The diagnostic sensitivity and specificity of HBS for biliary obstruction were 94% (16/17) and 97% (50/51), respectively. In conclusion, HBS is a highly accurate modality for the diagnosis of segmental biliary obstruction during long-term follow-up after hepatic resection with biliary-enteric anastomosis. (orig.)

  1. Prior inpatient admission increases the risk of post-operative infection in hepatobiliary and pancreatic surgery.

    Science.gov (United States)

    Dong, Zachary M; Chidi, Alexis P; Goswami, Julie; Han, Katrina; Simmons, Richard L; Rosengart, Matthew R; Tsung, Allan

    2015-12-01

    Hepatobiliary and pancreatic (HPB) operations have a high incidence of post-operative nosocomial infections. The aim of the present study was to determine whether hospitalization up to 1 year before HPB surgery is associated with an increased risk of post-operative infection, surgical-site infection (SSI) and infection resistant to surgical chemoprophylaxis. A retrospective cohort study of patients undergoing HPB surgeries between January 2008 and June 2013 was conducted. A multivariable logistic regression model was used for controlling for potential confounders to determine the association between pre-operative admission and post-operative infection. Of the 1384 patients who met eligibility criteria, 127 (9.18%) experienced a post-operative infection. Pre-operative hospitalization was independently associated with an increased risk of a post-operative infection [adjusted odds ratio (aOR): 1.61, 95% confidence interval [CI]: 1.06-2.46] and SSI (aOR: 1.79, 95% CI: 1.07-2.97). Pre-operative hospitalization was also associated with an increased risk of post-operative infections resistant to standard pre-operative antibiotics (OR: 2.64, 95% CI: 1.06-6.59) and an increased risk of resistant SSIs (OR: 3.99, 95% CI: 1.25-12.73). Pre-operative hospitalization is associated with an increased incidence of post-operative infections, often with organisms that are resistant to surgical chemoprophylaxis. Patients hospitalized up to 1 year before HPB surgery may benefit from extended spectrum chemoprophylaxis. © 2015 International Hepato-Pancreato-Biliary Association.

  2. Hepatobiliary scintigraphy in the assessment of biliary obstruction after hepatic resection with biliary-enteric anastomosis

    International Nuclear Information System (INIS)

    Kim, J.S.; Moon, D.H.; Shin, J.W.; Ryu, J.S.; Lee, H.K.; Lee, S.G.; Lee, Y.J.; Park, K.M.

    2000-01-01

    We investigated the usefulness of hepatobiliary scintigraphy (HBS) for diagnosing biliary obstruction after curative hepatic resection with biliary-enteric anastomosis. The study population consisted of 54 patients who underwent surgery for benign (n=18) or malignant (n=36) biliary disease. We analysed 68 technetium-99m DISIDA scintigrams which were performed at least 1 month after the surgery (median: 9 months). Final diagnosis was made by operative exploration, other invasive radiological studies or clinical and radiological follow-up for at least 6 months after the surgery. Diagnostic accuracy was analysed according to the pretest likelihood of biliary obstruction. There were two total and 15 segmental biliary obstructions. In patients with symptoms of biliary obstruction and abnormal liver function, HBS always allowed correct diagnosis (two instances of total obstruction, seven of segmental obstruction and seven of non-obstruction). Among the patients with non-specific symptoms or isolated elevation of serum alkaline phosphatase, HBS diagnosed segmental biliary obstruction in seven of the eight instances, and non-obstruction in 22 of 23 instances. There were no cases of biliary obstruction and no false-positive results of HBS in 21 instances with no clinical signs or symptoms of biliary obstruction. The diagnostic sensitivity and specificity of HBS for biliary obstruction were 94% (16/17) and 97% (50/51), respectively. In conclusion, HBS is a highly accurate modality for the diagnosis of segmental biliary obstruction during long-term follow-up after hepatic resection with biliary-enteric anastomosis. (orig.)

  3. A novel combined interventional radiologic and hepatobiliary surgical approach to a complex traumatic hilar biliary stricture

    Directory of Open Access Journals (Sweden)

    Rachel E. NeMoyer

    Full Text Available Introduction: Benign strictures of the biliary system are challenging and uncommon conditions requiring a multidisciplinary team for appropriate management. Presentation of case: The patient is a 32-year-old male that developed a hilar stricture as sequelae of a gunshot wound. Due to the complex nature of the stricture and scarring at the porta hepatis a combined interventional radiologic and surgical approach was carried out to approach the hilum of the right and left hepatic ducts. The location of this stricture was found by ultrasound guidance intraoperatively using a balloon tipped catheter placed under fluoroscopy in the interventional radiology suite prior to surgery. This allowed the surgeons to select the line of parenchymal transection for best visualization of the stricture. A left hepatectomy was performed, the internal stent located and the right hepatic duct opened tangentially to allow a side-to-side Roux-en-Y hepaticojejunostomy (a Puestow-like anastomosis. Discussion: Injury to the intrahepatic biliary ductal confluence is rarely fatal, however, the associated injuries lead to severe morbidity as seen in this example. Management of these injuries poses a considerable challenge to the surgeon and treating physicians. Conclusion: Here we describe an innovative multi-disciplinary approach to the repair of this rare injury. Keywords: Combined approach, Interventional radiology, Hepatobiliary surgery, Complex traumatic hilar biliary stricture, Case report

  4. Different CT perfusion algorithms in the detection of delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage.

    Science.gov (United States)

    Cremers, Charlotte H P; Dankbaar, Jan Willem; Vergouwen, Mervyn D I; Vos, Pieter C; Bennink, Edwin; Rinkel, Gabriel J E; Velthuis, Birgitta K; van der Schaaf, Irene C

    2015-05-01

    Tracer delay-sensitive perfusion algorithms in CT perfusion (CTP) result in an overestimation of the extent of ischemia in thromboembolic stroke. In diagnosing delayed cerebral ischemia (DCI) after aneurysmal subarachnoid hemorrhage (aSAH), delayed arrival of contrast due to vasospasm may also overestimate the extent of ischemia. We investigated the diagnostic accuracy of tracer delay-sensitive and tracer delay-insensitive algorithms for detecting DCI. From a prospectively collected series of aSAH patients admitted between 2007-2011, we included patients with any clinical deterioration other than rebleeding within 21 days after SAH who underwent NCCT/CTP/CTA imaging. Causes of clinical deterioration were categorized into DCI and no DCI. CTP maps were calculated with tracer delay-sensitive and tracer delay-insensitive algorithms and were visually assessed for the presence of perfusion deficits by two independent observers with different levels of experience. The diagnostic value of both algorithms was calculated for both observers. Seventy-one patients were included. For the experienced observer, the positive predictive values (PPVs) were 0.67 for the delay-sensitive and 0.66 for the delay-insensitive algorithm, and the negative predictive values (NPVs) were 0.73 and 0.74. For the less experienced observer, PPVs were 0.60 for both algorithms, and NPVs were 0.66 for the delay-sensitive and 0.63 for the delay-insensitive algorithm. Test characteristics are comparable for tracer delay-sensitive and tracer delay-insensitive algorithms for the visual assessment of CTP in diagnosing DCI. This indicates that both algorithms can be used for this purpose.

  5. Coding and transmission of subband coded images on the Internet

    Science.gov (United States)

    Wah, Benjamin W.; Su, Xiao

    2001-09-01

    Subband-coded images can be transmitted in the Internet using either the TCP or the UDP protocol. Delivery by TCP gives superior decoding quality but with very long delays when the network is unreliable, whereas delivery by UDP has negligible delays but with degraded quality when packets are lost. Although images are delivered currently over the Internet by TCP, we study in this paper the use of UDP to deliver multi-description reconstruction-based subband-coded images. First, in order to facilitate recovery from UDP packet losses, we propose a joint sender-receiver approach for designing optimized reconstruction-based subband transform (ORB-ST) in multi-description coding (MDC). Second, we carefully evaluate the delay-quality trade-offs between the TCP delivery of SDC images and the UDP and combined TCP/UDP delivery of MDC images. Experimental results show that our proposed ORB-ST performs well in real Internet tests, and UDP and combined TCP/UDP delivery of MDC images provide a range of attractive alternatives to TCP delivery.

  6. Triple-phase bone image abnormalities in Lyme arthritis

    International Nuclear Information System (INIS)

    Brown, S.J.; Dadparvar, S.; Slizofski, W.J.; Glab, L.B.; Burger, M.

    1989-01-01

    Arthritis is a frequent manifestation of Lyme disease. Limited triple-phase Tc-99m MDP bone imaging of the wrists and hands with delayed whole-body images was performed in a patient with Lyme arthritis. This demonstrated abnormal joint uptake in the wrists and hands in all three phases, with increased activity seen in other affected joints on delayed whole-body images. These findings are nonspecific and have been previously described in a variety of rheumatologic conditions, but not in Lyme disease. Lyme disease should be considered in the differential diagnosis of articular and periarticular bone scan abnormalities

  7. Classic conditioning in aged rabbits: delay, trace, and long-delay conditioning.

    Science.gov (United States)

    Solomon, P R; Groccia-Ellison, M E

    1996-06-01

    Young (0.5 years) and aged (2+, 3+, and 4+ years) rabbits underwent acquisition of the classically conditioned nictitating membrane response in a delay (500-ms conditioned stimulus [CS], 400-ms interstimulus interval [ISI]), long-delay (1,000-ms CS, 900-ms ISI), or trace (500-ms CS, 400-ms stimulus-free period) paradigm. Collapsing across age groups, there is a general tendency for animals to acquire trace conditioning more slowly than delay conditioning. Collapsing across conditioning paradigms, there is a general tendency for aged animals to acquire more slowly than younger animals. Of greater significance, however, are the age differences in the different conditioning paradigms. In the delay and long-delay paradigms, significant conditioning deficits first appeared in the 4(+)-year-old group. In the trace conditioning paradigm, significant conditioning deficits became apparent in the 2(+)-year-old animals.

  8. Severe atrophy of right hepatic lobe simulating right hepatic lobectomy

    International Nuclear Information System (INIS)

    Yeh, C.W.; Strashun, A.; Goldsmith, S.J.

    1981-01-01

    Absence of the right hepatic lobe following blunt abdominal trauma without surgical resection is reported. The usual site of the right hepatic lobe is demonstrated to be occupied by bowel by hepatobiliary imaging

  9. Delayed Transient Post-Traumatic Quadriplegia

    Directory of Open Access Journals (Sweden)

    Khaloud Al-Shaaibi

    2015-03-01

    Full Text Available Transient neurological deficit following cervical trauma have been reported following sports injuries, and has been referred to as cervical cord neurapraxia. The so-called "whiplash injuries" following minor motor vehicle collisions usually do not produce any neurological deficit. Here we report the case of a whiplash type of injury presenting with a delayed onset neurological deficit, which was followed by rapid and complete recovery. The patient, an otherwise healthy 34-year-old male, attended the emergency department of Sultan Qaboos University Hospital following a rear-end motor vehicle collision. We present images showing degenerative disc disease causing spinal canal narrowing and mild cord compression in the patient, but no spinal instability. Differential diagnoses are also discussed.

  10. Electro-Optical Imaging Fourier-Transform Spectrometer

    Science.gov (United States)

    Chao, Tien-Hsin; Zhou, Hanying

    2006-01-01

    An electro-optical (E-O) imaging Fourier-transform spectrometer (IFTS), now under development, is a prototype of improved imaging spectrometers to be used for hyperspectral imaging, especially in the infrared spectral region. Unlike both imaging and non-imaging traditional Fourier-transform spectrometers, the E-O IFTS does not contain any moving parts. Elimination of the moving parts and the associated actuator mechanisms and supporting structures would increase reliability while enabling reductions in size and mass, relative to traditional Fourier-transform spectrometers that offer equivalent capabilities. Elimination of moving parts would also eliminate the vibrations caused by the motions of those parts. Figure 1 schematically depicts a traditional Fourier-transform spectrometer, wherein a critical time delay is varied by translating one the mirrors of a Michelson interferometer. The time-dependent optical output is a periodic representation of the input spectrum. Data characterizing the input spectrum are generated through fast-Fourier-transform (FFT) post-processing of the output in conjunction with the varying time delay.

  11. Clinical evaluation of the scoring of optical findings with technetium-99m-N-pyridoxyl-5-methyl-tryptophan (PMT) hepatobiliary scintigraphy for fulminant hepatitis

    International Nuclear Information System (INIS)

    Uchiyama, Katsuhiro; Kuniyasu, Yoshio; Niio, Yasuo

    1998-01-01

    Fulminant hepatitis is one of the most life-threatening diseases for which adequate medical therapy does not exist. Then, we evaluated the usefulness of technetium-99m-N-pyridoxyl-5-methyl-tryptophan (PMT) hepatobiliary scintigraphy to estimate the diagnosis and prognosis of fulminant hepatitis. In total 60 patients, 23 with fulminant hepatitis (FH), 25 with severe acute hepatitis (SAH) and 12 with acute hepatitis (AH), computer data acquisition by gamma-camera system started just after the injection of 185 MBq 99m Tc-PMT. The optical finding score which included cardiac blood pool remaining time (0-3), distribution of radioactivity in the liver (0-3), extrahepatic bile duct (EHBD) and intestine appearance time (0-3) were studied. The cardiac blood pool remaining time score was 2.8±0.5 in FH, 2.2±0.8 in SAH, 0.9±1.1 in AH. The intrahepatic distribution score was 2.1±0.8 in FH, 0.3±0.6 in SAH, 0.1±0.3 in AH. The EHBD and intestine appearance time score was 1.9±1.1 in FH, 1.5±1.2 in SAH, 0.3±0.6 in AH. The total score was 6.7±1.4 in FH, 4.0±1.6 in SAH, 1.3±1.3 in AH. There were significantly statistical differences among three groups. While, the cardiac blood pool remaining time score was 3.0±0 in 14 hospital death patients (HD), 1.9±1.0 in 46 alive patients (AL). The intrahepatic distribution score was 2.2±0.8 in HD, 0.5±0.9 in AL. The EHBD and intestine appearance time score was 2.1±1.2 in HD, 1.2±1.1 in AL. The total score was 7.3±1.3 in HD, 3.6±2.2 in AL. There were significantly statistical differences in these groups. The optimal finding score of 99m Tc-PMT hepatobiliary scintigraphy was useful in establishing the diagnosis and prognosis of FH. (author)

  12. Global synchronization criteria with channel time-delay for chaotic time-delay system

    International Nuclear Information System (INIS)

    Sun Jitao

    2004-01-01

    Based on the Lyapunov stabilization theory, matrix measure, and linear matrix inequality (LMIs), this paper studies the chaos synchronization of time-delay system using the unidirectional linear error feedback coupling with time-delay. Some generic conditions of chaos synchronization with time-delay in the transmission channel is established. The chaotic Chua's circuit is used for illustration, where the coupling parameters are determined according to the criteria under which the global chaos synchronization of the time-delay coupled systems is achieved

  13. Delayed minocycline but not delayed mild hypothermia protects against embolic stroke

    Directory of Open Access Journals (Sweden)

    Noor Raza

    2002-04-01

    Full Text Available Abstract Background Inflammatory reactions occurring in the brain after ischemia may contribute to secondary damage. In the present study, effects of minocycline, an anti-inflammatory agent, alone or in combination with mild hypothermia on focal embolic cerebral ischemia have been examined. Methods Focal ischemic injury was induced by embolizing a preformed clot into the middle cerebral artery (MCA. Infarction volume was measured at 48 h after the injury. Mortality was also recorded. Results Delayed administration of minocycline alone or delayed minocycline plus delayed mild hypothermia reduced the infarction volume significantly. However, delayed mild hypothermia alone was not protective and delayed mild hypothermia in combination with minocycline did not show any additive effect. Conclusions These results suggest that minocycline is beneficial in focal ischemic brain injury, and the lack of the enhanced neuroprotection may be due to the brief exposure to hypothermia.

  14. Cost-effectiveness of CT angiography and perfusion imaging for delayed cerebral ischemia and vasospasm in aneurysmal subarachnoid hemorrhage

    NARCIS (Netherlands)

    P.C. Sanelli (Pina C.); A. Pandya; A.Z. Segal; A. Gupta; S. Hurtado-Rua; J. Ivanidze; K. Kesavabhotla; D. Mir; A.I. Mushlin; M.G.M. Hunink (Myriam)

    2014-01-01

    textabstractBACKGROUND AND PURPOSE: Delayed cerebral ischemia and vasospasm are significant complications following SAH leading to cerebral infarction, functional disability, and death. In recent years, CTA and CTP have been used to increase the detection of delayed cerebral ischemia and vasospasm.

  15. Delayed puberty in girls

    Science.gov (United States)

    ... sexual development - girls; Pubertal delay - girls; Constitutional delayed puberty ... In most cases of delayed puberty, growth changes just begin later than usual, sometimes called a late bloomer. Once puberty begins, it progresses normally. This pattern runs ...

  16. Delayed Puberty (For Teens)

    Science.gov (United States)

    ... Safe Videos for Educators Search English Español Delayed Puberty KidsHealth / For Teens / Delayed Puberty What's in this ... wonder if there's anything wrong. What Is Delayed Puberty? Puberty is the time when your body grows ...

  17. Vicarious visualization of gall bladder on 99mTc ethylene dicysteine renal dynamic study

    International Nuclear Information System (INIS)

    Arora, Geetanjali; Damle, Nishikant A.; Tripathi, Madhavi; Bal, Chandrasekhar; Praveen Kumar

    2012-01-01

    Though the hepatobiliary excretion of Technetium-99m ethylene dicysteine ( 99m Tc-EC) is very low and usually does not effect image interpretation on routine posterior imaging, the possibility of visualization of the gall bladder should be kept in mind while reporting the 99m Tc-EC scan especially, when anterior imaging is performed as in renal transplant patients. (author)

  18. Fate of hypointense lesions on Gd-EOB-DTPA-enhanced magnetic resonance imaging

    International Nuclear Information System (INIS)

    Akai, Hiroyuki; Matsuda, Izuru; Kiryu, Shigeru; Tajima, Taku; Takao, Hidemasa; Watanabe, Yasushi; Imamura, Hiroshi; Kokudo, Norihiro

    2012-01-01

    Purpose: To investigate the natural outcome and clinical implication of hypointense lesions in the hepatobiliary phase of Gd-EOB-DTPA-enhanced MRI. Materials and methods: Forty patients underwent Gd-EOB-DTPA-enhanced MRI for preoperative evaluation of HCC. Hypointense lesions in the hepatobiliary phase that were hypovascular 5 mm of more were extracted for follow-up. We performed a longitudinal study retrospectively for these lesions regardless of whether classical HCC developed or emerged in a different area from that of the lesions being followed. Results: Thirty one patients displayed 130 hypointense lesions on MRI and only nine showed no hypointense lesions. In total, 17 (13.1%) of 130 hypointense lesions on MRI developed into classical HCC. The cumulative rates for these lesions to develop into classical HCC were 3.2% at 1 year, 11.1% at 2 years and 15.9% at 3 years. The total occurrence rates of classical HCC (25.8% at 1 year, 52.6% at 2 years and 76.4% at 3 years) were higher compared to those regarding only occurrence of classical HCC from hypointense lesions on MRI (10.0% at 1 year, 35.6% at 2 years and 44.6% at 3 years), although no significant difference was observed (p = 0.073). Conclusions: Hypointense lesions that are detected in the hepatobiliary phase of Gd-EOB-DTPA-enhanced MRI have some malignant potential, although treating these lesions aggressively in patients who already have HCC may be too severe.

  19. N-substituted iminodiacetic acids

    International Nuclear Information System (INIS)

    Nunn, A.; Loberg, M.

    1982-01-01

    The chemical preparation of several new N-substituted iminodiacetic acid derivatives are described. These compounds when complexed with sup(99m)Tc provide useful radiopharmaceuticals for the external imaging of the hepatobiliary system. (U.K.)

  20. Pituitary gland imaging in Cushing's disease

    International Nuclear Information System (INIS)

    Bonneville, J.F.; Cattin, F.; Bonneville, F.; Schillo, F.; Jacquet, G.

    2003-01-01

    Specific MR techniques are r-required for optimal detection of adrenocorticotropic hormone secreting adenomas responsible for Cushing's disease. Adequate MR sequences, high resolution coronal T1 and T2 - weighted images, dynamic MR imaging, post-gadolinium delayed images, dose of gadolinium adjusted for each sequence can routinely demonstrate pituitary adenomas less than 3 mm in Cushing's disease. (authors)