WorldWideScience

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

    Energy Technology Data Exchange (ETDEWEB)

    Hasegawa, Y.; Nakano, S.; Ibuka, K.; Hashizume, T.; Noguchi, A.; Sasaki, Y.; Imaoka, S.; Fujita, M.; Kawamoto, S.; Kasugai, H.

    1986-01-15

    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. 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

  4. 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

  5. Hepatobiliary

    Science.gov (United States)

    ... exam. You should not have tests that use barium for 48 hours before hepatobiliary imaging. top of ... passing x-rays through the patient's body. In contrast, nuclear medicine procedures use a radioactive material, called ...

  6. Functional hepatobiliary MR imaging in children

    Energy Technology Data Exchange (ETDEWEB)

    Tamrazi, Anobel; Vasanawala, Shreyas S. [Stanford University, Department of Radiology, Stanford, CA (United States)

    2011-10-15

    Clinical application efforts for the hepatocyte-specific MRI contrast agent gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) have mainly been directed toward detection and characterization of various hepatic masses in the adult population. Here we report our initial experience with Gd-EOB-DTPA for evaluating congenital and acquired hepatobiliary pathologies in the pediatric population. Twenty-one consecutive children receiving Gd-EOB-DTPA for functional hepatobiliary evaluation at our institution were retrospectively identified with IRB approval. The use of Gd-EOB-DTPA was classified in each case as definite, potential, or no clinical utility, focusing on the clinical value gained beyond traditional noncontrast fluid-sensitive MR cholangiopancreatography (FS-MRCP) and other imaging modalities. Definite added value of Gd-EOB-DTPA was found in 12 patients, with potential value in 4 patients, and no value in 5 patients. Benefit was seen in cases of iatrogenic and non-iatrogenic biliary strictures, perihepatic fluid collections for biliary leak, hepatobiliary dysfunction in the absence of hyperbilirubinemia, and in the functional exclusion of cystic duct occlusion that can be seen in acute cholecystitis. This is the first reported series of children with Gd-EOB-DTPA and this early work suggests potential pediatric applications. (orig.)

  7. 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.

  8. Etiology of the obstructive pattern in hepatobiliary imaging

    Energy Technology Data Exchange (ETDEWEB)

    Hughes, K.S.; Marrangoni, A.G.; Turbiner, E.

    1984-04-01

    The records of all patients undergoing hepatobiliary imaging with technetion radioisotopes at our hospital from January 1980 to March 1983 were reviewed and 29 scans met the criteria for a pattern consistent with complete biliary tract obstruction. Biliary tract obstruction (due to choledocholithiasis, primary or secondary carcinoma involving the common bile duct, and pancreatitis) was documented in 24 of these patients. However, the remaining five patients had a patent common bile duct, and the etiologic factor was intrahepatic cholestasis secondary to sepsis in four and peritonitis in one. A classification of altered biliary dynamics in hepatobiliary imaging, which is based on the classification of jaundice, is proposed.

  9. The MR imaging diagnosis of liver diseases using gadoxetic acid: Emphasis on hepatobiliary phase

    Directory of Open Access Journals (Sweden)

    Woo Kyoung Jeong

    2013-12-01

    Full Text Available Hepatocyte specific contrast agents including gadoxetic acid and gadobenate dimeglumine are very useful to diagnose various benign and malignant focal hepatic lesions and even helpful to estimate hepatic functional reservoir. The far delayed phase image referred to as the hepatobiliary phase makes the sensitivity of detection for malignant focal hepatic lesions increased, but specificity of malignant diseases, including hepatocellular carcinoma, metastasis and cholangiocarcinoma, characterization remained to be undetermined.

  10. Multimodality imaging of hepato-biliary disorders in pregnancy: a pictorial essay.

    Science.gov (United States)

    Ong, Eugene M W; Drukteinis, Jennifer S; Peters, Hope E; Mortelé, Koenraad J

    2009-09-01

    Hepato-biliary disorders are rare complications of pregnancy, but they may be severe, with high fetal and maternal morbidity and mortality. Imaging is, therefore, essential in the rapid diagnosis of some of these conditions so that appropriate, life-saving treatment can be administered. This pictorial essay illustrates the multimodality imaging features of pregnancy-induced hepato-biliary disorders, such as acute fatty liver of pregnancy, preeclamsia and eclampsia, and HELLP syndrome, as well as those conditions which occur in pregnancy but are not unique to it, such as viral hepatitis, Budd-Chiari syndrome, focal hepatic lesions, biliary sludge, cholecystolithiasis, and choledocholithiasis.

  11. Epithelioid hemangioendothelioma of the liver: the role of hepatobiliary phase imaging for the preoperative diagnosis and qualification of patients for liver transplantation -- preliminary experience.

    Science.gov (United States)

    Cieszanowski, Andrzej; Pacho, Ryszard; Anysz-Grodzicka, Agnieszka; Gornicka, Barbara; Remiszewski, Piotr; Maj, Edyta; Grudzinski, Ireneusz P; Zieniewicz, Krzysztof; Oldakowska-Jedynak, Urszula; Rowinski, Olgierd; Krawczyk, Marek

    2013-08-19

    The aim of this study was to determine if the appearance of hepatic epithelioid hemangioendothelioma (HEHE) on state-of-the-art MRI including hepatocyte phase after administration of hepatobiliary contrast agent can facilitate preoperative diagnosis and identification of potential candidates for liver transplantation. The study group comprised 6 patients with pathologically confirmed HEHE. Analysis included signal characteristics of 55 tumor nodules (maximum of 10 lesions per patient) on T2-weighted images, dynamic contrast-enhanced, 5-minute delayed, and hepatobiliary phase images. The most common feature of HEHE, observed in 84% of lesions, was progressive contrast-enhancement, followed by subcapsular location (66%), confluent appearance (60%) and hyper- or isointensity on hepatobiliary phase images (53%). In 5 of 6 patients, capsular retraction was observed. The appearance of HEHE on hepatobiliary phase images was variable, but examined tumors often demonstrated hyper- or isointensity, most probably due to prolonged retention of contrast material. These features, along with typical morphology (subcapsular, confluent nodules, with progressive enhancement and capsular retraction), may contribute to correct diagnosis and recognition of potential candidates for liver transplantation.

  12. 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

  13. 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)

  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. 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

  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. 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

  18. 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.

  19. 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

  20. 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

  1. Delayed hepatobiliary injury in a decompression sickness patient after scuba diving: case report.

    Science.gov (United States)

    Kim, Hee Duck; Lee, Sang Hwan; Eom, Huisu; Kang, Young Joong

    2016-01-01

    We report here the first case of liver injury in a 51-year-old man following a dive to a depth of 40 meters. He presented with typical neurological symptoms affecting the lower limbs. Five days later, he experienced delayed abdominal pain, followed by rapidly progressive liver and adjacent organ injury due to air emboli in the intrahepatic portal vein. He received supportive care and hyperbaric therapy with a U.S. Navy Treatment Table 6 and recovered. Decompression sickness is a disease of protean manifestations. More information about venous gas emboli may be useful for better assessing decompression sickness. In this case, radiologic evaluation of the abdomen and the presentation of air bubbles in the portal vein in computed tomography played an essential role in diagnosing induced venous gas emboli in the liver and adjacent organs.

  2. Sensitivity of hepatobiliary imaging and real-time ultrasonography in the detection of acute cholecystitis

    Energy Technology Data Exchange (ETDEWEB)

    Fink-Bennett, D.; Freitas, J.E.; Ripley, S.D.; Bree, R.L.

    1985-08-01

    To determine the sensitivity of hepatobiliary imaging (HBI) and strict- and liberal-criteria real-time ultrasonography (RTUS), the authors retrospectively analyzed 100 cases of pathologically proved acute cholecystitis (AC). A positive HBI was one in which there was nonvisualization of the gallbladder up to four hours after the administration of technetium 99m-disofenin. In the absence of hypoalbuminemia, cirrhosis, or ascites, pathognomonic RTUS findings (strict criteria) for AC were wall edema and/or pericholecystic fluid. Findings indicative of AC (liberal criteria) included the demonstration of stones, a thick gallbladder wall, nonshadowing echoes, or the ultrasonographic Murphy's sign. Of the 100 cases of AC, 91 were calculous, and nine were acalculous. Four of 100 patients had associated choledocholithiasis. The sensitivities in detecting calculous AC were as follows: HBI, 97%; liberal-criteria RTUS, 86%; and strict-criteria RTUS, 24%. The sensitivities in detecting acalculous AC were as follows: HBI, 100%; liberal-criteria RTUS, 89%; and strict-criteria RTUS, 44%.

  3. Sensitivity of hepatobiliary imaging and real-time ultrasonography in the detection of acute cholecystitis

    International Nuclear Information System (INIS)

    Fink-Bennett, D.; Freitas, J.E.; Ripley, S.D.; Bree, R.L.

    1985-01-01

    To determine the sensitivity of hepatobiliary imaging (HBI) and strict- and liberal-criteria real-time ultrasonography (RTUS), the authors retrospectively analyzed 100 cases of pathologically proved acute cholecystitis (AC). A positive HBI was one in which there was nonvisualization of the gallbladder up to four hours after the administration of technetium 99m-disofenin. In the absence of hypoalbuminemia, cirrhosis, or ascites, pathognomonic RTUS findings (strict criteria) for AC were wall edema and/or pericholecystic fluid. Findings indicative of AC (liberal criteria) included the demonstration of stones, a thick gallbladder wall, nonshadowing echoes, or the ultrasonographic Murphy's sign. Of the 100 cases of AC, 91 were calculous, and nine were acalculous. Four of 100 patients had associated choledocholithiasis. The sensitivities in detecting calculous AC were as follows: HBI, 97%; liberal-criteria RTUS, 86%; and strict-criteria RTUS, 24%. The sensitivities in detecting acalculous AC were as follows: HBI, 100%; liberal-criteria RTUS, 89%; and strict-criteria RTUS, 44%

  4. 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.

  5. 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.

  6. The target sign in colorectal liver metastases: an atypical Gd-EOB-DTPA "uptake" on the hepatobiliary phase of MR imaging.

    Science.gov (United States)

    Granata, Vincenza; Catalano, Orlando; Fusco, Roberta; Tatangelo, Fabiana; Rega, Daniela; Nasti, Guglielmo; Avallone, Antonio; Piccirillo, Mauro; Izzo, Francesco; Petrillo, Antonella

    2015-10-01

    To describe the MRI findings in colorectal cancer liver metastases using gadoxetic acid (Gd-EOB-DTPA), with special emphasis on the target feature seen on the hepatobiliary phase. The medical records of 45 colorectal cancer patients with an overall number of 150 liver metastases were reviewed. All patients underwent Gd-EOB-DTPA-enhanced MRI before any kind of treatment. We retrospectively evaluated, for each lesion, the signal intensity on the T1-weighted, T2-weighted, and diffusion-weighted images. Additionally, the enhancement pattern during the arterial-, portal-, equilibrium-, and hepatobiliary-phase was assessed. Fourteen lesions had a pathological correlation. Lesions size was 5-40 mm (mean 15 mm). All metastases were hypointense on T1-w imaging. Ninety-nine lesions (66%) had a central area of very high signal intensity on T2-w imaging. Fifty-one metastases (34%) were hyperintense on the T2-w images. In DWI, all lesions had a restricted diffusion. The mean ADC value was 1.31 × 10(-3) mm(2)/s (range 1.10-1.45 × 10(-3) mm(2)/s). During the arterial-phase imaging, 61 lesions (41%) showed a rim enhancement, while 89 lesions (59%) appeared as hypointense. All lesions had low signal intensity in the portal and equilibrium phase. Thirty-nine percent of the lesions also showed an enhancing rim on the portal-phase images. During the hepatobiliary phase, 80 lesions (53.3%) were hypointense, while 70 lesions (46.7%) had a target appearance. A number of metastases show an atypical contrast medium uptake during the hepatobiliary phase of gadoxetic acid-enhanced MRI, consisting in a target appearance.

  7. 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.)

  8. Hyperintense HCC on hepatobiliary phase images of gadoxetic acid-enhanced MRI: Correlation with clinical and pathological features

    International Nuclear Information System (INIS)

    Kim, Ja Young; Kim, Myeong-Jin; Kim, Kyung Ah; Jeong, Hyeon Tae; Park, Young Nyun

    2012-01-01

    Purpose: To retrospectively determine whether the hyperintense hepatocellular carcinomas (HCCs) seen on the hepatobiliary phase of gadoxetic acid-enhanced MR imaging (EOB-MRI) might have different histologic characteristics from usual hypointense HCCs. Materials and methods: Two hundred three surgically proven HCCs from 192 patients who underwent preoperative EOB-MRI were analyzed. The demographic and histologic characteristics of hyperintense HCCs were compared with usual hypointense HCCs by using the t-test or Fisher's exact test. Results: By visual assessment, 18 (8.8%) tumors were classified as hyperintense HCCs. Patients with hyperintense HCC were significantly (p < 0.05) older (60.1 vs. 55.2 years) than those with hypointense HCCs. Hyperintense HCCs showed significantly lower rate of microvascular invasion (27.8% vs. 53.5%) and significantly higher rate of peliosis (61.1% vs. 30.8%). Hyperintense HCCs were more frequently expanding type, and none showed infiltrative type or scirrhous histologic pattern. Conclusions: Hyperintense HCCs seem to have clinical and histologic features that might be related with more favorable outcomes.

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

    International Nuclear Information System (INIS)

    Ringe, Kristina I.; Husarik, Daniela B.; Gupta, Rajan T.; Boll, Daniel T.; Merkle, Elmar M.

    2011-01-01

    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.

  10. 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.)

  11. Hepatobiliary sequential scintiscanning

    International Nuclear Information System (INIS)

    Eissner, D.

    1985-01-01

    The main criteria for interpreting hepatobiliary sequential scintiscanning (HBSS) data are given to be the following: (1) In young infants - without previous parenteral feeding - a normal up to a slightly increased activity uptake in the liver, accompanied by lack of activity excretion into the intestine (which requires a 24 - hour scan for detection) is a clear indication of bile duct atresia. However, the same findings can be obtained on very young newborn (up to one week of age) in case of a hepatitis with defined cholestasis. (2) In case of a comparably high activity uptake in the liver together with activity excretion into the intestine, which may be detectable in due time or after a delay (24-hour scan required), bile duct atresia can be excluded, the diagnosis being hepatitis. In general, hepatitis will cause a stronger liver cell damage, which excludes the criterion of activity excretion into the intestine. Similar findings can be obtained on infants with bile duct atresia with previous parenteral feeding. This is why the interpretation of HBSS data can only be effectively carried out in close cooperation with the pediatrician, and on the basis of profound knowledge of the overall clinical state of the infant. (orig.) [de

  12. {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.)

  13. 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

  14. 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.

  15. 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.

  16. 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.

  17. 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.)

  18. 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.

  19. 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

  20. Hepatobiliary Cystadenoma Revealed by a Jaundice: A Case Report

    Directory of Open Access Journals (Sweden)

    Taoufiq Harmouch

    2011-01-01

    Full Text Available Introduction. Hepatobiliary cystadenomas are rare benign cystic tumors and have a potential for recurrence and malignant transformation. The diagnosis may be very difficult because of absence of typical imaging feature in some cases. Case Presentation. In this paper, the authors discuss a 57-year-old woman who presented a jaundice related to hepatobiliary cystadenoma. Biological and radiological examinations have led to surgery, and the diagnosis is made after a histological examination of surgical specimens. Conclusion. This observation illustrates a hepatobiliary cystadenoma revealed by jaundice. Histology examination contributed to diagnosis. The authors discussed the mechanisms of biliary obstruction and differential diagnoses through a review of the literature.

  1. Periportal lymphatic system on post-hepatobiliary phase Gd-EOB-DTPA-enhanced MR imaging in normal subjects and patients with chronic hepatitis C.

    Science.gov (United States)

    Yamada, Yasunari; Matsumoto, Shunro; Mori, Hiromu; Takaji, Ryo; Kiyonaga, Maki; Hijiya, Naoki; Tanoue, Rika; Tomonari, Kenichiro; Tanoue, Shuichi; Hongo, Norio; Ohta, Masayuki; Seike, Masataka; Inomata, Masafumi; Murakami, Kazunari; Moriyama, Masatsugu

    2017-10-01

    We sought to evaluate visualization of periportal lymphatics and lymph nodes (lymphatic system) on Gd-EOB-DTPA-enhanced magnetic resonance (MR) images using a fat-suppressed T2-weighted sequence with 3-dimensional (3D) volume isotropic turbo spin echo acquisition (VISTA) at 3.0 T in normal subjects and patients with chronic hepatitis C. MR imaging was performed in 254 subjects between June 2013 and May 2016. After applying inclusion and exclusion criteria, the final population was 31 normal subjects and 34 patients with chronic hepatitis C. Images were acquired after the hepatobiliary phase following intravenous administration of Gd-EOB-DTPA, which causes signal loss in the bile ducts, to facilitate the visualization of the periportal lymphatic system. Two radiologists assessed the visualization of the periportal lymphatic system in 31 normal subjects. The axial dimensions of the main periportal lymphatic system in normal subjects were measured and compared with those of 34 patients with chronic hepatitis C using the Mann-Whitney U-test, and their correlation with a hepatic fibrosis marker, the Fibrosis-4 (FIB-4), was assessed using Spearman's rank correlation test. The periportal lymphatic system was detected as high signal intensity areas surrounding the portal vein up to the third branches by each reader in all normal subjects. The axial dimensions of the main periportal lymphatic system in patients with chronic hepatitis C were significantly larger than those in normal subjects (p system and the degree of hepatic fibrosis.

  2. Hepatobiliary scintigraphy in current pediatric practice

    Energy Technology Data Exchange (ETDEWEB)

    Roca, I. [Division of Nuclear Medicine `HGU` Vall d`Hebron, Barcelona (Spain); Ciofetta, G. [Division of Nuclear Medicine `HGU` Vall d`Hebron, Barcelona (Spain)]|[Rome, Univ. `La Sapienza` (Italy). Pediatric Clinic. Laboratory of Pediatric Nuclear Medicine

    1998-06-01

    Hepatobiliary scintigraphy is the only non-invasive technique providing real-time assessment of hepatocytes function and bile progression from the liver to the intestine; for this reason it is of great importance in the study of jaundice and many other disorders of the liver and the biliary tract in children. Ultrasonography is the initial method of evaluating the intra- and extrahepatic bile ducts dilatation: the differential diagnosis between biliary atresia and neonatal hepatitis cannot however be done without hepatobiliary scintigraphy. Cystic fibrosis patients also require hepatobiliary scintigraphy; liver and biliary tract disease can really occur independently of the underlying disease severity and the presence of steatorrhoea. Hepatobiliary imaging in children who have undergone liver transplantation is of major importance; it can assess vascularity, parenchymal function biliary drainage, possible presence of a bile leak and obstruction; it has very good sensitivity and specificity for the detection of biliary leak and biliary stricture. Due to those important clinical conditions being studied in pediatrics, both qualitative and quantitative information (functional indices obtained from radioactivity/ time curve analysis) need to be extracted; in addition, SPECT acquisition allows more accurate evaluation of abdominal activity during the excretory phase.

  3. Hepatobiliary scintigraphy in current pediatric practice

    International Nuclear Information System (INIS)

    Roca, I.; Ciofetta, G.; Rome, Univ. 'La Sapienza'

    1998-01-01

    Hepatobiliary scintigraphy is the only non-invasive technique providing real-time assessment of hepatocytes function and bile progression from the liver to the intestine; for this reason it is of great importance in the study of jaundice and many other disorders of the liver and the biliary tract in children. Ultrasonography is the initial method of evaluating the intra- and extrahepatic bile ducts dilatation: the differential diagnosis between biliary atresia and neonatal hepatitis cannot however be done without hepatobiliary scintigraphy. Cystic fibrosis patients also require hepatobiliary scintigraphy; liver and biliary tract disease can really occur independently of the underlying disease severity and the presence of steatorrhoea. Hepatobiliary imaging in children who have undergone liver transplantation is of major importance; it can assess vascularity, parenchymal function biliary drainage, possible presence of a bile leak and obstruction; it has very good sensitivity and specificity for the detection of biliary leak and biliary stricture. Due to those important clinical conditions being studied in pediatrics, both qualitative and quantitative information (functional indices obtained from radioactivity/ time curve analysis) need to be extracted; in addition, SPECT acquisition allows more accurate evaluation of abdominal activity during the excretory phase

  4. 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.

  5. 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.

  6. 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.

  7. 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.

  8. 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)

  9. Thin-slice Free-breathing Pseudo-golden-angle Radial Stack-of-stars with Gating and Tracking T1-weighted Acquisition: An Efficient Gadoxetic Acid-enhanced Hepatobiliary-phase Imaging Alternative for Patients with Unstable Breath Holding.

    Science.gov (United States)

    Kajita, Kimihiro; Goshima, Satoshi; Noda, Yoshifumi; Kawada, Hiroshi; Kawai, Nobuyuki; Okuaki, Tomoyuki; Honda, Masatoshi; Matsuo, Masayuki

    2018-03-09

    To compare four free-breathing scan techniques for gadoxetic acid-enhanced hepatobiliary phase imaging with conventional breath-hold scans. Gadoxetic acid-enhanced hepatobiliary phase imaging with six image acquisition sets performed in 50 patients. Image acquisition sets included fat-suppressed 3D T 1 -weighted turbo field echo with free-breathing pseudo-golden-angle radial stack-of-stars (FBRS) acquisition, FBRS with track (FBRS T ), FBRS with gate and track (FBRS G&T ), thin-slice FBRS with gate and track (thin-slice FBRS G&T ), free-breathing Cartesian acquisition (Cartesian FB ), and breath-hold Cartesian acquisition (Cartesian BH ). Signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and image quality compared to the six-image acquisition sets. Signal-to-noise ratio and CNR were significantly higher in FBRS, FBRS T , FBRS G&T , and thin-slice FBRS G&T than in Cartesian FB and Cartesian BH (P breath holding.

  10. Early and delayed indium 111 leukocyte imaging in Crohn's disease

    International Nuclear Information System (INIS)

    Navab, F.; Boyd, C.M.; Diner, W.C.; Subramani, R.; Chan, C.

    1987-01-01

    Twenty-seven patients with Crohn's disease were studied for the presence and location of activity by both early (4 h) and delayed (18-24 h) indium 111 leukocyte imaging. The results were compared with other parameters of disease activity including Crohn's disease activity index, barium studies, and endoscopy. There was a correlation between early images and Crohn's disease activity index (r = 0.78) and between delayed images and index (r = 0.82). Based upon the corresponding Crohn's disease activity index, the sensitivity of early and delayed imaging was 81.0% and 95.2%, respectively. Specificity of early and delayed imaging was 75.0% and 87.0%, respectively. Presence of activity on the early and delayed imaging agreed with activity on barium studies and colonoscopy in approximately 80% of cases. Correlation of location of disease by leukocyte imaging and x-ray was observed in 58.9% of early scans and 55.0% of delayed scans. Correlation of the location of disease by imaging and endoscopy was observed in 71.4% of early and 75.0% of delayed studies. Because of the possibility of occurrence of false-negative results in early images, delayed imaging should always be included in evaluation of disease activity in patients with Crohn's disease who are suspected of having mild activity. Delayed imaging is not required if the early imaging study clearly shows activity

  11. Relationship between signal intensity on hepatobiliary phase of gadolinium ethoxybenzyl diethylenetriaminepentaacetic acid (Gd-EOB-DTPA)-enhanced MR imaging and prognosis of borderline lesions of hepatocellular carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Kobayashi, Satoshi, E-mail: satoshik@staff.kanazawa-u.ac.jp [Department of Radiology, Kanazawa University School of Medicine, 13-1, Takara Machi, Kanazawa 920-8641 (Japan); Matsui, Osamu, E-mail: matsuio@med.kanazawa-u.ac.jp [Department of Radiology, Kanazawa University School of Medicine, 13-1, Takara Machi, Kanazawa 920-8641 (Japan); Gabata, Toshifumi, E-mail: gabata@med.kanazawa-u.ac.jp [Department of Radiology, Kanazawa University School of Medicine, 13-1, Takara Machi, Kanazawa 920-8641 (Japan); Koda, Wataru, E-mail: wkoda@staff.kanazawa-u.ac.jp [Department of Radiology, Kanazawa University School of Medicine, 13-1, Takara Machi, Kanazawa 920-8641 (Japan); Minami, Tetsuya, E-mail: tminami@staff.kanazawa-u.ac.jp [Department of Radiology, Kanazawa University School of Medicine, 13-1, Takara Machi, Kanazawa 920-8641 (Japan); Ryu, Yasuji, E-mail: yryu-kanazawa@umin.ac.jp [Department of Radiology, Kanazawa University School of Medicine, 13-1, Takara Machi, Kanazawa 920-8641 (Japan); Kozaka, Kazuto, E-mail: k-kozaka@staff.kanazawa-u.ac.jp [Department of Radiology, Kanazawa University School of Medicine, 13-1, Takara Machi, Kanazawa 920-8641 (Japan); Kitao, Azusa, E-mail: azusa@med.kanazawa-u.ac.jp [Department of Radiology, Kanazawa University School of Medicine, 13-1, Takara Machi, Kanazawa 920-8641 (Japan)

    2012-11-15

    Purpose: To elucidate the incidence of signal intensity patterns of borderline lesions of hepatocellular carcinoma (HCC) on hepatobiliary phase Gd-EOB-DTPA (EOB) enhanced MRI and clarify the natural histories of these lesions. Materials and methods: Total 99 borderline lesions of HCC were identified by angiography-assisted CT. The signal intensity of borderline lesions on hepatobiliary phase of EOB-enhanced MRI was analyzed. Progress rate from borderline lesions to hypervascular HCC was calculated with the Kaplan-Meier method among each signal intensity groups of nodules. Results: On hepatobiliary phase of EOB-enhanced MRI, 41.4% of the borderline lesions showed hypo-, 42.4% showed iso-, and 16.2% showed hyperintense, compared to background liver. Overall progress rates from borderline lesions to HCC were 10% in 1-year, 14% in 2-year and 20% in 3-year follow-up period. Progress rates to HCC in hypointense borderline lesions were 17% in 1-year, 28% in 2-year and 41% in 3-year follow-up period, and in isointense borderline lesions were 7% in 1-year, 7% in 2-year and 7% in 3-year follow-up period. No hyperintense borderline lesions progressed to HCC in follow-up period. Conclusion: Although borderline lesions of HCC may show hypo-, iso- and hyperintensity on hepatobiliary phase of EOB-enhanced MRI, hypointense borderline lesions are high risk to progress HCC.

  12. 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.

  13. 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

  14. Hepatobiliary disease in children and adolescents with cystic fibrosis.

    Science.gov (United States)

    Nascimento, Fernanda de S; Sena, Nelson A; Ferreira, Tatiane da A; Marques, Cibele D F; Silva, Luciana R; Souza, Edna Lúcia

    2017-09-07

    The aims of the study were to determine the frequency of hepatobiliary disease in patients with cystic fibrosis and to describe the sociodemographic, clinical, and laboratory profile of these patients. This was a retrospective, descriptive, and analytical study of 55 patients diagnosed with cystic fibrosis, aged between 3 months and 21 years, followed-up from January 2008 to June 2016 in a referral center. Medical records were consulted and sociodemographic, clinical and laboratory data, including hepatobiliary alterations, imaging studies, genetic studies, liver biopsies, and upper digestive endoscopies were registered. Hepatobiliary disease was diagnosed in 16.4% of the patients and occurred as an initial manifestation of cystic fibrosis in 55.6% of these cases. The diagnosis of hepatopathy occurred before or concomitantly with the diagnosis of cystic fibrosis in 88.9% of the children. All patients with hepatobiliary disease were considered non-white, with a predominance of females (77.8%) and median (IQR) of 54 (27-91) months. Compared with the group without hepatobiliary disease, children with liver disease had a higher frequency of severe mutations identified in the CFTR gene (77.8% vs. 39.6%, p=0.033) and severe pancreatic insufficiency (88.9% vs. 31.6%, p=0.007). The frequency of hepatobiliary disease was high, with a very early diagnosis of the disease and its complications in the studied series. A statistical association was observed between the occurrence of hepatobiliary disease and the presence of pancreatic insufficiency and severe mutations in the CFTR gene. It is emphasized that cystic fibrosis is an important differential diagnosis of liver diseases in childhood. Copyright © 2017 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  15. Hepatobiliary imaging: the use of 99Tcsup(m)-pyridoxylidene glutamate scanning in jaundiced adults and infants

    International Nuclear Information System (INIS)

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

    1978-01-01

    99 Tcsup(m)-pyridoxylidene glutamate ( 99 Tcsup(m)-PG) scans have been carried out in 24 jaundiced adults (mean total bilirubin 255 μmol/1 and 11 infants with prolonged obstructive jaundice (mean total bilirubin 165 μmol/1). Absence of radioactivity in the gut was interpreted as complete biliary obstruction which was the cause of jaundice in ten adults and six infants. Using this criterion occlusion or patency of the bile ducts was correctly determined in 21 adults and eight infants. False-negative gut images found in one adult were and two infants, and three scans were inconclusive (two adults, one infant). The scan was unable to show details of the site of obstruction or pathology but the technique was simple and atraumatic and was safely performed in patients with serious complications, e.g. renal failure, coagulation defects, septicaemia. In infants the 99 Tcsup(m)-PG scan compared well with the 131 I rose bengal faecal excretion test and with liver biopsy in the investigation of prolonged obstructive jaundice. Repeat scans in infants with biliary atresia were used to assess post-operative bile drainage. It is suggested that 99 Tcsup(m)-PG scanning is a useful screening test in difficult cases of jaundice. It is especially useful in frail patients, and patients with complications. (author)

  16. Image Quality Degradation from Transmit Delay Profile Quantization

    DEFF Research Database (Denmark)

    Stuart, Matthias Bo; Jensen, Jonas; di Ianni, Tommaso

    2015-01-01

    The investigated hypothesis is that quantization of the transmit delay profiles degrades the image quality in plane wave ultrasound imaging. Simulated point spread functions show that transmit delay profile quantization gives rise to artefacts behind the point target. The axial and lateral 6 dB r...

  17. Understanding and controlling hepatobiliary function

    NARCIS (Netherlands)

    Elferink, Ronald P. J. Oude

    2002-01-01

    Over the past decade, enormous progress has been made in identifying the mechanisms that underlie hepatobiliary excretion. A set of transport proteins mediates the canalicular transport of most important bile constituents. With the discovery of these transporter genes, the mechanism of bile

  18. Hepatobiliary scintigraphy in chronic intrahepatic cholestasis. Diagnosis of primary sclerosing cholangitis

    Energy Technology Data Exchange (ETDEWEB)

    Aburano, Tamio; Takayama, Teruhiko; Shuke, Noriyuki

    1987-05-01

    Primary sclerosing cholangitis (PSC) is a rare disease of unknown origin, leading to chronic intermittent cholestasis. Due to its low incidence, insidious clinical onset and varied clinical picture, the diagnosis is often delayed by years. PSC is sometimes diagnosed falsely as another disease of chronic intermittent cholestasis, primary biliary cirrhosis (PBC). In the present study, the hepatobiliary imaging with Tc-99m diethyl IDA was done in a total of 14 patients with chronic intermittent cholestasis including 3 patients with PSC and 11 patients with PBC, in order to decide its clinical usefulness as a noninvasive method for the differentiation between PSC and PBC. All three patients with PSC showed a typical pattern of radionuclide stasis within the area of intrahepatic and/or extrahepatic ductal system, representing the stenosis on endoscopic retrograde cholangiogram. On the other hand, none of 11 patients with PBC showed any radionuclide stasis within the area of intrahepatic and/or extrahepatic ductal system. This result suggests that the radionuclide hepatobiliary imaging may be a noninvasive method for investigating patients with chronic intermittent cholestasis, leading to earlier differentiation between PSC and PBC.

  19. 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

  20. Peritoneal and pleural fluids may appear hyperintense on hepatobiliary phase using hepatobiliary MR contrast agents.

    Science.gov (United States)

    Ciolina, Maria; Di Martino, Michele; Bruno, Onorina; Pommier, Romain; Vilgrain, Valérie; Ronot, Maxime

    2018-01-26

    To describe the effect of hepatobiliary-specific MR imaging contrast agent (HBCA) administration on the signal intensity of peritoneal and pleural fluid effusions on T1-weighted MR images. From October 2015 to May 2016 139 patients (mean 60±10 years old, 69 % males) with peritoneal or pleural effusions without biliary leakage who underwent HBCA-MRI (Gd-BOPTA or Gd-EOB-DTPA) at 1.5T and 3T were included from two centres. The fluid signal intensity was classified as hypo/iso/hyperintense before/after HBCA administration. The relative signal enhancement (RE) was calculated. On hepatobiliary phase (HBP), peritoneal fluids appeared hyper/isointense in 88-100 % and pleural effusions in 100 % of the patients following Gd-BOPTA administration. All fluids remained hypointense following Gd-EOB-DTPA. The signal intensity of fluids increased with both HBCA but RE was significantly higher following Gd-BOPTA (p=0.002 to fluids). The signal intensity of pleural and peritoneal fluids progressively increases following HBCA administration in the absence of biliary leakage. Due to its later hepatobiliary phase, this is more pronounced after Gd-BOPTA injection, leading to fluid hyperintensity that is not observed after Gd-EOB-DTPA injection. • Fluids appear hyper/isointense on HBP in most patients after Gd-BOPTA injection. • Fluids remain hypointense on HBP after Gd-EOB-DTPA injection. • RE of fluids increases with time after liver-specific Gd injection. • RE of fluids is higher in patients with chronic liver disease.

  1. Combined common bile duct and gastric outlet obstruction demonstrated during hepatobiliary scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Moreno, A.J.; Rodriguez, A.A.; Sorensen, K.A.; Turnbull, G.L.; Parker, A.L.

    1985-06-01

    A 64-year-old man presented with jaundice. Hepatobiliary imaging using /sup 99m/Tc-DISIDA revealed complete hepatobiliary tract obstruction with a photopenic area corresponding to a dilated gallbladder and a large photopenic region corresponding to a distended stomach as a result of gastric outlet obstruction. At surgery, carcinoma of the head of the pancreas was found to be the cause of the combined common bile duct and gastric outlet obstruction.

  2. Combined common bile duct and gastric outlet obstruction demonstrated during hepatobiliary scintigraphy

    International Nuclear Information System (INIS)

    Moreno, A.J.; Rodriguez, A.A.; Sorensen, K.A.; Turnbull, G.L.; Parker, A.L.

    1985-01-01

    A 64-year-old man presented with jaundice. Hepatobiliary imaging using sup(99m)Tc-DISIDA revealed complete hepatobiliary tract obstruction with a photopenic area corresponding to a dilated gallbladder and a large photopenic region corresponding to a distended stomach as a result of gastric outlet obstruction. At surgery, carcinoma of the head of the pancreas was found to be the cause of the combined common bile duct and gastric outlet obstruction. (orig.)

  3. 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

  4. LIVER ULTRASONOGRAPHY IN DOLPHINS: USE OF ULTRASONOGRAPHY TO ESTABLISH A TECHNIQUE FOR HEPATOBILIARY IMAGING AND TO EVALUATE METABOLIC DISEASE-ASSOCIATED LIVER CHANGES IN BOTTLENOSE DOLPHINS (TURSIOPS TRUNCATUS).

    Science.gov (United States)

    Seitz, Kelsey E; Smith, Cynthia R; Marks, Stanley L; Venn-Watson, Stephanie K; Ivančić, Marina

    2016-12-01

    The objective of this study was to establish a comprehensive technique for ultrasound examination of the dolphin hepatobiliary system and apply this technique to 30 dolphins to determine what, if any, sonographic changes are associated with blood-based indicators of metabolic syndrome (insulin greater than 14 μIU/ml or glucose greater than 112 mg/dl) and iron overload (transferrin saturation greater than 65%). A prospective study of individuals in a cross-sectional population with and without elevated postprandial insulin levels was performed. Twenty-nine bottlenose dolphins ( Tursiops truncatus ) in a managed collection were included in the final data analysis. An in-water ultrasound technique was developed that included detailed analysis of the liver and pancreas. Dolphins with hyperinsulinemia concentrations had larger livers compared with dolphins with nonelevated concentrations. Using stepwise, multivariate regression including blood-based indicators of metabolic syndrome in dolphins, glucose was the best predictor of and had a positive linear association with liver size (P = 0.007, R 2 = 0.24). Bottlenose dolphins are susceptible to metabolic syndrome and associated complications that affect the liver, including fatty liver disease and iron overload. This study facilitated the establishment of a technique for a rapid, diagnostic, and noninvasive ultrasonographic evaluation of the dolphin liver. In addition, the study identified ultrasound-detectable hepatic changes associated primarily with elevated glucose concentration in dolphins. Future investigations will strive to detail the pathophysiological mechanisms for these changes.

  5. Reinterpretation of radiological imaging in patients referred to a tertiary referral centre with a suspected pancreatic or hepatobiliary malignancy: impact on treatment strategy

    International Nuclear Information System (INIS)

    Tilleman, Esther H.B.M.; Gulik, Thomas M. van; Gouma, Dirk J.; Phoa, Saffire S.K.S.; Delden, Otto M. van; Lameris, Johan S.; Rauws, Erik A.J.

    2003-01-01

    Our objective was to determine the clinical importance of reinterpretation of radiological investigations performed in a referring hospital and the value of additional investigations in a referral centre. A panel of four experts retrospectively evaluated the technical quality of radiological investigations and made reinterpretation reports, of 78 patients referred with a suspected pancreatic or hepatobiliary malignancy. The value of additional radiological investigations performed in the referral centre was assessed. The quality of ultrasound and CT examinations was sufficient for reinterpretation in (36 of 69) 52% and (42 of 60) 70%, respectively. The reinterpretation reports of the ultrasound investigations were scored as ''in accordance'' in (30 of 36) 83%, as ''minor discordance'' in (3 of 36) 8% and as ''major discordance'' in (3 of 36) 8%. For CT proportions of (29 of 42) 69%, (8 of 42) 19% and (5 of 42) 12%, respectively, were found. Additional ultrasound (n=55) showed no additional findings in 16%, minor additional findings in 53% and major additional findings in 31% of cases. For additional spiral CT scan (n=47) results were of 21, 47 and, 32%, respectively. Reinterpretation of ultrasound and CT resulted in a change in treatment strategy for 7 patients (9%). Additional ultrasound or CT resulted in a change in treatment strategy for 24 patients (30%). Improved communication and reinterpretation of radiological investigations may reduce unnecessary referral. (orig.)

  6. 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.)

  7. Chimpanzees recognize their own delayed self-image.

    Science.gov (United States)

    Hirata, Satoshi; Fuwa, Kohki; Myowa, Masako

    2017-08-01

    Unlike mirror self-recognition, recognizing one's own image in delayed video footage may indicate the presence of a concept of self that extends across time and space. While humans typically show this ability around 4 years of age, it is unknown whether this capacity is found in non-human animals. In this study, chimpanzees performed a modified version of the mark test to investigate whether chimpanzees could remove stickers placed on the face and head while watching live and delayed video images. The results showed that three of five chimpanzees consistently removed the mark in delayed-viewing conditions, while they removed the stickers much less frequently in control video conditions which lacked a link to their current state. These findings suggest that chimpanzees, like human children at the age of 4 years and more, can comprehend temporal dissociation in their concept of self.

  8. 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)

  9. Hepatobiliary manifestations of gastrointestinal and nutritional disorders.

    Science.gov (United States)

    Samarasena, Jason B; Hu, Ke-Qin

    2011-02-01

    Hepatobiliary manifestations of gastrointestinal and nutritional disorders can occur as part of the clinical spectrum of the underlying disease or as a consequence of the treatment of the disease. This article reviews aspects of pathogenesis, diagnosis, and management of hepatobiliary manifestations associated with a selection of gastrointestinal and nutritional disorders including inflammatory bowel disease, celiac disease, Whipple's disease, and parenteral nutrition associated disorders. Copyright © 2011 Elsevier Inc. All rights reserved.

  10. 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)

  11. 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).

  12. 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

    International Nuclear Information System (INIS)

    Kim, Jeong Woo; Lee, Chang Hee; Park, Yang Shin; Seo, Tae Seok; Song, Myung Gyu; Kim, Ji Hoon; Kim, Kyeong Ah; Park, Cheol Min

    2017-01-01

    Highlights: • HCC para shows more frequent initial compact lipiodol uptake after TACE than HCC def . • HCC para demonstrates less frequent early local recurrence after TACE. • HCC 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 para ) and HCC with defect on the HBP (HCC 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 para and HCC 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 para and 78 HCC def were included. Compared to HCC def , HCC 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 para than in HCC def (p = 0.008). Conclusion: Despite larger size and lower AER, HCC para showed more frequent initial compact lipiodol uptake and lower early local recurrence rate after TACE than did HCC def .

  13. 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

  14. Cumulative phase delay imaging - A new contrast enhanced ultrasound modality

    Energy Technology Data Exchange (ETDEWEB)

    Demi, Libertario, E-mail: l.demi@tue.nl; Sloun, Ruud J. G. van; Mischi, Massimo [Lab. of Biomedical Diagnostics, Dept. of Electrical Eng., Eindhoven University of Technology (Netherlands); Wijkstra, Hessel [Lab. of Biomedical Diagnostics, Dept. of Electrical Eng., Eindhoven University of Technology (Netherlands); Academic Medical Center, Urology Dept., University of Amsterdam (Netherlands)

    2015-10-28

    Recently, a new acoustic marker for ultrasound contrast agents (UCAs) has been introduced. A cumulative phase delay (CPD) between the second harmonic and fundamental pressure wave field components is in fact observable for ultrasound propagating through UCAs. This phenomenon is absent in the case of tissue nonlinearity and is dependent on insonating pressure and frequency, UCA concentration, and propagation path length through UCAs. In this paper, ultrasound images based on this marker are presented. The ULA-OP research platform, in combination with a LA332 linear array probe (Esaote, Firenze Italy), were used to image a gelatin phantom containing a PVC plate (used as a reflector) and a cylindrical cavity measuring 7 mm in diameter (placed in between the observation point and the PVC plate). The cavity contained a 240 µL/L SonoVueO{sup ®} UCA concentration. Two insonating frequencies (3 MHz and 2.5 MHz) were used to scan the gelatine phantom. A mechanical index MI = 0.07, measured in water at the cavity location with a HGL-0400 hydrophone (Onda, Sunnyvale, CA), was utilized. Processing the ultrasound signals backscattered from the plate, ultrasound images were generated in a tomographic fashion using the filtered back-projection method. As already observed in previous studies, significantly higher CPD values are measured when imaging at a frequency of 2.5 MHz, as compared to imaging at 3 MHz. In conclusion, these results confirm the applicability of the discussed CPD as a marker for contrast imaging. Comparison with standard contrast-enhanced ultrasound imaging modalities will be the focus of future work.

  15. 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

  16. 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

  17. 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

  18. 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...

  19. 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}.

  20. 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....

  1. 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.

  2. 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...... increasing trend of FDG uptake over time has been shown in malignant cells, and a decreasing or constant trend has been shown in inflammatory/infectious processes. Tumor heterogeneity can be assessed by using early and delayed imaging because differences between primary versus metastatic sites become more...... detectable compared with single time points. This article discusses the applications of DTPI and delayed-time-point imaging....

  3. Effect of altered thyroid status on the transport of hepatobiliary radiopharmaceuticals

    Energy Technology Data Exchange (ETDEWEB)

    Pahuja, D.N.; Noronha, O.P.

    1985-10-01

    The effect of induced hypothyroidism (by feeding an antithyroid drug-propylthiouracil) on the transport and clearance of the routinely used hepatobiliary radiopharmaceuticals--radioiodinated iodine- T (131I) rose bengal and technetium-99m-N-(4-n-butylphenylcarbamoylmethyl) iminodiacetate, was studied in the rats. Hypothyroidism was associated with depressed growth and retarded clearance of these radiotracers from the in vivo system. Treatment of the hypothyroid rats with thyroxine (2-5 micrograms/100 g b.w. day) for 6 wk, restored these parameters towards normal values. These data suggest that delayed clearance of these hepatobiliary tracers could be related to reduced metabolic rate accompanied with the hypotonia and hypomotility of intestine normally observed in the hypothyroid state.

  4. 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...

  5. Role of hepatobiliary scintigraphy in obstructive jaundice

    International Nuclear Information System (INIS)

    Jadhav, Praveen; Shikare, Shekhar; Tilve, Gundu

    1990-01-01

    Hepatobiliary scintigraphy is a very useful investigation in cholestatic jaundice, especially when serum bilirubin is less than 20 mg %. It is particularly useful to diagnose early biliary obstruction, to quantitate biliary obstruction with measurement of hepatic and gall bladder bile excretion rate, to determine the urgency of therapeutic procedure and to evaluate the effect of therapy in all these cases. In these cases other investagations like ultrasonography are less useful as compared to scintigraphy which has a high index of sensitivity. In this study, comparative analysis of 32 cases of cholestatic jaundice is presented. (author). 12 refs ., 4 tabs

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

    Energy Technology Data Exchange (ETDEWEB)

    Park, Sung Bin [Chung-Ang University Hospital, Chung-Ang University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Moon, Min Hoan; Sung, Chang Kyu [Seoul National University College of Medicine, 41, Department of Radiology, SMG-SNU Boramae Medical Center, Seoul (Korea, Republic of); Oh, Sohee [Seoul National University College of Medicine, 41, Department of Biostatistics, SMG-SNU Boramae Medical Center, Seoul (Korea, Republic of); Lee, Young Ho [Kwandong University College of Medicine, Department of Radiology, Cheil General Hospital and Women' s Healthcare Center, Seoul (Korea, Republic of)

    2014-11-15

    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.)

  7. 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.)

  8. Time-Delay Integration Imaging with ICON's Far-Ultraviolet Imager

    Science.gov (United States)

    Wilkins, Colin W.; Mende, Stephen B.; Frey, Harald U.; England, Scott L.

    2017-10-01

    A Time-Delay Integration (TDI) image acquisition and processing system has been developed to capture ICON's Far Ultraviolet (FUV) Spectrographic Imager data. The TDI system is designed to provide variable-range motion-compensated imaging of Earth's nightside ionospheric limb and sub-limb scenes viewed from Low Earth Orbit in the 135.6 nm emission of oxygen with an integration time of 12 seconds. As a pre-requisite of the motion compensation the TDI system is also designed to provide corrections for optical distortions generated by the FUV Imager's optical assembly. On the dayside the TDI system is used to process 135.6 nm and 157.0 nm wavelength altitude profiles simultaneously. We present the TDI system's design methodology and implementation as an FPGA module with an emphasis on minimization of on-board data throughput and telemetry. We also present the methods and results of testing the TDI system in simulation and with Engineering Ground Support Equipment (EGSE) to validate its performance.

  9. Delayed 18F-fluorodeoxyglucose PET/CT imaging improves quantitation of atherosclerotic plaque inflammation

    DEFF Research Database (Denmark)

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

    2014-01-01

    BACKGROUND: This study aimed to determine if delayed (18)F-fluorodeoxyglucose ((18)FDG) PET/CT imaging improves quantitation of atherosclerotic plaque inflammation. Blood-pool activity can disturb the arterial (18)FDG signal. With time, blood-pool activity declines. Therefore, delayed imaging can...... potentially improve quantitation of vascular inflammation. METHODS AND RESULTS: 40 subjects were prospectively assessed by dual-time-point PET/CT imaging at approximately 90 and 180 minutes after (18)FDG administration. For both time-points, global uptake of (18)FDG was determined in the carotid arteries...... at 180 minutes significant positive relations were observed between SCORE % and carotid (τ = 0.25, P = .045) and aortic (τ = 0.33, P = .008) cSUVMAX. CONCLUSIONS: Delayed (18)FDG PET/CT imaging at 180 minutes improves quantitation of atherosclerotic plaque inflammation over imaging at 90 minutes...

  10. Pharmacokinetics and clinical application of technetium 99m-labeled hepatobiliary agents.

    Science.gov (United States)

    Krishnamurthy, G T; Turner, F E

    1990-04-01

    Hepatobiliary imaging, introduced first in late 1950s with iodine 131 rose bengal, has undergone major changes since the introduction of technetium 99m-labeled agents in the late 1970s. 99mTc-labeled iminodiacetic acid (IDA) agents, with their high hepatic uptake and fast biliary excretion, provide superior image resolution in addition to supplying simultaneous physiologic parameters quantitatively. The measurement of hepatic extraction fraction by deconvolutional analysis aids in separating hepatocyte from biliary disease. Excretion half-time calculation by nonlinear least square fit provides a quantitative method of analyzing hepatobiliary function and correlates directly with the severity of disease. The measurement of gallbladder ejection fraction, ejection rate, and common bile duct bile reflux index following cholecystokinin, enables quantification of the degree of obstruction to bile flow through the common bile duct. The combined application of morphologic and physiologic parameters enables diagnosis of various hepatobiliary disease, especially in early stages. Quantitative functional parameters not only provide criteria for diagnosis, but also assist in monitoring the therapeutic benefit from drugs and interventional techniques such as endoscopic sphincterotomy or balloon dilation of the obstruction. Biliary dynamic studies with cholecystokinin assist in distinguishing common bile duct dilation without obstruction from dilation with obstruction. Methods of application of 99mTc-IDA agents in quantitative physiologic studies are reviewed and future direction of their use is proposed.

  11. Clinical implications of hepatobiliary scintigraphy and ultrasound in the diagnosis of acute cholecystitis.

    Science.gov (United States)

    Rodriguez, Limael E; Santaliz-Ruiz, Luis E; De La Torre-Bisot, Gabriel; Gonzalez, Giovanni; Serpa, Miguel A; Sanchez-Gaetan, Felipe; Martinez-Trabal, Jorge L; Peguero-Rivera, Julio A; Bolanos-Avila, Guillermo

    2016-11-01

    We assess the performance of ultrasound (US) and hepatobiliary scintigraphy (HIDA) as confirmatory studies in acute cholecystitis (AC) and demonstrate our current imaging protocol's impact on outcomes. Between January 2013 to July 2014, 117 patients were admitted through the emergency room with a preliminary diagnosis of AC. Overall, 106/117 (91%) of the patients received US preadmission and 34/117 (29%) received a HIDA post admission. Primary end points included: 1) diagnostic test reliability for AC, and 2) outcome and quality measures (time to surgery, LOS, costs, etc.). Laparoscopic cholecystectomy was performed in 96/117 (82%) and open cholecystectomy in 21/117 (18%) of the patients. Overall, histopathologic features consistent with AC was present in 46/117 (39%). AC alone was present in 23/117 (20%), and AC superimposed on chronic cholecystitis was present in 23/117 (20%). For AC, US had a sensitivity and specificity of 26% and 80%, respectively. HIDA scan had a sensitivity and specificity of 87% and 79%, respectively. Time to surgery (TTS) was 4 vs 2.3 days in patients who received HIDA vs US alone (p = 0.001), and length of stay (LOS) was 6.7 vs 4.3 days, respectively (p = 0.001). Age >50 years, glucose >140 (mg/dl), and WBC count >10 (×10 9 /L) were statistically significant independent variables associated with AC. HIDA scan is superior to US as a diagnostic study in the setting of AC. Our current protocol of delayed HIDA (post-admission) was associated with increased TTS, LOS, and overall costs. Early confirmation with HIDA in high risk patients may hasten treatment allocation and improve outcomes in the setting of AC. Copyright © 2016 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

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

    2013-12-01

    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. 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. 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%. 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. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  13. 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 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. 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.

  14. 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.

  15. Hepato-biliary clinical trials and their inclusion in the Cochrane Hepato-Biliary Group register and reviews

    DEFF Research Database (Denmark)

    Klingenberg, Sarah Louise; Nikolova, Dimitrinka; Alexakis, Nicholas

    2011-01-01

    The Cochrane Hepato-Biliary Group (CHBG) is one of the 52 collaborative review groups within The Cochrane Collaboration. The activities of the CHBG focus on collecting hepato-biliary randomized clinical trials (RCT) and controlled clinical trials (CCT), and including them in systematic reviews wi...... with meta-analyses of the trials. In this overview, we present the growth of The CHBG Controlled Trials Register, as well as the systematic reviews that have been produced since March 1996....

  16. Contrast-enhanced free-breathing 3D T1-weighted gradient-echo sequence for hepatobiliary MRI in patients with breath-holding difficulties.

    Science.gov (United States)

    Reiner, C S; Neville, A M; Nazeer, H K; Breault, S; Dale, B M; Merkle, E M; Bashir, M R

    2013-11-01

    Evaluate the image quality and diagnostic performance of a free-breathing 3D-gradient-echo sequence with radial acquisition (rGRE) compared with a Cartesian breath-hold 3D-GRE (cGRE) sequence on hepatobiliary phase MRI in patients with breath-holding difficulties. Twenty-eight consecutive patients (15 males; mean age 61 ± 11.9 years) were analysed in this retrospective IRB-approved study. Breath-holding difficulties during gadoxetate-disodium-enhanced liver MRI manifested as breathing artefacts during dynamic-phase imaging. MRI included axial and coronal cGRE and a radially sampled rGRE sequence during the hepatobiliary phase. Two radiologists independently evaluated cGRE and rGRE images for image quality, liver lesion detection and conspicuity, and bile duct conspicuity on a four-point scale. Liver edge sharpness was significantly higher on rGRE images (P breath-holding difficulties, overall image quality and liver lesion conspicuity on hepatobiliary phase MRI can be improved using the rGRE sequence. • Patients with diminished breath-holding capacities present a major challenge in abdominal MRI. • A free-breathing sequence for hepatobiliary-phase MRI can improve image quality. • Further advances are needed to reduce acquisition time of the free-breathing gradient-echo sequence.

  17. Precise Time Delays from Strongly Gravitationally Lensed Type Ia Supernovae with Chromatically Microlensed Images

    Science.gov (United States)

    Goldstein, Daniel A.; Nugent, Peter E.; Kasen, Daniel N.; Collett, Thomas E.

    2018-03-01

    Time delays between the multiple images of strongly gravitationally lensed Type Ia supernovae (glSNe Ia) have the potential to deliver precise cosmological constraints, but the effects of microlensing on time delay extraction have not been studied in detail. Here we quantify the effect of microlensing on the glSN Ia yield of the Large Synoptic Survey Telescope (LSST) and the effect of microlensing on the precision and accuracy of time delays that can be extracted from LSST glSNe Ia. Microlensing has a negligible effect on the LSST glSN Ia yield, but it can be increased by a factor of ∼2 over previous predictions to 930 systems using a novel photometric identification technique based on spectral template fitting. Crucially, the microlensing of glSNe Ia is achromatic until three rest-frame weeks after the explosion, making the early-time color curves microlensing-insensitive time delay indicators. By fitting simulated flux and color observations of microlensed glSNe Ia with their underlying, unlensed spectral templates, we forecast the distribution of absolute time delay error due to microlensing for LSST, which is unbiased at the sub-percent level and peaked at 1% for color curve observations in the achromatic phase, while for light-curve observations it is comparable to state-of-the-art mass modeling uncertainties (4%). About 70% of LSST glSN Ia images should be discovered during the achromatic phase, indicating that microlensing time delay uncertainties can be minimized if prompt multicolor follow-up observations are obtained. Accounting for microlensing, the 1–2 day time delay on the recently discovered glSN Ia iPTF16geu can be measured to 40% precision, limiting its cosmological utility.

  18. 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.

  19. Delay-Encoded Harmonic Imaging (DE-HI) in Multiplane-Wave Compounding.

    Science.gov (United States)

    Gong, Ping; Song, Pengfei; Chen, Shigao

    2017-04-01

    The development of ultrafast ultrasound imaging brings great opportunities to improve imaging technologies such as shear wave elastography and ultrafast Doppler imaging. In ultrafast imaging, several tilted plane or diverging wave images are coherently combined to form a compounded image, leading to trade-offs among image signal-to-noise ratio (SNR), resolution, and post-compounded frame rate. Multiplane wave (MW) imaging is proposed to solve this trade-off by encoding multiple plane waves with Hadamard matrix during one transmission event (i.e. pulse-echo event), to improve image SNR without sacrificing the resolution or frame rate. However, it suffers from stronger reverberation artifacts in B-mode images compared to standard plane wave compounding due to longer transmitted pulses. If harmonic imaging can be combined with MW imaging, the reverberation artifacts and other clutter noises such as sidelobes and multipath scattering clutters should be suppressed. The challenge, however, is that the Hadamard codes used in MW imaging cannot encode the 2 nd harmonic component by inversing the pulse polarity. In this paper, we propose a delay-encoded harmonic imaging (DE-HI) technique to encode the 2 nd harmonic with a one quarter period delay calculated at the transmit center frequency, rather than reversing the pulse polarity during multiplane wave emissions. Received DE-HI signals can then be decoded in the frequency domain to recover the signals as in single plane wave emissions, but mainly with improved SNR at the 2 nd harmonic component instead of the fundamental component. DE-HI was tested experimentally with a point target, a B-mode imaging phantom, and in-vivo human liver imaging. Improvements in image contrast-to-noise ratio (CNR), spatial resolution, and lesion-signal-to-noise ratio ( l SNR) have been achieved compared to standard plane wave compounding, MW imaging, and standard harmonic imaging (maximal improvement of 116% on CNR and 115% on l SNR as compared

  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. Whole heart coronary imaging with flexible acquisition window and trigger delay.

    Science.gov (United States)

    Kawaji, Keigo; Foppa, Murilo; Roujol, Sébastien; Akçakaya, Mehmet; Nezafat, Reza

    2015-01-01

    Coronary magnetic resonance imaging (MRI) requires a correctly timed trigger delay derived from a scout cine scan to synchronize k-space acquisition with the quiescent period of the cardiac cycle. However, heart rate changes between breath-held cine and free-breathing coronary imaging may result in inaccurate timing errors. Additionally, the determined trigger delay may not reflect the period of minimal motion for both left and right coronary arteries or different segments. In this work, we present a whole-heart coronary imaging approach that allows flexible selection of the trigger delay timings by performing k-space sampling over an enlarged acquisition window. Our approach addresses coronary motion in an interactive manner by allowing the operator to determine the temporal window with minimal cardiac motion for each artery region. An electrocardiogram-gated, k-space segmented 3D radial stack-of-stars sequence that employs a custom rotation angle is developed. An interactive reconstruction and visualization platform is then employed to determine the subset of the enlarged acquisition window for minimal coronary motion. Coronary MRI was acquired on eight healthy subjects (5 male, mean age = 37 ± 18 years), where an enlarged acquisition window of 166-220 ms was set 50 ms prior to the scout-derived trigger delay. Coronary visualization and sharpness scores were compared between the standard 120 ms window set at the trigger delay, and those reconstructed using a manually adjusted window. The proposed method using manual adjustment was able to recover delineation of five mid and distal right coronary artery regions that were otherwise not visible from the standard window, and the sharpness scores improved in all coronary regions using the proposed method. This paper demonstrates the feasibility of a whole-heart coronary imaging approach that allows interactive selection of any subset of the enlarged acquisition window for a tailored reconstruction for each branch

  2. 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.

  3. Differentiation of focal nodular hyperplasia from hepatocellular adenoma: Role of the quantitative analysis of gadobenate dimeglumine-enhanced hepatobiliary phase MRI.

    Science.gov (United States)

    Roux, Marion; Pigneur, Frederic; Calderaro, Julien; Baranes, Laurence; Chiaradia, Mélanie; Tselikas, Lambros; Decaens, Thomas; Costentin, Charlotte; Laurent, Alexis; Azoulay, Daniel; Mallat, Ariane; Zafrani, Elie-Serge; Rahmouni, Alain; Luciani, Alain

    2015-11-01

    To determine the value of quantitative analysis of the hepatobiliary phase (HBP) in gadobenate dimeglumine (Gd-BOPTA)-enhanced magnetic resonance imaging (MRI) to differentiate focal nodular hyperplasia (FNH) from hepatocellular adenoma (HCA). Thirty-eight patients bearing 67 lesions (40 FNH; 27 HCA) were retrospectively included in this Institutional Review Board-approved study. The same volumetric interpolated breath-hold examination (VIBE) T1 -weighted sequences were performed before and after contrast injection on a 1.5T MRI, with HBP images acquired with a mean delay of 80 minutes (range 60-120 min). After a visual assessment of lesions enhancement (qualitative HBP analysis), the HBP signal intensity ratio (SIR) and the lesion-to-liver contrast enhancement ratio (LLCER) were calculated for each lesion by two observers (Mann-Whitney test). The sensitivities, specificities (receiver operating characteristic [ROC] curve analysis) and interobserver correlation (intraclass coefficient, ICC) of quantitative HBP analysis were determined. All FNH and 44.4% of HCA appeared hyper- or isointense relative to the adjacent liver on qualitative HBP analysis. The mean SIR (P Quantitative LLCER assessment allows an accurate differentiation of FNH from HCA, even in hyper- or isointense HCA on HBP images. © 2015 Wiley Periodicals, Inc.

  4. ADL ORVIS: an air-delay-leg, line-imaging optically recording velocity interferometer system.

    Science.gov (United States)

    Trott, Wayne M; Castañeda, Jaime N; Cooper, Marcia A

    2014-04-01

    An interferometry system that enables acquisition of spatially resolved velocity-time profiles with very high velocity sensitivity has been designed and applied to two diverse, instructive experimental problems: (1) measurement of low-amplitude reverberations in laser-driven flyer plates and (2) measurement of ramp-wave profiles in symmetric impact studies of fused silica. The delay leg in this version of a line-imaging optically recording velocity interferometer system (ORVIS) consists of a long air path that includes relay optics to transmit the optical signal through the interferometer cavity. Target image quality from the delay path at the image recombination plane is preserved by means of a compact and flexible optical design utilizing two parabolic reflectors (serving as the relay optics) in a folded path. With an instrument tuned to a velocity per fringe constant of 22.4 m s(-1) fringe(-1), differences of 1-2 m s(-1) across the probe line segment can be readily distinguished. Measurements that capture small spatial variations in flyer velocity are presented and briefly discussed. In the fused silica impact experiments, the ramp-wave profile observed by this air-delay instrument compares favorably to the profile recorded simultaneously by a conventional line-imaging ORVIS.

  5. Position and time sensitive photon counting detector with image charge delay-line readout

    Science.gov (United States)

    Czasch, Achim; Dangendorf, Volker; Milnes, James; Schössler, Sven; Lauck, Ronald; Spillmann, Uwe; Howorth, Jon; Jagutzki, Ottmar

    2007-09-01

    We have developed single photon counting image intensifier tubes combining position and time information read-out with at least 500x500 pixels and sub-nanosecond time resolution. This image intensifier type uses a resistive screen instead of a phosphor screen and the image charge pickup anode is placed outside the sealed tube. We present a novel delay-line anode design which allows for instance detecting simultaneously arriving pairs of photons. Due to the very low background this technique is suited for applications with very low light intensity and especially if a precise time tagging for each photon is required. We show results obtained with several anode types on a 25 mm image intensifier tube and a 40 mm open-face MCP detector and discuss the performance in neutron radiography, e.g. for homeland security, and the prospects for applications like Fluorescence Life-time Imaging Microscopy (FLIM), astronomy and X-ray polarimetry.

  6. Advantage of delayed whole-body FDG-PET imaging for tumour detection

    Energy Technology Data Exchange (ETDEWEB)

    Kubota, Kazuo; Ono, Shuichi; Akaizawa, Takashi; Fukuda, Hiroshi [Dept. of Nuclear Medicine and Radiology, Tohoku Univ., Sendai (Japan); Itoh, Masatoshi; Ozaki, Kaoru; Tashiro, Manabu; Yamaguchi, Keiichiro [Cyclotron and Radioisotope Center, Tohoku Univ. (Japan); Yamada, Kenji [Sendai Kosei Hospital (Japan)

    2001-06-01

    Delayed imaging that coincides with the highest uptake of fluorine-18 fluorodeoxyglucose (FDG) by tumour may be advantageous in oncological positron emission tomography (PET), where delineation of metastasis from normal tissue background is important. In order to identify the better imaging protocol for tumour detection, whole-body FDG-PET images acquired at 1 h and 2 h after injection were evaluated in 22 subjects, with a post-injection transmission scan at 90 min for attenuation correction. After visual interpretation, tumour uptake [tumour standardised uptake ratio (SUR)], normal tissue uptake (normal SUR) and tumour to background contrast (tumour SUR/normal tissue SUR) were evaluated in the images acquired at 1 h and at 2 h. Most malignant lesions, including primary lung cancer, metastatic mediastinal lymph nodes and lymphoma lesions, showed higher FDG uptake at 2 h than at 1 h. By contrast, benign lesions, with the exception of sarcoidosis, showed lower uptake of FDG at 2 h than at 1 h. Among normal tissues, the kidney, liver, mediastinum, lung, upper abdomen and left abdomen showed significant falls in FDG uptake from 1 h to 2 h. The lower abdomen, right abdomen and muscles (shoulder and thigh) showed no significant changes. Consequently, malignant lesions of the lung, mediastinum and upper abdomen showed significant increases in tumour to background contrast from 1 to 2 h. Three lesions (two lung cancers and a malignant lymphoma) that were equivocal on 1-h images became evident on 2-h images, changing the results of interpretation. All other malignant lesions were detected on 1-h images, but were clearer, with higher contrast, on 2-h images. Lesion-based sensitivity was improved from 92% (49/53) to 98% (52/53), and patient-based sensitivity from 78% (14/18) to 94% (17/18). It is concluded that delayed whole-body FDG-PET imaging is a better and more reliable imaging protocol for tumour detection. (orig.)

  7. Two-dimensional GEM imaging detector with delay-line readout

    Science.gov (United States)

    Guedes, G. P.; Breskin, A.; Chechik, R.; Vartsky, D.; Bar, D.; Barbosa, A. F.; Marinho, P. R. B.

    2003-11-01

    A 100×100 mm 2 2D imaging detector, based on a triple-GEM gaseous multiplier, striped x- y readout anode and discrete delay-line readout, is presented. The fast (2.1 ns tap -1) delay-line circuit was designed to match the anode-charge signal profile, namely its rise-time and length. The detector's imaging capability was systematically studied in Ar/CO 2 (70/30) with 5.9 keV X-rays; x- y resolution of σ=0.05 and 0.1 mm for top and bottom anode strips, respectively, and integral non-linearity of ˜0.15% are demonstrated.

  8. 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)

  9. Assessment of atherosclerotic plaque inflammation can be improved by delayed time point FDG PET CT imaging

    DEFF Research Database (Denmark)

    Blomberg, Björn; Thomassen, Anders; Hildebrandt, Malene

    2013-01-01

    Objectives: Blood pool FDG activity can cloud the atherosclerotic plaque FDG signal. Over time, blood pool FDG activity declines. Therefore, delayed time point FDG PET CT imaging can potentially enhance the assessment of atherosclerotic plaque inflammation. Methods: Twelve healthy volunteers...... without traditional cardiovascular risk factors and three subjects with angina pectoris were prospectively assessed by dual time point 18-FDG PET CT imaging at 90 and 180 minutes after tracer injection. The ratio between aortic SUVmax and the blood pool SUVmean (TBR) was calculated to show the change...

  10. Accuracy of Hepatobiliary Scintigraphy after Liver Transplantation and Liver Resection

    Directory of Open Access Journals (Sweden)

    Manuel Eckenschwiller

    2016-01-01

    Full Text Available Background and Aims. Biliary complications are the most frequent complications after common liver surgeries. In this study, accuracy of hepatobiliary scintigraphy (HBS and impact of hyperbilirubinemia were evaluated. Methods. Between November 2007 and February 2016, 131 patients underwent hepatobiliary scintigraphy after having liver surgery. 39 patients with 42 scans after LTX (n=13 or hepatic resection (n=26 were evaluated in the study; 27 were male, with mean age 60 years. The subjects underwent hepatobiliary scintigraphy with Tc-99m labeled Mebrofenin. The results were compared to ERCP as gold standard performed within one month after HBS. We calculated sensitivity, specificity, PPV, and NPV. We compared LTX patients to patients with other liver surgeries. Furthermore the influence of hyperbilirubinemia on HBS scans was evaluated. Results. HBS always provided the correct diagnosis in cases of bile leak in the liver-resected group (14/14. Overall diagnostic accuracy was 76% (19/25 in this group and 54% (7/13 in the LTX group. False negative (FN diagnoses occurred more often among LTX patients (p=0.011. Hyperbilirubinemia (>5 mg/dL significantly influenced the excretion function of the liver, prolonging HBS’s time-activity-curve (p=0.001. Conclusions. Hepatobiliary scintigraphy is a reliable tool to detect biliary complications, but reduced accuracy must be considered after LTX.

  11. Radiological findings of intraparenchymal liver Ascaris (hepatobiliary ascariasis)

    Energy Technology Data Exchange (ETDEWEB)

    Akata, D.; Oezmen, M.N.; Kaya, A.; Akhan, O. [Dept. of Radiology, Hacettepe University School of Medicine, Ankara (Turkey)

    1999-02-01

    Ascariasis is a well-known cause of acute cholangitis and cholecystitis; however, very rarely do worms penetrate and colonize the liver parenchyma. Here we present the unique radiological demonstration (US, CT and ERCP) of hepatobiliary ascariasis in which worm was first alive in the parenchyma of the liver and subsequently died and formed liver abscess. (orig.) (orig.) With 3 figs., 8 refs.

  12. 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.

  13. Small Hypervascular Hepatocellular Carcinoma: Limited Value of Portal and Delayed Phases on Dynamic Magnetic Resonance Imaging

    International Nuclear Information System (INIS)

    Yu, J.S.; Lee, J.H.; Chung, J.J.; Kim, J.H.; Kim, K.W.

    2008-01-01

    Background: Characterization of small nodules in the cirrhotic liver is always challenging in clinical practice. In the differential diagnosis of small hypervascular lesions, it has been reported that portal venous or delayed hypointensity is a useful sign to characterize hepatocellular carcinomas (HCCs) during dynamic magnetic resonance (MR) imaging. However, few studies have assessed the diagnostic value of this sign. Purpose: To determine the diagnostic value of portal-phase (PP) and delayed-phase (DP) images for the diagnosis of small hypervascular HCCs during intravenous (IV) contrast-enhanced dynamic MR imaging of cirrhotic liver. Material and Methods: A total of 69 small (6-20 mm) hypervascular HCCs in 53 cirrhotic patients were subjected to a retrospective analysis of the signal intensities (hypo-, iso-, or hyperintense) and rim enhancement on PP and 5-min DP images from three-phased dynamic MR imaging according to the pre-contrast T1- and T2-weighted imaging features. After exclusion of 33 subcapsular wedge-shaped pseudolesions and three hemangiomas by typical imaging features, 74 centrally located small hypervascular benign or pseudolesions were used as a control group for comparative analyses. Results: The sensitivities of PP hypointensity, DP hypointensity, and rim enhancement in the diagnosis were 11%, 29%, and 18%, respectively, for 6-10-mm hypervascular HCCs, and 42%, 63%, and 58%, respectively, for 16-20-mm lesions. After exclusion of the 48 lesions showing T2-weighted hyperintensity (HCCs, n=39; benign lesions, n=9), the overall sensitivity for diagnosis of small hypervascular HCCs decreased (8.3%, 25.0%, and 8.3%, respectively). Conclusion: Although DP provides a better sensitivity than PP, both PP and DP have very limited diagnostic value for diagnosis of small hypervascular HCCs during dynamic MR imaging of the cirrhotic liver

  14. 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.

  15. 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.

  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. {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.)

  18. Assisting people with Nystagmus through image stabilization: Using an ARX model to overcome processing delays.

    Science.gov (United States)

    Polzer, Stephan; Miesenberger, Klaus

    2017-07-01

    Pathological Nystagmus is characterized by an unintended and involuntary eye-movement, which tends to impact on visual acuity. Today only view therapies (for instance medication or surgeries) to treat nystagmus are at hand and the existing therapies only show partial improvement. Only general Assistive Technology (AT) solutions like glasses, screen magnifiers, speech output, display adaptation and concepts holders are at hand to support daily living. More specific ATs to reduce the impact of nystagmus are missing. This paper presents conceptual research and feasibility studies with the attempt to reduce the impact of nystagmus by stabilizing the image on the retina (digital Retinal Image Stabilization) by moving the digital image synchronal with the unintended eye movement using gaze contingent display technology. Further an identification and validation process using recorded eye-movements is presented since the synchronization approach relies on predicting eye-movements to reduce the impact of delays due to processing time.

  19. 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.

  20. 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.)

  1. 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

  2. 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

  3. An X-ray imaging device based on a GEM detector with delay-line readout

    Science.gov (United States)

    Zhou, Yi; Li, Cheng; Sun, Yong-Jie; Shao, Ming

    2010-01-01

    An X-ray imaging device based on a triple-GEM (Gas Electron Multiplier) detector, a fast delay-line circuit with 700 MHz cut-off frequency and two dimensional readout strips with 150 μm width on the top and 250 μm width on the bottom, is designed and tested. The localization information is derived from the propagation time of the induced signals on the readout strips. This device has a good spatial resolution of 150 μm and works stably at an intensity of 105 Hz/mm2 with 8 keV X-rays.

  4. 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

  5. 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.

  6. Assessment of atherosclerotic plaque inflammation can be improved by delayed time point FDG PET CT imaging

    DEFF Research Database (Denmark)

    Blomberg, Björn; Thomassen, Anders; Hildebrandt, Malene

    2013-01-01

    Objectives: Blood pool FDG activity can cloud the atherosclerotic plaque FDG signal. Over time, blood pool FDG activity declines. Therefore, delayed time point FDG PET CT imaging can potentially enhance the assessment of atherosclerotic plaque inflammation. Methods: Twelve healthy volunteers...... without traditional cardiovascular risk factors and three subjects with angina pectoris were prospectively assessed by dual time point 18-FDG PET CT imaging at 90 and 180 minutes after tracer injection. The ratio between aortic SUVmax and the blood pool SUVmean (TBR) was calculated to show the change...... the data. Results: At 90 minutes, the aortic TBR was 2.072 ± 0.599. At 180 minutes, the aortic TBR significantly increased to 3.488 ± 1.138 (P = relationship was observed between aortic cSUV, aging (β = 0.019; t = 2.79; df = 12; P...

  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. Robotic hepatobiliary surgery: update on the current status.

    Science.gov (United States)

    Carr, A D; Ali, M R; Khatri, V P

    2013-10-01

    An update on the current status of robotic hepatobiliary surgery based on a review of the available literature. A literature search was performed using the PubMed database with search phrases "robotic hepatectomy", "robotic liver resection", "robotic liver surgery", "robotic hepatobiliary surgery", and "robotic biliary reconstruction". We selected articles with high volume case series or case controlled series. As a result of our literature search we will focus on the 9 major articles on robotic liver resection (RLR) with 235 patients undergoing RLR for a total of 244 liver resections. In addition a brief update on robotic biliary reconstruction will also be presented based on the above articles and recent review articles. Indications for robotic liver resection included both benign (N.=72, 29.5%) and malignant disease (N.=172, 70.5%). The most common indication was colorectal liver metastasis (N.=87, 50.6%) and hepatocellular carcinoma (N.=57, 33%). The most common type of resection was subsegmental (N.=55, 22.5%), with a significant number of major hepatectomies (N.=80, 32.8%). Overall conversion rate was 7.8%, with majority converted to open (N.=18) and one converted to hand assisted. The overall complication rate was 11.8% (N.=29). No perioperative mortality was reported. Preliminary results show that robotic assisted laparoscopic hepatobiliary surgery has materialized as a new technique that combines the advantages of laparoscopy with the dissection, suturing and articulation of robotics. This more closely approximates open surgery. The preliminary data demonstrates that RLR can be applied in major hepatobiliary centers safely. Future comparative studies are needed to determine if this is of significant benefit over current open techniques.

  9. 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.

  10. 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.

  11. The pattern of hepatobiliary complications among Egyptian sickle cell disease children

    Directory of Open Access Journals (Sweden)

    Dalia A. Saied

    2017-07-01

    Conclusion: Hepatobiliary complications are frequent among sickle cell disease children especially gallbladder diseases. Repeated clinical and ultrasound screening is needed for early detection and treatment of these complications.

  12. Hepatobiliary rhabdomyosarcoma in children: diagnostic radiology

    International Nuclear Information System (INIS)

    Roebuck, D.J.; Yang Weitse; Lam, W.W.M.; Stanley, P.

    1998-01-01

    Rhabdomyosarcoma (RMS) occurs infrequently in the liver and biliary tree. Although the radiological diagnosis may be simple when the tumour involves the extrahepatic bile ducts, no specific imaging features are known for hepatic RMS. We present four cases and discuss the role of diagnostic radiology in the management of this tumour. (orig.)

  13. 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.)

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

    Science.gov (United States)

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

    2011-09-01

    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.

  15. 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.)

  16. 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...

  17. A single-chip 32-channel analog beamformer with 4-ns delay resolution and 768-ns maximum delay range for ultrasound medical imaging with a linear array transducer.

    Science.gov (United States)

    Um, Ji-Yong; Kim, Yoon-Jee; Cho, Seong-Eun; Chae, Min-Kyun; Kim, Byungsub; Sim, Jae-Yoon; Park, Hong-June

    2015-02-01

    A single-chip 32-channel analog beamformer is proposed. It achieves a delay resolution of 4 ns and a maximum delay range of 768 ns. It has a focal-point based architecture, which consists of 7 sub-analog beamformers (sub-ABF). Each sub-ABF performs a RX focusing operation for a single focal point. Seven sub-ABFs perform a time-interleaving operation to achieve the maximum delay range of 768 ns. Phase interpolators are used in sub-ABFs to generate sampling clocks with the delay resolution of 4 ns from a low frequency system clock of 5 MHz. Each sub-ABF samples 32 echo signals at different times into sampling capacitors, which work as analog memory cells. The sampled 32 echo signals of each sub-ABF are originated from one target focal point at one instance. They are summed at one instance in a sub-ABF to perform the RX focusing for the target focal point. The proposed ABF chip has been fabricated in a 0.13- μ m CMOS process with an active area of 16 mm (2). The total power consumption is 287 mW. In measurement, the digital echo signals from a commercial ultrasound medical imaging machine were applied to the fabricated chip through commercial DAC chips. Due to the speed limitation of the DAC chips, the delay resolution was relaxed to 10 ns for the real-time measurement. A linear array transducer with no steering operation is used in this work.

  18. Added value products for imaging remote sensing by processing actual GNSS reflectometry delay doppler maps

    Science.gov (United States)

    Schiavulli, Domenico; Frappart, Frédéric; Ramilien, Guillaume; Darrozes, José; Nunziata, Ferdinando; Migliaccio, Maurizio

    2016-04-01

    Global Navigation Satellite System Reflectometry (GNSS-R) is an innovative and promising tool for remote sensing. It is based on the exploitation of GNSS signals reflected off Earth's surface as signals of opportunity to infer geophysical information of the reflecting surface. The main advantages of GNSS-R with respect dedicated sensors are: the unprecedented spatial-temporal coverage due to the availability of a great amount of transmitting satellite, e.g. GPS, Galileo, Glonass, etc…, long term GNSS mission life and cost effectiveness. In fact only a simple receiver is needed. In the last years several works demonstrated the meaningful of this technique in several Earth Observation applications. All these applications presented results obtained by using a receiver mounted on an aircraft or on a fixed platform. Moreover, space borne missions have been launched or are planned: UK-DMC, TechDemoSat-1 (TDS-1), NASA CYGNSS, Geros ISS. Practically, GNSS-R can be seen as a bistatic radar system where the GNSS satellites continuously transmit the L-band all-weather night-and-day signals that are reflected off a surface, called Glistening Zone (GZ), and a receiver measures the scattered microwave signals in terms of Delay-Doppler maps (DDMs) or delay waveforms. These two products have been widely studied in the literature to extract compact parameters for different remote sensing applications. However, products measured in the Delay Doppler (DD) domain are not able to provide any spatial information of the scattering scene. This could represent a drawback for applications related to imaging remote sensing, e.g. target detection, sea/land and sea/ice transition, oil spill detection, etc…. To overcome these limitations some deconvolution techniques have been proposed in the state of the art aiming at the reconstruction of a radar image of the observed scene by processing the measured DDMs. These techniques have been tested on DDMs related to simulated marine scenario

  19. Management of subcentimetre arterially enhancing and hepatobiliary hypointense lesions on gadoxetic acid-enhanced MRI in patients at risk for HCC.

    Science.gov (United States)

    Park, Chae Jung; An, Chansik; Park, Sumi; Choi, Jin-Young; Kim, Myeong-Jin

    2018-04-01

    To investigate the significance of subcentimetre (≤1 cm) arterially enhancing and hepatobiliary hypointense lesions (SAELs) observed on gadoxetic acid-enhanced magnetic resonance imaging (MRI) of patients at risk of hepatocellular carcinoma (HCC). A SAEL was defined as a subcentimetre hypervascular nodule exhibiting a hepatobiliary phase defect on gadoxetic acid-enhanced MRI. We included 52 SAELs from 46 patients in a HCC surveillance population. The HCC reference standard was pathologic confirmation or a nodule >1 cm with typical imaging features of HCC at follow-up imaging. The malignancy rate and HCC-favourable imaging findings of SAELs were evaluated. The malignancy rate among SAELs was 57.7% (30/52). At diagnosis, all SAELs that progressed to overt HCC were treatable with curative intention. Venous or late dynamic phase washout was more frequently observed with malignant SAELs than with benign SAELs (57.7% vs. 30.6%; P = 0.01). If SAELs exhibiting washout were considered as HCC, sensitivity, specificity, and positive predictive value was 83.3%, 50%, and 69.4%, respectively. Among patients at risk of HCC, SAELs on gadoxetic acid-enhanced MRI exhibited high malignant potential. However, close observation may be an appropriate strategy for isolated SAELs. A washout appearance may be helpful for predicting malignancy. • Gadoxetic acid-enhanced MRI provides hepatobiliary phase (HBP) images. • Screening frequently detects subcentimetre arterially enhancing and hepatobiliary hypointense lesions (SAELs). • A majority of SAELs progressed to overt HCC within 2 years. • A venous-phase washout appearance correlated significantly with malignancy in SAELs.

  20. Delayed Ejaculation

    Science.gov (United States)

    ... the penis Psychological causes of delayed ejaculation include: Depression, anxiety or other mental health conditions Relationship problems due to stress, poor communication or other concerns Anxiety about performance Poor body image Cultural or religious taboos Differences between the reality ...

  1. Assessment of Future Remnant Liver Function Using Hepatobiliary Scintigraphy in Patients Undergoing Major Liver Resection

    NARCIS (Netherlands)

    de Graaf, W.; van Lienden, K.P.; Dinant, S.; Roelofs, J.J.T.H.; Busch, O.R.C.; Gouma, D.J.; Bennink, R.J.; van Gulik, T.M.

    2010-01-01

    Tc-99m-mebrofenin hepatobiliary scintigraphy (HBS) was used as a quantitative method to evaluate liver function. The aim of this study was to compare future remnant liver function assessed by Tc-99m-mebrofenin hepatobiliary scintigraphy with future remnant liver volume in the prediction of liver

  2. 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.

  3. Direct imaging of delayed magneto-dynamic modes induced by surface acoustic waves.

    Science.gov (United States)

    Foerster, Michael; Macià, Ferran; Statuto, Nahuel; Finizio, Simone; Hernández-Mínguez, Alberto; Lendínez, Sergi; Santos, Paulo V; Fontcuberta, Josep; Hernàndez, Joan Manel; Kläui, Mathias; Aballe, Lucia

    2017-09-01

    The magnetoelastic effect-the change of magnetic properties caused by the elastic deformation of a magnetic material-has been proposed as an alternative approach to magnetic fields for the low-power control of magnetization states of nanoelements since it avoids charge currents, which entail ohmic losses. Here, we have studied the effect of dynamic strain accompanying a surface acoustic wave on magnetic nanostructures in thermal equilibrium. We have developed an experimental technique based on stroboscopic X-ray microscopy that provides a pathway to the quantitative study of strain waves and magnetization at the nanoscale. We have simultaneously imaged the evolution of both strain and magnetization dynamics of nanostructures at the picosecond time scale and found that magnetization modes have a delayed response to the strain modes, adjustable by the magnetic domain configuration. Our results provide fundamental insight into magnetoelastic coupling in nanostructures and have implications for the design of strain-controlled magnetostrictive nano-devices.Understanding the effects of local dynamic strain on magnetization may help the development of magnetic devices. Foerster et al. demonstrate stroboscopic imaging that allows the observation of both strain and magnetization dynamics in nickel when surface acoustic waves are driven in the substrate.

  4. 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)

  5. Analysis of serum corticosteroid-induced alkaline phosphatase isoenzyme in dogs with hepatobiliary diseases.

    Science.gov (United States)

    Kojima, K; Ohno, K; Kanemoto, H; Goto-Koshino, Y; Fukushima, K; Tsujimoto, H

    2017-05-01

    To reveal the relationship between canine corticosteroid-induced alkaline phosphatase isoenzyme activity and hepatobiliary diseases. Retrospective analysis of the relationship between serum corticosteroid-induced alkaline phosphatase activity and diagnosis, serum cortisol concentration and alanine transferase activity in dogs with hepatobiliary diseases. Dogs with a history of glucocorticoid administration were excluded. Seventy-two dogs with hepatobiliary diseases were analysed. The serum corticosteroid-induced alkaline phosphatase concentration was increased in dogs with hepatobiliary diseases. There was no correlation between serum cortisol concentration and serum corticosteroid-induced alkaline phosphatase percentage or activity. Dogs with hepatobiliary disease can exhibit high serum alkaline phosphatase activity even if the dogs have not been administrated glucocorticoids and the serum cortisol concentration is normal. © 2017 British Small Animal Veterinary Association.

  6. 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.

  7. Delayed enhancement imaging of myocardial viability: low-dose high-pitch CT versus MRI

    Energy Technology Data Exchange (ETDEWEB)

    Goetti, Robert; Feuchtner, Gudrun; Stolzmann, Paul; Donati, Olivio F.; Frauenfelder, Thomas; Leschka, Sebastian; Alkadhi, Hatem [University Hospital Zurich, Department of Radiology, Zurich (Switzerland); Wieser, Monika; Plass, Andre [University Hospital Zurich, Division of Cardiac and Vascular Surgery, Zurich (Switzerland)

    2011-10-15

    To evaluate the accuracy of high-pitch delayed enhancement (DE) CT for the assessment of myocardial viability with MRI as the reference standard. Twenty-four patients (mean age 66.9 {+-} 9.2 years) with coronary artery disease underwent DE imaging with 128-slice dual-source CT (prospective electrocardiography (ECG)-triggering) and MRI at 1.5 T. Two observers assessed DE transmurality per segment, and measured signal intensity (MRI) or attenuation (CT) in infarcted and healthy myocardium and noise in the left ventricular blood pool for calculating contrast-to-noise ratios (CNR). 75/408 (18.4%) segments in 18/24 patients (75.0%) showed DE in MRI, of which 28 segments in 10/24 (41.7%) patients were non-viable (scar tissue transmurality >50%). Sensitivity, specificity and accuracy of CT for diagnosis of non-viability were 60.7%, 96.8% and 94.4% per segment, and 90.0%, 92.9% and 91.7% per patient. CNR was significantly higher in MR (7.4 {+-} 3.0 vs. 4.6 {+-} 1.5; p = 0.018), and image noise significantly lower (11.6 {+-} 5.7 vs.15.0 {+-} 4.5; p = 0.019). Radiation dose of DECT was 0.89 {+-} 0.07 mSv. CTDE imaging in the high-pitch mode enables myocardial viability assessment at a low radiation dose and good accuracy compared with MR, although associated with a lower CNR and higher noise. (orig.)

  8. Clinical value of 4-hour delayed gadolinium-Enhanced 3D FLAIR MR Images in Acute Vestibular Neuritis.

    Science.gov (United States)

    Byun, Hayoung; Chung, Jae Ho; Lee, Seung Hwan; Park, Chul Won; Park, Dong Woo; Kim, Tae Yoon

    2018-01-13

    To investigate the clinical significance of 4-hour delayed-enhanced 3.0 Tesla three-dimensional (3D) fluid-attenuated inversion recovery (FLAIR) magnetic resonance (MR) imaging in acute vestibular neuritis. A prospective observational study. Twenty-nine vestibular neuritis patients were enrolled between January 2017 and June 2017. Vestibular function tests, comprising the caloric and video head impulse tests and vestibular-evoked myogenic potential measurements, were performed. Precontrast, 10-minute, and 4-hour delayed-enhanced 3D-FLAIR MR images using double-dose IV gadolinium were obtained. After laterality and extent of inner ear enhancement were defined, the patients were divided into groups based on the patterns of enhancement, and clinical parameters were analyzed according to the groups. Twenty patients (20 of 29, 69.0%) had obviously asymmetric enhancement of the affected inner ear structures on 4-hour delayed images, whereas only three patients (10.3%) had marked enhancement on 10-minute delayed images. The duration of spontaneous nystagmus (DurSN) was significantly longer in the patients with enhancement, especially with enhancement of the whole inner ear, including the vestibule and semicircular canals (P vestibular function tests did not reveal any significant associations with MR enhancement. Contrast enhancement of the vestibular nerve and inner ear structures can be identified on 4-hour delayed-enhanced 3T 3D-FLAIR MR images in acute vestibular neuritis. The extent of inner ear enhancement may be associated with the DurSN. IV. Laryngoscope, 2017. © 2018 The American Laryngological, Rhinological and Otological Society, Inc.

  9. Relative filling time delay based on CT perfusion source imaging: a simple method to predict outcome in acute ischemic stroke.

    Science.gov (United States)

    Cao, W; Campbell, B C V; Dong, Q; Davis, S M; Yan, B

    2014-09-01

    Collateral vessel status is strongly associated with clinical outcome in ischemic stroke but can be challenging to assess. The aim of this study was to develop a tomography perfusion source imaging-based assessment of collateral vessel status. Consecutive patients with ischemic stroke who received intravenous thrombolysis or intra-arterial reperfusion therapy after CTP were retrospectively analyzed. In those with middle cerebral artery or internal carotid artery occlusion, CT perfusion source imaging was used to identify the relative filling time delay between the normal MCA Sylvian branches and those in the affected hemisphere. Receiver operating characteristic analysis and logistic regression were used to assess the association of the relative filling time delay with the 24-hour Alberta Stroke Program Early CT Score based on noncontrast CT and the 90-day modified Rankin Scale score. There were 217 patients treated in 2009-2011 who had CTP data, of whom 60 had MCA or ICA occlusion and 55 had 90-day mRS data. The intraclass correlation coefficient for relative filling time delay was 0.95. Relative filling time delay was correlated with 24-hour ASPECTS (Spearman ρ=-0.674; Prelative filling time delay was associated with poor radiologic outcome (ASPECTS, 0-7) (area under the curve=0.79, Prelative filling time delay with poor outcome remained significant, independent of age, sex, and baseline National Institutes of Health Stroke Scale score. Relative filling time delay is a useful independent predictor of clinical outcome after ischemic stroke. © 2014 by American Journal of Neuroradiology.

  10. 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.)

  11. 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.)

  12. 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.)

  13. Quantification of myocardial delayed enhancement and wall thickness in hypertrophic cardiomyopathy: Multidetector computed tomography versus magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Zhao, Lei [Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Rd Beijing (China); Ma, Xiaohai, E-mail: maxi8238@gmail.com [Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Rd Beijing (China); Feuchtner, Gudrun Maria [Department of Radiology II, Innsbruck Medical University, Innsbruck (Austria); Zhang, Chen; Fan, Zhanming [Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Rd Beijing (China)

    2014-10-15

    Objectives: To evaluate the accuracy of multidetector computed tomography (MDCT) in assessing myocardial delayed enhancement and left ventricle wall thickness in hypertrophic cardiomyopathy (HCM) compared with cardiac magnetic resonance (CMR) as the reference standard. Materials and methods: Eighty consecutive patients (59 male; 53.2 ± 13.0 years) were examined with MDCT, followed by CMR 1 day later. Cardiac CT angiography and a delayed CT were performed. CMR was performed according to a standardized protocol. Left ventricle wall thickness and positions of myocardial delayed enhancement were identified in both CMR and CT images according to the American Heart Association left ventricle 17-segment model. Myocardial delayed enhancement was characterized as “dense” (areas with clear defined borders) or “diffuse” and then quantified using both techniques. Results: Left ventricle wall thickness determined by MDCT was significantly correlated with CMR (R = 0.88, P < 0.01). Compared with CMR, MDCT accurately diagnosed 74 of 78 (94.9%) patients and 1243 of 1326 (93.7%) segments. For dense myocardial delayed enhancement, MDCT significantly correlated with CMR (R = 0.88, P < 0.01) and slightly underestimated myocardial delayed enhancement (mean, −3.85%; lower and upper limits of agreement, −13.40% and 5.70%, respectively). Conclusions: MDCT provides reliable quantification of myocardial delayed enhancement and evaluation of left ventricle wall thickness and has a good correlation with CMR in patients with HCM when a comprehensive cardiac CT protocol is used and can be applied for intervention planning.

  14. 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

  15. 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

  16. Functional optoacoustic imaging of moving objects using microsecond-delay acquisition of multispectral three-dimensional tomographic data

    Science.gov (United States)

    Deán-Ben, Xosé Luís; Bay, Erwin; Razansky, Daniel

    2014-01-01

    The breakthrough capacity of optoacoustics for three-dimensional visualization of dynamic events in real time has been recently showcased. Yet, efficient spectral unmixing for functional imaging of entire volumetric regions is significantly challenged by motion artifacts in concurrent acquisitions at multiple wavelengths. Here, we introduce a method for simultaneous acquisition of multispectral volumetric datasets by introducing a microsecond-level delay between excitation laser pulses at different wavelengths. Robust performance is demonstrated by real-time volumetric visualization of functional blood parametrers in human vasculature with a handheld matrix array optoacoustic probe. This approach can avert image artifacts imposed by velocities greater than 2 m/s, thus, does not only facilitate imaging influenced by respiratory, cardiac or other intrinsic fast movements in living tissues, but can achieve artifact-free imaging in the presence of more significant motion, e.g. abrupt displacements during handheld-mode operation in a clinical environment. PMID:25073504

  17. The use of thermal infra-red imaging to detect delayed onset muscle soreness.

    Science.gov (United States)

    Al-Nakhli, Hani H; Petrofsky, Jerrold S; Laymon, Michael S; Berk, Lee S

    2012-01-22

    Delayed onset muscle soreness (DOMS), also known as exercise induced muscle damage (EIMD), is commonly experienced in individuals who have been physically inactive for prolonged periods of time, and begin with an unexpected bout of exercise, but can also occur in athletes who exercise beyond their normal limits of training. The symptoms associated with this painful phenomenon can range from slight muscle tenderness, to severe debilitating pain. The intensity of these symptoms and the related discomfort increases within the first 24 hours following the termination of the exercise, and peaks between 24 to 72 hours post exercise. For this reason, DOMS is one of the most common recurrent forms of sports injury that can affect an individual's performance, and become intimidating for many. For the last 3 decades, the DOMS phenomenon has gained a considerable amount of interest amongst researchers and specialists in exercise physiology, sports, and rehabilitation fields. There has been a variety of published studies investigating this painful occurrence in regards to its underlying mechanisms, treatment interventions, and preventive strategies. However, it is evident from the literature that DOMS is not an easy pathology to quantify, as there is a wide amount of variability between the measurement tools and methods used to quantify this condition. It is obvious that no agreement has been made on one best evaluation measure for DOMS, which makes it difficult to verify whether a specific intervention really helps in decreasing the symptoms associated with this type of soreness or not. Thus, DOMS can be seen as somewhat ambiguous, because many studies depend on measuring soreness using a visual analog scale (VAS), which is a subjective rather than an objective measure. Even though needle biopsies of the muscle, and blood levels of myofibre proteins might be considered a gold standard to some, large variations in some of these blood proteins have been documented, in addition

  18. Dual-phase 99mTc-sestamibi imaging: its utility in parathyroid hyperplasia and use of immediate/delayed image ratios to improve diagnosis of hyperparathyroidism.

    Science.gov (United States)

    Gordon, Leonie; Burkhalter, William; Mah, Eugene

    2002-12-01

    Dual-phase (99m)Tc-sestamibi (methoxyisobutylisonitrile [MIBI]) imaging is the technique of choice for hyperparathyroidism (HPT), especially for localizing parathyroid adenomas. Prior studies have shown its utility for detecting hyperplasia is equivocal, but we believe this is not true. We attempted to quantitate the region-of-interest counts per pixel between immediate images and delayed images (I/D ratio) and use this ratio to distinguish normal parathyroid versus hyperplasia versus adenoma. Anterior pinhole and upper thorax images with a low-energy, high-resolution collimator at 20 min and 2 h after (99m)Tc-MIBI injection were obtained on 54 subjects. The results were analyzed retrospectively as hyperplasia, adenoma, or normal parathyroid by the persistence of activity in 2 or more foci, a solitary focus, or no activity on the delayed images. These interpretations were compared with pathology when available. I/D ratios were computed for all scans, and mean ratios were calculated for each type of pathology (normal parathyroid, hyperplasia, and adenoma). The resulting ratios were analyzed with a t test to determine significant differences between the ratios. Sensitivity and specificity were 96% and 88%, respectively, for parathyroid hyperplasia. Mean I/D ratios were 2.26 +/- 0.68, 2.80 +/- 0.95, and 3.10 +/- 0.77 for subjects with hyperplasia, adenoma, and normal parathyroid, respectively (hyperplasia vs. normal, P = 0.020; adenoma vs. normal, P = 0.381; hyperplasia vs. adenoma, P = 0.033). Dual-phase (99m)Tc-MIBI imaging is more sensitive and specific for parathyroid hyperplasia than reported previously, supporting its use to localize hyperplastic glands preoperatively and to help guide resection. A thyroid ratio between immediate and delayed images will aid in distinguishing hyperplasia from normal parathyroid in uncertain cases.

  19. The role of hepatobiliary scintigraphy and oral cholecystography in predicting the performance of laparoscopic cholecystectomy

    Energy Technology Data Exchange (ETDEWEB)

    Won, Kyoung Sook [Kangnung Hospital, Kangnung (Korea, Republic of); Ryu, Jin Sook; Moon, Dae Hyuk [College of Medicine, Ulsan Univ., Seoul (Korea, Republic of)] [and others

    1997-03-01

    Laparoscopic cholecystectomy can be performed safely in most patients with symptomatic cholelithiasis. Preoperative evaluation should assess the potential problems that affect the performance of laparoscopic cholecystectomy. Hepatobiliary scintigraphy or oral cholecystography can assess the gallbladder function and nonvisualization of gallbladder usually indicates acute or severe chronic cholecystitis. The purpose of this study was to evaluate the role of preoperative hepatobiliary scintigraphy or oral cholecystography in predicting the performance of laparoscopic cholecystectomy. The study group consists of 176 patients who underwent both hepatobiliary scintigraphy with Tc-99m DISIDA and oral choelcystography within one month before laparoscopic cholecystectomy. Nonvisualization of gallbladder was defined as persistent nonvisualization of gallbladder until 4 hours on hepatobiliary scintigraphy or 12 hours on oral cholecystography. Among 176 patients, gallbladder was not visualized in 38 patients on hepatobiliary scintigraphy and 41 patients on oral cholecystography. Concordance rate between hepatobiliary scintigraphy and oral cholecystography was 89.2%. The conversion rate to open cholocystectomy was significantly higher in patients with nonvisualization of gallbladder than in patients with gallbladder higher in patients with nonvisualization of gallbladder visualization (15.8% vs 2.9% on hepatobiliary scintigraphy, 12.2% vs 3.7% on oral cholecystography: p<0.01 and p<0.05 respectively). The operative complication rate was also significantly higher in patients with nonvisualization of gallbladder (13.2% vs 2.9% on hepatobiliary scintigraphy, 14.6% vs 2.2% on oral cholecystography : p<0.01 and p<0.001, respectively). Similarly, operation time was significantly prolonged in patients with nonvisualization of gallbladder (88.8{+-}41.9 min vs 62.5{+-}23.6 min on hepatobiliary scintigraphy : p<0.001, 89.4{+-}41.3 min vs 61.8{+-}22.8 min on oral cholecystography :p<0

  20. 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.)

  1. 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.)

  2. 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

  3. 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

  4. 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

  5. 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

  6. The Impact of New Technologic and Molecular Advances in the Daily Practice of Gastrointestinal and Hepatobiliary Pathology.

    Science.gov (United States)

    Xue, Yue; Farris, Alton Brad; Quigley, Brian; Krasinskas, Alyssa

    2017-04-01

    The practice of anatomic pathology, and of gastrointestinal pathology in particular, has been dramatically transformed in the past decade. In addition to the multitude of diseases, syndromes, and clinical entities encountered in daily clinical practice, the increasing integration of new technologic and molecular advances into the field of gastroenterology is occurring at a fast pace. Application of these advances has challenged pathologists to correlate newer methodologies with existing morphologic criteria, which in many instances still provide the gold standard for diagnosis. This review describes the impact of new technologic and molecular advances on the daily practice of gastrointestinal and hepatobiliary pathology. We discuss new drugs that can affect the gastrointestinal tract and liver, new endoluminal techniques, new molecular tests that are often performed reflexively, new imaging techniques for evaluating hepatocellular carcinoma, and modified approaches to the gross and histologic assessment of tissues that have been exposed to neoadjuvant therapies.

  7. Ghost reduction in echo-planar imaging by joint reconstruction of images and line-to-line delays and phase errors.

    Science.gov (United States)

    Ianni, Julianna D; Welch, E Brian; Grissom, William A

    2017-10-16

    To correct line-to-line delays and phase errors in echo-planar imaging (EPI). EPI-trajectory auto-corrected image reconstruction (EPI-TrACR) is an iterative maximum-likelihood technique that exploits data redundancy provided by multiple receive coils between nearby lines of k-space to determine and correct line-to-line trajectory delays and phase errors that cause ghosting artifacts. EPI-TrACR was efficiently implemented using a segmented FFT and was applied to in vivo brain data acquired at 7 T across acceleration (1×-4×) and multishot factors (1-4 shots), and in a time series. EPI-TrACR reduced ghosting across all acceleration factors and multishot factors, compared to conventional calibrated reconstructions and the PAGE method. It also achieved consistently lower ghosting in the time series. Averaged over all cases, EPI-TrACR reduced root-mean-square ghosted signal outside the brain by 27% compared to calibrated reconstruction, and by 40% compared to PAGE. EPI-TrACR automatically corrects line-to-line delays and phase errors in multishot, accelerated, and dynamic EPI. While the method benefits from additional calibration data for initialization, it was not a requirement for most reconstructions. Magn Reson Med, 2017. © 2017 International Society for Magnetic Resonance in Medicine. © 2017 International Society for Magnetic Resonance in Medicine.

  8. Surgical outcomes for 131 cases of carcinosarcoma of the hepatobiliary tract.

    Science.gov (United States)

    Okabayashi, Takehiro; Shima, Yasuo; Iwata, Jun; Iiyama, Tatsuo; Sumiyoshi, Tatsuaki; Kozuki, Akihito; Tokumaru, Teppei; Hata, Yasuhiro; Noda, Yoshihiro; Morita, Masanori

    2014-06-01

    Carcinosarcoma of the hepatobiliary tract is highly aggressive and has a poor prognosis even after curative resection. The purpose of this study was to collate and analyze published data to clarify the surgical outcome of carcinosarcoma of the hepatobiliary tract and the relationships between potential prognostic factors and survival after surgery. We surveyed worldwide literature from 1970 to 2012 and obtained clinicopathological data for 131 patients who had undergone surgical resection for carcinosarcoma of the hepatobiliary tract, including one patient from our clinic. The relationships between potential prognostic factors and survival rates were examined using the Kaplan-Meier method and the log-rank test. The overall 1-, 3-, and 5-year survival rates for patients with carcinosarcoma of the hepatobiliary tract after surgery were 44.0, 29.3, and 27.0 %, respectively. In univariate analyses, age and gender were not significant prognostic factors; however, advanced stage according to the classification of the Union for International Cancer Control in resected specimens was significantly associated with a shorter survival time after surgery. Although carcinosarcoma of the hepatobiliary tract remains a rare disease worldwide, its poor prognosis, even after curative resection, demands further epidemiological and pathological study that could lead to the development of new management strategies.

  9. Thallium reinjection after stress-redistribution imaging. Does 24-hour delayed imaging after reinjection enhance detection of viable myocardium

    International Nuclear Information System (INIS)

    Dilsizian, V.; Smeltzer, W.R.; Freedman, N.M.; Dextras, R.; Bonow, R.O.

    1991-01-01

    Thallium reinjection immediately after conventional stress-redistribution imaging improves the detection of viable myocardium, as many myocardial regions with apparently 'irreversible' thallium defects on standard 3-4-hour redistribution images manifest enhanced thallium uptake after reinjection. Because the 10-minute period between reinjection and imaging may be too short, the present study was designed to determine whether 24-hour imaging after thallium reinjection provides additional information regarding myocardial viability beyond that obtained by imaging shortly after reinjection. We studied 50 patients with chronic stable coronary artery disease undergoing exercise thallium tomography, radionuclide angiography, and coronary arteriography. Immediately after the 3-4-hour redistribution images were obtained, 1 mCi thallium was injected at rest, and images were reacquired at 10 minutes and 24 hours after reinjection. The stress, redistribution, reinjection, and 24-hour images were then analyzed qualitatively and quantitatively. Of the 127 abnormal myocardial regions on the stress images, 55 had persistent defects on redistribution images by qualitative analysis, of which 25 (45%) demonstrated improved thallium uptake after reinjection. At the 24-hour study, 23 of the 25 regions (92%) with previously improved thallium uptake by reinjection showed no further improvement. Similarly, of the 30 regions determined to have irreversible defects after reinjection, 29 (97%) remained irreversible on 24-hour images. These findings were confirmed by the quantitative analysis. The mean normalized thallium activity in regions with enhanced thallium activity after reinjection increased from 57 +/- 13% on redistribution studies to 70 +/- 14% after reinjection but did not change at 24 hours (71 +/- 14%)

  10. 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

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

    Energy Technology Data Exchange (ETDEWEB)

    Chapman, Christopher H., E-mail: chchap@umich.edu [Department of Radiation Oncology, University of Michigan Medical School, Ann Arbor, MI (United States); Nagesh, Vijaya [Department of Radiation Oncology, University of Michigan Medical School, Ann Arbor, MI (United States); Sundgren, Pia C. [Department of Radiology, University of Michigan Medical School, Ann Arbor, MI (United States); Department of Radiology, Skane University Hospital, Lund (Sweden); Buchtel, Henry [Department of Psychiatry, University of Michigan Medical School, Ann Arbor, MI (United States); Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI (United States); Chenevert, Thomas L. [Department of Radiology, University of Michigan Medical School, Ann Arbor, MI (United States); Junck, Larry [Department of Neurology, University of Michigan Medical School, Ann Arbor, MI (United States); Lawrence, Theodore S.; Tsien, Christina I. [Department of Radiation Oncology, University of Michigan Medical School, Ann Arbor, MI (United States); Cao, Yue [Department of Radiation Oncology, University of Michigan Medical School, Ann Arbor, MI (United States); Department of Radiology, University of Michigan Medical School, Ann Arbor, MI (United States)

    2012-04-01

    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 ({lambda}{sub Double-Vertical-Line }) decreased and perpendicular diffusivity ({lambda}{sub Up-Tack }) increased after RT, with early changes correlating to later changes (p < .05). The radiation dose correlated with an increase in cingulum {lambda}{sub Up-Tack} at 3 weeks, and patients with >50% of cingula volume receiving >12 Gy had a greater increase in {lambda}{sub Up-Tack} at 3 and 6 weeks (p < .05). The post-RT changes in verbal recall scores correlated linearly with the late changes in cingulum {lambda}{sub Double-Vertical-Line} (30 weeks, p < .02). Using receiver operating characteristic curves, early cingulum {lambda}{sub Double-Vertical-Line} 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.

  12. 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).

  13. 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.

  14. [The biochemical markers of hepatobiliary function in children under environmental pollution].

    Science.gov (United States)

    Lukach, M V; Hnateĭko, O Z; Kosmynina, N S

    2014-01-01

    It has been carred out an analysis of biochemical parameters of the hepatobiliary system in 119 children who have been living in ecologically unfavourable districts in order to improve early diagnosis of environmentally triggered hepatobiliary disease. Our results found that 57.2% of patients from polluted region had early signs of liver dysfunction the most frequently of which was elevation of biochemical markers of cholestasis. Among the investigated enzymes the high frequency of abnormal levels of gamma-glutamyltransferase (54.6%) alkaline phosphatase (36.1%), sorbitol dehydrogenase (28.6%) were detected in children from ecologically unfavorable districts which may indicate that these markers were helpful for the early diagnosis of environmentally triggered hepatobiliary disease. It was revealed that almost every third child (41.1% examined children) from the ecologically unfavourable districts had decrease of liver detoxification enzyme activity (arginase).

  15. Clinical value of delayed thallium-201 myocardial imaging in suspected acute myocardial infarction.

    Science.gov (United States)

    McKillop, J H; Turner, J G; Gray, H W; Bessent, R G; Greig, W R

    1978-01-01

    Fifty patients with acute chest pain had thallium-201 myocardial imaging performed three to six days after emergency admission to hospital. The image was abnormal in 20 out of 22 patients with acute transmural myocardial infarcts but in only 1 of 5 with acute subendocardial infarcts. Indistinguishable scan abnormalities caused by old infarcts were seen in 7 patients, and caused by myocardial ischaemia in 1 patient. A single thallium-201 myocardial scan some days after the onset of symptoms appears to be of little value in the clinical assessment of patients with suspected acute myocardial infarction. Images PMID:687488

  16. Hepatobiliary functional scintiscanning (HBFS) - a nuclear medical method for diagnosis of icteric diseases

    International Nuclear Information System (INIS)

    Weber, K.

    1979-01-01

    The results of 146 hepatobiliary functional scintiscannings were analysed and compared with those results obtained by means of laboratory and roentgenologic methods. In 115 cases the obtained results could be examined by the final diagnosis. The accuracy of the HBFS was 87%. In hepatobiliary functional scintiscanning the indications are the differential diagnoses between hepatic and post-hepatic icterus and between total and subtotal obstruction. This method can be applied for all patients whose bilirubin concentration of the blood does not exceed 15 mg%. It can be performed even with serious syndromes or heavy contrast media allergies, because any side effects are absent. (orig.) [de

  17. 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

  18. 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)

  19. Data on hepatobiliary examination by sup(99m)Tc dimethyl IDA

    International Nuclear Information System (INIS)

    Herry, J.Y.; Messner, M.; Le Jeune, J.J.; Moisan, A.

    1980-01-01

    Hepatobiliary elimination of sup(99m)Tc dimethyl IDA was studied by scintiphotographic detection in 16 normal subjects. Normal criterion were established. Scintiphotographic modifications due to the principal hepatobiliary disease were described. Abnormal scintiphotographic sequences can be described in terms of accumulative figures in the biliary tract, of deficit of hepatocytary collecting, of figures of hepatocytary retention of deficit of local fixation, of absence of gallbladder illumination. Examination by sup(99m)Tc dimethyl IDA is a precious help for diagnosis of icterus, of disease of the gallbladder. An interesting indication is control of biliarydigestive anastomosis [fr

  20. 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 ...

  1. 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 ...

  2. Delayed-onset adrenoleukodystrophy after cerebral contusion : progressive pattern of demyelination on serial MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Kwon Ha; Suh, Dae chul; Lee, Sang Ahm; Lee, Ho Kyu; Choi, Choong Gon; Yoo, Shi Joon [Ulsan Univ. College of Medicine, Seoul (Korea, Republic of)

    1996-08-01

    We described serial MR findings in a 20-year-old male with adrenoleuko-dystrophy who presented progressive neurologic deterioration after cerebral contusion. On MR imaging, progressive demyelination was predominant in the white matter of the right temporal lobe as well as tn the parietalobe at the site of prior trauma and exteded into the contralateral hemisphere through the anterior commissure.

  3. Experimental colitis in rats induces low-grade endotoxinemia without hepatobiliary abnormalities

    NARCIS (Netherlands)

    Brand, H. S.; Maas, M. A.; Bosma, A.; van Ketel, R. J.; Speelman, P.; Chamuleau, R. A.

    1994-01-01

    In three experimental models in rats, surgical construction of a self-filling blind loop (SFBL), trinitrobenzene sulfonic acid (TNB) -induced colitis, and the combination of SFBL and TNB, the hypothesis was studied that intestine-derived endotoxins play a role in the pathogenesis of hepatobiliary

  4. Subtle to severe hepatobiliary morbidity in Opisthorchis viverrini endemic settings in southern Laos.

    Science.gov (United States)

    Ayé Soukhathammavong, Phonepasong; Rajpho, Virasack; Phongluxa, Khampheng; Vonghachack, Youthanavanh; Hattendorf, Jan; Hongvanthong, Bouasy; Rasaphon, Oroth; Sripa, Banchob; Akkhavong, Kongsap; Hatz, Christoph; Odermatt, Peter

    2015-01-01

    Evidence of severe hepatobiliary morbidity associated with Opisthorchis viverrini liver fluke infection including cholangiocarcinoma (CCA) is scarce in Laos although O. viverrini infection is highly prevalent. We assessed hepatobiliary morbidity using abdominal ultrasonography (US) in O. viverrini adult patients in Saravan province, Southern Laos. A random sample of 431 O. viverrini patients from 10 villages underwent abdominal US. Mild, moderate and markedly advanced periductal fibrosis was diagnosed in 7.0%, 66.5%, and 17.0% of patients, respectively. Normal liver parenchyma was seen in only 9.5% of patients. Presence of gall stones (13.2%), sludge (1.4%), gall wall thickening (1.2%), bile duct dilatation (1.6%), fatty liver (12.0%), kidney stones (8.6%) and cysts (7.9%) were diagnosed in considerable frequencies. In five patients (1.2%) hepatobiliary lesions suggesting CCA were diagnosed. Tumour markers, i.e. Interleukin-6, plasminogen activator inhibitor and carbohydrate antigen 19-9 were within normal range. The number of CCA suspected liver masses and hepatobiliary morbidity diagnosed among clinically asymptomatic adult patients in O. viverrini endemic area presents a major public health concern in Laos. However, definitive diagnosis of Opisthorchis-related severe sequelae including CCA is urgently needed to gauge the burden of this deadly disease in Laos. Copyright © 2014 Elsevier B.V. All rights reserved.

  5. Robotics in hepatobiliary surgery-initial experience, first reported case series from India

    Directory of Open Access Journals (Sweden)

    S. Goja

    2017-01-01

    Conclusion: This initial series adds to existing data on the feasibility of robotic hepatobiliary cases with inherent advantages of minimal invasive surgery, however with limitation of availability and use of devices like cavitron ultrasonic surgical aspirator (CUSA and higher operative cost.

  6. Anatomy of the Murine Hepatobiliary System: A Whole-Organ-Level Analysis Using a Transparency Method.

    Science.gov (United States)

    Higashiyama, Hiroki; Sumitomo, Hiroyuki; Ozawa, Aisa; Igarashi, Hitomi; Tsunekawa, Naoki; Kurohmaru, Masamichi; Kanai, Yoshiakira

    2016-02-01

    The biliary tract is a well-branched ductal structure that exhibits great variation in morphology among vertebrates. Its function is maintained by complex constructions of blood vessels, nerves, and smooth muscles, the so-called hepatobiliary system. Although the mouse (Mus musculus) has been used as a model organism for humans, the morphology of its hepatobiliary system has not been well documented at the topographical level, mostly because of its small size and complexity. To reconcile this, we conducted whole-mount anatomical descriptions of the murine extrahepatic biliary tracts with related blood vessels, nerves, and smooth muscles using a recently developed transparentizing method, CUBIC. Several major differences from humans were found in mice: (1) among the biliary arteries, the arteria gastrica sinistra accessoria was commonly found, which rarely appears in humans; (2) the sphincter muscle in the choledochoduodenal junction is unseparated from the duodenal muscle; (3) the pancreatic duct opens to the bile duct without any sphincter muscles because of its distance from the duodenum. This state is identical to a human congenital malformation, an anomalous arrangement of pancreaticobiliary ducts. However, other parts of the murine hepatobiliary system (such as the branching patterns of the biliary tract, blood vessels, and nerves) presented the same patterns as humans and other mammals topologically. Thus, the mouse is useful as an experimental model for studying the human hepatobiliary system. © 2015 Wiley Periodicals, Inc.

  7. The effect of preoperative biliary drainage on infectious complications after hepatobiliary resection with cholangiojejunostomy.

    Science.gov (United States)

    Sugawara, Gen; Ebata, Tomoki; Yokoyama, Yukihiro; Igami, Tsuyoshi; Takahashi, Yu; Takara, Daisuke; Nagino, Masato

    2013-02-01

    Arguments against biliary drainage before pancreatoduodenectomy have been gaining momentum recently. The benefits of biliary drainage before hepatobiliary resection, ie, combined liver and extrahepatic bile duct resection, however, are still debatable. To review the outcomes of patients who underwent hepatobiliary resection, with special attention to preoperative biliary drainage, to investigate whether biliary drainage increases the risk of postoperative infectious complications. This study involved 587 patients who underwent hepatobiliary resection with cholangiojejunostomy, including 475 patients who underwent preoperative biliary drainage and 112 patients who did not. Before each operation, surveillance bile cultures were performed at least once a week. Postoperatively, the bile and drainage fluid were cultured on days 1, 4, and 7. The hospital records of consecutive patients who underwent hepatobiliary resection were reviewed retrospectively. Of the 475 patients with biliary drainage, 356 (74.9%) had a positive bile culture during the preoperative period. The incidence of postoperative infectious complications, including surgical-site infection and bacteremia, was similar between patients with biliary drainage and those without (28.2% vs 28.6%, P = .939). A positive bile culture during the perioperative period was highly associated with infectious complications and was one of the independent predictive factors related to infectious complications in a multivariate analysis. Preoperative biliary drainage is unlikely to increase the incidence of infectious complications after hepatobiliary resection. Perioperative surveillance bile culture is useful for the perioperative selection of appropriate antibiotics because of the high likelihood that micro-organisms isolated from infected sites are identical to those isolated from bile. Copyright © 2013 Mosby, Inc. All rights reserved.

  8. 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

  9. 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

  10. 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...

  11. 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

  12. 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

    2018-02-19

    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

  13. Delayed clearance of cerebrospinal fluid tracer from entorhinal cortex in idiopathic normal pressure hydrocephalus: A glymphatic magnetic resonance imaging study.

    Science.gov (United States)

    Eide, Per K; Ringstad, Geir

    2018-01-01

    The glymphatic system plays a key role for clearance of waste solutes from the rodent brain. We recently found evidence of glymphatic circulation in the human brain when using magnetic resonance imaging (MRI) contrast agent as cerebrospinal fluid (CSF) tracer in conjunction with multiple MRI acquisitions (gMRI). The present study explored the hypothesis that reduced glymphatic clearance in entorhinal cortex (ERC) may be instrumental in idiopathic normal pressure hydrocephalus (iNPH) dementia. gMRI acquisitions were obtained over a 24-48 h time span in cognitively affected iNPH patients and non-cognitively affected patients with suspected CSF leaks. The CSF tracer enrichment was determined as changes in normalized MRI T1 signal units. The study included 30 patients with iNPH and 8 individuals with suspected CSF leaks (i.e. reference individuals). Compared to reference individuals, iNPH patients presented with higher medial temporal lobe atrophy score and Evan's index and inferior ERC thickness. We found delayed clearance of the intrathecal CSF tracer gadobutrol from CSF, the ERC and adjacent white matter, suggesting impaired glymphatic circulation. Reduced clearance and accumulation of toxic waste product such as amyloid-β may be a mechanism behind dementia in iNPH. Glymphatic MRI (gMRI) may become a tool for assessment of early dementia.

  14. Referencing techniques for high-speed confocal fluorescence lifetime imaging microscopy (FLIM) based on analog mean-delay (AMD) method

    Science.gov (United States)

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

    2017-02-01

    Analog mean-delay (AMD) method is a new powerful alternative method in determining the lifetime of a fluorescence molecule for high-speed confocal fluorescence lifetime imaging microscopy (FLIM). Even though the photon economy and the lifetime precision of the AMD method are proven to be as good as the state-of-the-art time-correlated single photon counting (TC-SPC) method, there have been some speculations and concerns about the accuracy of this method. In the AMD method, the temporal waveform of an emitted fluorescence signal is directly recorded with a slow digitizer whose bandwidth is much lower than the temporal resolution of lifetime to be measured. We found that the drifts and the fluctuations of the absolute zero position in a measured temporal waveform are the major problems in the AMD method. As a referencing technique, we already proposed dual-channel waveform measurement scheme that may suppress these errors. In this study, we have demonstrated real-time confocal AMD-FLIM system with dual-channel waveform measurement technique.

  15. 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.)

  16. 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.

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

    International Nuclear Information System (INIS)

    Hirobe, Seiichi; Ishida, Haruo; Hayashi, Akira; Kamagata, Shoichiro; Fuchimoto, Yasufumi; Mizuno, Dai; Yano, Tsunehiro; Ishii, Katsumi.

    1995-01-01

    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 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)

  18. Hepatobiliary scanning with 99mTc-PIPIDA in acute cholecystitis

    Energy Technology Data Exchange (ETDEWEB)

    Mauro, M.A.; McCartney, W.H.; Melmed, J.R.

    1982-01-01

    Ninety-five patients with clinically suspected acute cholecystitis underwent hepatobiliary scanning with 99mTc-PIPIDA. A positive scan (nonvisualization of the gallbladder with visualization of the common bile duct and gut) was found in 29 patients; 25 of them (86%) had surgically proven acute cholecystitis and 4 (14%) had chronic cholecystitis. Five of the 25 with acute cholecystitis had acalculous disease. A negative examination (gallbladder visualization) occurred in 63 patients; 18 (29%) had chronic cholecystitis and 45 (71%) were subsequently found to have nonbiliary disease. Three indeterminate studies (nonvisualization of both the gallbladder and gut) were obtained in patients with choledocholithiasis and chronic cholecystitis. In the evaluation of acute cholecystitis, the 99mTc-PIPIDA hepatobiliary scan was 100% sensitive and 94% specific.

  19. Hepatobiliary scanning with /sup 99//sup m/Tc-PIPIDA in acute cholecystitis

    Energy Technology Data Exchange (ETDEWEB)

    Mauro, M.A.; McCartney, W.H.; Melmed, J.R.

    1982-01-01

    Ninety-five patients with clinically suspected acute cholecystitis underwent hepatobiliary scanning with /sup 99//sup m/Tc-PIPIDA. A positive scan (nonvisualization of the gallbladder with visualization of the common bile duct and gut) was found in 29 patients; 25 of them (86%) had surgically proven acute cholecystitis and 4(14%) had chronic cholecystitis. Five of the 25 with acute cholecystitis had acalculous disease. A negative examination (gallbladder visualization) occurred in 63 patients; 18 (29%) had chronic cholecystitis and 45 (71%) were subsequently found to have nonbiliary disease. Three indeterminate studies (nonvisualization of both the gallbladder and gut) were obtained in patients with choledocholithiasis and chronic cholecystitis. In the evaluation of acute cholecystitis, the /sup 99//sup m/Tc-PIPIDA hepatobiliary scan was 100% sensitive and 94% specific.

  20. 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).

  1. COSMOGRAIL: the COSmological MOnitoring of GRAvItational Lenses. XVI. Time delays for the quadruply imaged quasar DES J0408-5354 with high-cadence photometric monitoring

    Science.gov (United States)

    Courbin, F.; Bonvin, V.; Buckley-Geer, E.; Fassnacht, C. D.; Frieman, J.; Lin, H.; Marshall, P. J.; Suyu, S. H.; Treu, T.; Anguita, T.; Motta, V.; Meylan, G.; Paic, E.; Tewes, M.; Agnello, A.; Chao, D. C.-Y.; Chijani, M.; Gilman, D.; Rojas, K.; Williams, P.; Hempel, A.; Kim, S.; Lachaume, R.; Rabus, M.; Abbott, T. M. C.; Allam, S.; Annis, J.; Banerji, M.; Bechtol, K.; Benoit-Lévy, A.; Brooks, D.; Burke, D. L.; Carnero Rosell, A.; Carrasco Kind, M.; Carretero, J.; D'Andrea, C. B.; da Costa, L. N.; Davis, C.; DePoy, D. L.; Desai, S.; Flaugher, B.; Fosalba, P.; García-Bellido, J.; Gaztanaga, E.; Goldstein, D. A.; Gruen, D.; Gruendl, R. A.; Gschwend, J.; Gutierrez, G.; Honscheid, K.; James, D. J.; Kuehn, K.; Kuhlmann, S.; Kuropatkin, N.; Lahav, O.; Lima, M.; Maia, M. A. G.; March, M.; Marshall, J. L.; McMahon, R. G.; Menanteau, F.; Miquel, R.; Nord, B.; Plazas, A. A.; Sanchez, E.; Scarpine, V.; Schindler, R.; Schubnell, M.; Sevilla-Noarbe, I.; Smith, M.; Soares-Santos, M.; Sobreira, F.; Suchyta, E.; Tarle, G.; Tucker, D. L.; Walker, A. R.; Wester, W.

    2018-01-01

    We present time-delay measurements for the new quadruple imaged quasar DES J0408-5354, the first quadruple imaged quasar found in the Dark Energy Survey (DES). Our result is made possible by implementing a new observational strategy using almost daily observations with the MPIA 2.2 m telescope at La Silla observatory and deep exposures reaching a signal-to-noise ratio of about 1000 per quasar image. This data qualityallows us to catch small photometric variations (a few mmag rms) of the quasar, acting on temporal scales much shorter than microlensing, and hence making the time delay measurement very robust against microlensing. In only seven months we very accurately measured one of the time delays in DES J0408-5354: Δt(AB) = -112.1 ± 2.1 days (1.8%) using only the MPIA 2.2 m data. In combination with data taken with the 1.2 m Euler Swiss telescope, we also measured two delays involving the D component of the system Δt(AD) = -155.5 ± 12.8 days (8.2%) and Δt(BD) = -42.4 ± 17.6 days (41%), where all the error bars include systematics. Turning these time delays into cosmological constraints will require deep Hubble Space Telescope (HST) imaging or ground-based adaptive optics (AO), and information on the velocity field of the lensing galaxy. Lightcurves are only available at the CDS via anonymous ftp to http://cdsarc.u-strasbg.fr (http://130.79.128.5) or via http://cdsarc.u-strasbg.fr/viz-bin/qcat?J/A+A/609/A71

  2. 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.

  3. 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.

  4. Paediatric ultrasonography of the liver, hepatobiliary tract and pancreas

    NARCIS (Netherlands)

    van Rijn, R. R.; Nievelstein, R. A. J.

    2014-01-01

    In the field of paediatric radiology ultrasonography (US) is the most versatile imaging tool available. Children in general, by virtue of their body composition, are excellent candidates for US exams in whom abdominal anatomy and pathology can be visualised in great detail. The fact that during the

  5. Paediatric ultrasonography of the liver, hepatobiliary tract and pancreas.

    Science.gov (United States)

    van Rijn, R R; Nievelstein, R A J

    2014-09-01

    In the field of paediatric radiology ultrasonography (US) is the most versatile imaging tool available. Children in general, by virtue of their body composition, are excellent candidates for US exams in whom abdominal anatomy and pathology can be visualised in great detail. The fact that during the US study a clinical history can be obtained strongly adds to the value of the US exam. This does require investment in time and expertise and ideally a paediatric radiologist performing the exam. In this review the role of ultrasonography (US) of the liver, biliary tract and pancreas in children is discussed. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  6. Paediatric ultrasonography of the liver, hepatobiliary tract and pancreas

    Energy Technology Data Exchange (ETDEWEB)

    Rijn, R.R. van, E-mail: r.r.vanrijn@amc.uva.nl [Department of Radiology, Emma Children' s Hospital – Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam (Netherlands); Nievelstein, R.A.J. [Department of Radiology, Wilhelmina Children' s Hospital – University Medical Center, Heidelberglaan 100, 3584 CX Utrecht (Netherlands)

    2014-09-15

    In the field of paediatric radiology ultrasonography (US) is the most versatile imaging tool available. Children in general, by virtue of their body composition, are excellent candidates for US exams in whom abdominal anatomy and pathology can be visualised in great detail. The fact that during the US study a clinical history can be obtained strongly adds to the value of the US exam. This does require investment in time and expertise and ideally a paediatric radiologist performing the exam. In this review the role of ultrasonography (US) of the liver, biliary tract and pancreas in children is discussed.

  7. Clinical analysis of 22 patients with hepatobiliary disease caused by liver fluke

    Directory of Open Access Journals (Sweden)

    ZHANG Hui

    2013-07-01

    Full Text Available ObjectiveTo clinically analyze the hepatobiliary disease caused by the liver fluke and to increase the knowledge of this disease and reduce misdiagnosis. MethodsA retrospective analysis was performed on the clinical data of 22 patients who had a confirmed diagnosis of clonorchiasis after being admitted to our hospital due to hepatobiliary disease over the past 20 years. ResultsOf the 22 patients, who had a mean age of 45.41 years, 19 were males, and 3 were females. When admitted to the hospital, 8 cases were diagnosed with cholecystitis or gallstones, 7 cases with clonorchiasis, and 7 cases with other diseases. Alanine aminotransferase elevation was found in 14 cases (6363%, aspartate aminotransferase elevation in 16 cases (72.72%, total bilirubin elevation in 11 cases (5000%, gamma-glutamyl transpeptidase elevation in 17 cases (77.27%, and increased eosinophils in 14 cases (63.63%. Ten cases (45.45% were diagnosed by fecal examination, 7 cases (31.82% by bile smears, 2 cases (9.09% by liver fluke antibody detection, and 3 cases (1364% according to the history of clonorchiasis. Deworming and comprehensive treatment produced a good outcome in these patients. ConclusionClonorchiasis is endemic and clinically rare, without specific clinical features, and it is easily confused with other hepatobiliary diseases, resulting in a high rate of misdiagnosis. Therefore, for the patients with abdominal pain, jaundice, and liver damage of unknown causes, we should inquire whether they or their family have a special dietary history and need to perform relevant examinations to confirm the diagnosis, so as to provide timely treatment.

  8. 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.

  9. Hepatobiliary scintigraphy in diagnosis and follow-up of biliary atresia; Stellenwert der hepatobiliaeren Funktionsszintigrafie in Diagnostik und Nachsorge der Gallengangsatresie

    Energy Technology Data Exchange (ETDEWEB)

    Rossmueller, B.; Knesewitsch, P.; Hahn, K. [Klinik und Poliklinik fuer Nuklearmedizin, Klinikum der Ludwig-Maximilians-Univ. Muenchen (Germany)

    2009-03-15

    In newborns with biliary atresia immediate diagnosis is crucial, as only early portoenterostomie (Kasai) may prevent development of an incurable liver cirrhosis. Hepatobiliary scintigraphy has a major role in diagnostic work up, in prognostic evaluation and in postoperativ follow up of biliary atresia. Indication, technical procedure and interpretation of hepatobiliary scintigraphy in children with suspicion of biliary atresia will be discussed. (orig.)

  10. 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

  11. 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

  12. Focal nodular hyperplasia. /sup 99m/Tc-EHIDA hepatobiliary scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Fujimori, Kenji; Saito, Hiroya; Itoh, Kazuo; Furudate, Masayori

    1987-09-01

    One case of focal nodular hyperplasia of the liver was reported. Time activity curves of the hepatobiliary scintigraphy were evaluated. The peak time, T1/2 in excretion phase and mean transit time of the FNH were longer than the normal liver and 13.8 min, 41.8 min and 22.7 min, respectively. Proliferation of the bile duct cell and stenosis of the bile duct were not shown pathologically. Dysfunction of the hepatocytes may cause retention of the /sup 99m/Tc-EHIDA in this case.

  13. Modern imaging in patients with obstructive jaundice

    African Journals Online (AJOL)

    2007-07-19

    Jul 19, 2007 ... upper gastro-intestinal interventional endoscopy and surgical diseases of the liver, bile ducts and pancreas. ... major areas of clinical interest include imaging and intervention in hepatobiliary disease, vascular imaging and intervention, and computer applications ... in which ultrafast detector rotation and.

  14. 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

  15. Cellular MR Imaging

    OpenAIRE

    Michel Modo; Mathias Hoehn; Jeff W.M. Bulte

    2005-01-01

    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 [(U)SPIO] 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, ...

  16. 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

    2018-03-07

    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.

  17. Magnetic resonance imaging and proton magnetic resonance spectroscopy of the brain in the diagnostic evaluation of developmental delay

    NARCIS (Netherlands)

    Verbruggen, Krijn T.; Meiners, Linda C.; Sijens, Paul E.; Lunsing, Roelineke J.; van Spronsen, Francjan J.; Brouwer, Oebele F.

    Aim: To assess the contribution of MRI and proton spectroscopy (1HMRS) in establishing an etiological diagnosis in children with developmental delay (DD) and to assess whether the chance of finding specific abnormalities correlates with the presence of neurological signs and/or abnormal head

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

    Science.gov (United States)

    Urdaneta, Verónica; Casadesús, Josep

    2017-01-01

    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. PMID:29043249

  19. 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

  20. 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.

  1. Delayed Puberty

    DEFF Research Database (Denmark)

    Kolby, Nanna; Busch, Alexander Siegfried; Juul, Anders

    2017-01-01

    Delayed puberty can be a source of great concern and anxiety, although it usually is caused by a self-limiting variant of the normal physiological timing named constitutional delay of growth and puberty (CDGP). Delayed puberty can, however, also be the first presentation of a permanent condition ...... mineral density) and psychological (e.g., low self-esteem) and underline the importance of careful clinical assessment of the patients....

  2. The delay of contrast arrival in magnetic resonance first-pass perfusion imaging: a novel non-invasive parameter detecting collateral-dependent myocardium.

    Science.gov (United States)

    Muehling, O M; Huber, A; Cyran, C; Schoenberg, S O; Reiser, M; Steinbeck, G; Nabauer, M; Jerosch-Herold, M

    2007-07-01

    To establish the regional delay of contrast arrival in magnetic resonance perfusion imaging (MRPI) for the detection of collateral-dependent myocardium in patients with coronary artery disease. Observational study, case series; single centre, university hospital. 30 patients with coronary artery disease and collateral-dependent myocardium and 17 healthy volunteers. Resting and hyperaemic (adenosine) MRPI was used to determine the delay time (Deltat(d)) of contrast arrival between the left ventricle and collateral-dependent or antegradely perfused myocardium, and myocardial perfusion (MP, ml/min/g). In healthy volunteers, mean (SD) Deltat(d) at rest and during hyperaemia were 0.8 (0.4) and 0.3 (0.3) s, and MP was 1.14 (0.21) and 4.23 (1.12) ml/min/g. In patients Deltat(d) in antegradely perfused vs collateral-dependent myocardium was 0.9 (0.7) vs 1.7 (1.0) s at rest (p0.6 s (area under the curve (AUC) = 0.89) to detect collateral-dependent myocardium, while resting Deltat(d) (AUC = 0.77) and perfusion (AUC = 0.69 at rest or 0.70 during hyperaemia) were less accurate. MRPI-derived hyperaemic delay of contrast arrival detects collateral-dependent myocardium with high sensitivity and specificity. Perfusion was less sensitive, emphasising the clinical role of Deltat(d) in non-invasive detection of collateral-dependent myocardium.

  3. Prediagnostic selenium status and hepatobiliary cancer risk in the European Prospective Investigation into Cancer and Nutrition cohort

    NARCIS (Netherlands)

    Hughes, David J.; Duarte-Salles, Talita; Hybsier, Sandra; Trichopoulou, Antonia; Stepien, Magdalena; Aleksandrova, Krasimira; Overvad, Kim; Tjønneland, Anne; Olsen, Anja; Affret, Aurélie; Fagherazzi, Guy; Boutron-Ruault, Marie Christine; Katzke, Verena; Kaaks, Rudolf; Boeing, Heiner; Bamia, Christina; Lagiou, Pagona; Peppa, Eleni; Palli, Domenico; Krogh, Vittorio; Panico, Salvatore; Tumino, Rosario; Sacerdote, Carlotta; Bueno de Mesquita, Hendrik Bastiaan|info:eu-repo/dai/nl/06929528X; Peeters, Petra H.|info:eu-repo/dai/nl/074099655; Engeset, Dagrun; Weiderpass, Elisabete; Lasheras, Cristina; Agudo, Antonio; Sánchez, Maria José; Navarro, Carmen; Ardanaz, Eva; Dorronsoro, Miren; Hemmingsson, Oskar; Wareham, Nicholas J.; Khaw, Kay Tee; Bradbury, Kathryn E.; Cross, Amanda J.; Gunter, Marc; Riboli, Elio; Romieu, Isabelle; Schomburg, Lutz; Jenab, Mazda

    2016-01-01

    Selenium status is suboptimal in many Europeans and may be a risk factor for the development of various cancers, including those of the liver and biliary tract. Objective: We wished to examine whether selenium status in advance of cancer onset is associated with hepatobiliary cancers in the EPIC

  4. Function and regulation of ATP-binding cassette transport proteins involved in hepatobiliary transport (vol 12, pg 13, 2000)

    NARCIS (Netherlands)

    Hooiveld, GJEJ; van Montfoort, JE; Meijer, DKF; Muller, M

    Hepatobiliary transport of endogenous and exogenous compounds is mediated by the coordinated action of multiple transport systems present at the sinusoidal (basolateral) and canalicular (apical) membrane domains of hepatocytes. During the last few years many of these transporters have been cloned

  5. Acute myocardial infarction: serial cardiac MR imaging shows a decrease in delayed enhancement of the myocardium during the 1st week after reperfusion.

    Science.gov (United States)

    Ibrahim, Tareq; Hackl, Thomas; Nekolla, Stephan G; Breuer, Martin; Feldmair, Michael; Schömig, Albert; Schwaiger, Markus

    2010-01-01

    To evaluate the time course of delayed gadolinium enhancement of infarcted myocardium by using serial contrast agent-enhanced (CE) cardiac magnetic resonance (MR) images obtained during the acute, subacute, and chronic stages of infarction. The study protocol was reviewed and approved by the local ethics committee, and written informed consent was obtained. Seventeen patients with reperfused acute myocardial infarction (AMI) underwent cine and CE cardiac MR a median of 1, 7, 35, and 180 days after reperfusion. Infarct size determined on the basis of delayed enhancement MR imaging at different times was compared by using nonparametric tests and Bland-Altman analysis. Extent of myocardial enhancement was compared with single photon emission computed tomographic (SPECT) measures of infarct size with Spearman correlation. Regional myocardial enhancement extent and contractility were analyzed with nonparametric tests. Infarct size was 18.3% of total myocardial LV volume on day 1 after AMI and decreased to 12.9% on day 7, 11.3% on day 35, and 11.6% on day 180 (all P infarct size on day 7, as compared with day 1 enhancement size, declined by 57.1% within the epicardium and by 6.3% within the endocardium (both P Infarct size on day 7 showed only minor changes at subsequent imaging and yielded a high correlation with SPECT measurements of infarct size (r = 0.84). Infarct size on day 7 inversely correlated with long-term wall thickening (P infarction. Thus, timing of CE cardiac MR imaging is crucial for accurate measurement of myocardial infarct size early after AMI.

  6. Non-ischemic perfusion defects due to delayed arrival of contrast material on stress perfusion cardiac magnetic resonance imaging after coronary artery bypass graft surgery

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Yeo Koon; Park, Eun Ah; Park, Sang Joon; Cheon, Gi Jeong; Lee, Whal; Chung, Jin Wook; Park, Jae Hyung [Seoul National University Hospital, Seoul (Korea, Republic of)

    2014-04-15

    Herein we report about the adenosine stress perfusion MR imaging findings of a 50-year-old man who exhibited two different perfusion defects resulting from two different mechanisms after a coronary artery bypass surgery. An invasive coronary angiography confirmed that one perfusion defect at the mid-anterior wall resulted from an ischemia due to graft stenosis. However, no stenosis was detected on the graft responsible for the mid-inferior wall showing the other perfusion defect. It was assumed that the perfusion defect at the mid-inferior wall resulted from delayed perfusion owing to the long pathway of the bypass graft. The semiquantitative analysis of corrected signal-time curves supported our speculation, demonstrating that the rest-to-stress ratio index of the maximal slope of the myocardial territory in question was similar to those of normal myocardium, whereas that of myocardium with the stenotic graft showed a typical ischemic pattern. A delayed perfusion during long graft pathway in a post-bypass graft patient can mimick a true perfusion defect on myocardial stress MR imaging. Radiologists should be aware of this knowledge to avoid misinterpretation of graft and myocardial status in post bypass surgery patients.

  7. 18F-FDG PET/CT qualitative and quantitative evaluation in neurofibromatosis type 1 patients for detection of malignant transformation: comparison of early to delayed imaging with and without liver activity normalization.

    Science.gov (United States)

    Chirindel, Alin; Chaudhry, Muhammad; Blakeley, Jaishri O; Wahl, Richard

    2015-03-01

    (18)F-FDG PET/CT has shown increased accuracy, compared with morphologic imaging, in differentiating malignant peripheral nerve sheath tumors (MPNSTs) from benign neurofibromas (BNFs) in patients with neurofibromatosis type 1 (NF1). Delayed (18)F-FDG PET imaging typically enhances malignant tumor to background. Our goal was to compare the effectiveness of early (1-h) and delayed (4-h) (18)F-FDG PET/CT imaging in differentiating MPNSTs from BNFs in patients with NF1, with and without liver activity normalization. NF1 patients presenting new symptoms or enlarging lesions were clinically evaluated with early and delayed (18)F-FDG PET/CT imaging. SULmax (maximum standardized uptake value derived for lean body) and SULmax/liver (lesion uptake adjusted to mean liver activity) were obtained for all sites identified with abnormal metabolic activity. Qualitative and quantitative evaluations, including receiver-operating-characteristic (ROC) comparison of early and delayed imaging sessions, were performed. Histopathology and clinical follow-up (1-9 y) were considered as a gold standard. Forty-one NF1 patients with early and delayed (18)F-FDG PET/CT scans were identified, and 93 lesions were retrospectively analyzed, representing 24 MPNSTs (all histologically confirmed) and 69 BNFs (26 histologically confirmed). Qualitative evaluation on early imaging showed sensitivity, specificity, positive predictive value, and negative predictive value for separating MPNSTs from BNFs of 91%, 84%, 67%, and 96% versus 91%, 81%, 63%, and 96%, respectively, on 4-h delayed imaging. The mean SULmax was significantly higher for MPNSTs than BNFs on both early scans (6.5 vs. 2.0, P Qualitative interpretation of (18)F-FDG PET/CT discriminates MPNSTs from BNFs in NF1 patients with similar accuracy on both early and delayed imaging. Quantitative data showed better sensitivity on delayed acquisition and best test specificity with lesion SULmax normalization to liver activity, more so than with delayed

  8. 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

  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. 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

  11. Risk of hepatobiliary cancer after solid organ transplant in the United States.

    Science.gov (United States)

    Koshiol, Jill; Pawlish, Karen; Goodman, Marc T; McGlynn, Katherine A; Engels, Eric A

    2014-09-01

    Studies of liver cancer risk in recipients of solid organ transplants generally have been small, yielding mixed results, and little is known about biliary tract cancers among transplant recipients. We identified incident hepatobiliary cancers among 201,549 US recipients of solid organs, from 1987 through 2008, by linking data from the US transplant registry with 15 cancer registries. We calculated standardized incidence ratios (SIRs), comparing risk relative to the general population. We also calculated incidence rate ratios (RRs), comparing risk for hepatocellular carcinoma (HCC) and total (intrahepatic and extrahepatic) cholangiocarcinoma among subgroups of recipients. Of transplant recipients, 165 developed hepatobiliary cancers (SIR, 1.2; 95% confidence interval [CI], 1.0-1.4). HCC risk was increased among liver recipients (SIR, 1.5; 95% CI, 1.0-2.2), especially 5 or more years after transplant (SIR, 1.8; 95% CI, 1.0-3.0). Cholangiocarcinoma was increased among liver (SIR, 2.9; 95% CI, 1.6-4.8) and kidney recipients (SIR, 2.1; 95% CI, 1.3-3.1). HCC was associated with hepatitis B virus (RR, 3.2; 95% CI, 1.3-6.9), hepatitis C virus (RR, 10; 95% CI, 5.9-16.9), and non-insulin-dependent diabetes (RR, 2.5; 95% CI, 1.2-4.8). Cholangiocarcinoma was associated with azathioprine maintenance therapy (RR, 2.0; 95% CI, 1.1-3.7). Among liver recipients, primary sclerosing cholangitis was associated with an increased risk of cholangiocarcinoma, compared with the general population (SIR, 21; 95% CI, 8.2-42) and compared with liver recipients without primary sclerosing cholangitis (RR, 12.3; 95% CI, 4.1-36.4). Risks for liver and biliary tract cancer are increased among organ transplant recipients. Risk factors for these cancers include medical conditions and potentially medications taken by recipients. Copyright © 2014 AGA Institute. Published by Elsevier Inc. All rights reserved.

  12. Delayed Ejaculation

    Science.gov (United States)

    ... of stress Delayed ejaculation Symptoms & causes Diagnosis & treatment Advertisement Mayo Clinic does not endorse companies or products. ... a Job Site Map About This Site Twitter Facebook Google YouTube Pinterest Mayo Clinic is a not- ...

  13. Evaluation of sup(99m)Tc-pyridoxylidene-isoleucine (PI) hepatobiliary scintigraphy in cholelithiasis

    International Nuclear Information System (INIS)

    Kida, Toshiyuki; Higuchi, Yoshinori; Miura, Norimasa; Fujita, Yuji; Munekata, Shiro.

    1981-01-01

    The disappearance time of heart pool image and in visualization time of the intrahepatic bile ducts were significantly delayed in the cases of cholecystolithiasis; and in addition to the significant delay of those, there were dilatation of the intrahepatic ducts and interruption of the common bile duct in all of the cases of choledocholithiasis and cholecysto-choledocholithiasis. The gall bladder was not visualized in 27 of 30 cases of cholecystolithiasis, in all 2 cases of choledocholithiasis, and in 3 of 7 cases of cholecysto-choledocholithiasis. The gall bladder was visualized in 4 of 7 cases of cholecysto-choledocholithiasis, though some abnormality was found in the cases. The gall bladder was not visualized in all of the cases of acute cholecystitis and in 77% of the cases of chronic cholecystitis. Even in those of chronic cholecystitis in which gall bladder was visualized, scintigram findings revealed some abnormality. Consequently, sup(99m)Tc-PI cholescintigram was of value in diagnosing cholecystolithiasis, especially detecting the presence of cholecystitis, and demonstrating dilatation of the intrahepatic bile ducts and common bile duct, and the site of interruption. (Ueda, J.)

  14. Evaluation of sup(99m)Tc-pyridoxylidene-isoleucine (PI) hepatobiliary scintigraphy in cholelithiasis

    Energy Technology Data Exchange (ETDEWEB)

    Kida, T.; Higuchi, Y. (Fukushima Medical Coll. (Japan)); Miura, N.; Fujita, Y.; Munekata, S.

    1981-07-01

    The disappearance time of heart pool image and in visualization time of the intrahepatic bile ducts were significantly delayed in the cases of cholecystolithiasis; and in addition to the significant delay of those, there were dilatation of the intrahepatic ducts and interruption of the common bile duct in all of the cases of choledocholithiasis and cholecysto-choledocholithiasis. The gall bladder was not visualized in 27 of 30 cases of cholecystolithiasis, in all 2 cases of choledocholithiasis, and in 3 of 7 cases of cholecysto-choledocholithiasis. The gall bladder was visualized in 4 of 7 cases of cholecysto-choledocholithiasis, though some abnormality was found in the cases. The gall bladder was not visualized in all of the cases of acute cholecystitis and in 77% of the cases of chronic cholecystitis. Even in those of chronic cholecystitis in which gall bladder was visualized, scintigram findings revealed some abnormality. Consequently, sup(99m)Tc-PI cholescintigram was of value in diagnosing cholecystolithiasis, especially detecting the presence of cholecystitis, and demonstrating dilatation of the intrahepatic bile ducts and common bile duct, and the site of interruption.

  15. Evaluation of hepatobiliary imaging by radionuclide scintigraphy, ultrasonography, and contrast cholangiography

    International Nuclear Information System (INIS)

    Cheng, T.H.; Davis, M.A.; Seltzer, S.E.; Jones, B.; Abbruzzese, A.A.; Finberg, H.J.; Drum, D.E.

    1979-01-01

    Cholescintigraphy, ultrasonography, and contrast cholangiography were compared in 60 patients. Among those having abdominal pain but no biliary disease or jaundice, cholescintigraphy was normal in 14/14, ultrasound in 10/13, and cholangiography in 13/14. Jaundice due to hepatocellular disease was correctly distinguished from complete biliary obstruction by cholescintigraphy in 17/17 patients and by ultrasound in 14/17. In cholelithiasis, ultrasound was abnormal in 10/12 and cholangiography in 7/9. Cholescintigraphy appeared most sensitive to active cholecystitis; only cholangiography and ultrasound visualized gallstones

  16. The delay of contrast arrival in magnetic resonance first‐pass perfusion imaging: a novel non‐invasive parameter detecting collateral‐dependent myocardium

    Science.gov (United States)

    Muehling, O M; Huber, A; Cyran, C; Schoenberg, S O; Reiser, M; Steinbeck, G; Nabauer, M; Jerosch‐Herold, M

    2007-01-01

    Aim To establish the regional delay of contrast arrival in magnetic resonance perfusion imaging (MRPI) for the detection of collateral‐dependent myocardium in patients with coronary artery disease. Design and setting Observational study, case series; single centre, university hospital. Patients 30 patients with coronary artery disease and collateral‐dependent myocardium and 17 healthy volunteers. Methods Resting and hyperaemic (adenosine) MRPI was used to determine the delay time (Δtd) of contrast arrival between the left ventricle and collateral‐dependent or antegradely perfused myocardium, and myocardial perfusion (MP, ml/min/g). Results In healthy volunteers, mean (SD) Δtd at rest and during hyperaemia were 0.8 (0.4) and 0.3 (0.3) s, and MP was 1.14 (0.21) and 4.23 (1.12) ml/min/g. In patients Δtd in antegradely perfused vs collateral‐dependent myocardium was 0.9 (0.7) vs 1.7 (1.0) s at rest (p0.6 s (area under the curve (AUC) = 0.89) to detect collateral‐dependent myocardium, while resting Δtd (AUC = 0.77) and perfusion (AUC = 0.69 at rest or 0.70 during hyperaemia) were less accurate. Conclusions MRPI‐derived hyperaemic delay of contrast arrival detects collateral‐dependent myocardium with high sensitivity and specificity. Perfusion was less sensitive, emphasising the clinical role of Δtd in non‐invasive detection of collateral‐dependent myocardium. PMID:17344328

  17. 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

  18. Delayed Methylene Blue Improves Lesion Volume, Multi-Parametric Quantitative Magnetic Resonance Imaging Measurements, and Behavioral Outcome after Traumatic Brain Injury

    Science.gov (United States)

    Long, Justin Alexander; Boggs, Robert Cole; Manga, Hemanth; Huang, Shiliang; Shen, Qiang; Duong, Timothy Q.

    2016-01-01

    Abstract Traumatic brain injury (TBI) remains a primary cause of death and disability in both civilian and military populations worldwide. There is a critical need for the development of neuroprotective agents that can circumvent damage and provide functional recovery. We previously showed that methylene blue (MB), a U.S. Food and Drug Administration–grandfathered drug with energy-enhancing and antioxidant properties, given 1 and 3 h post-TBI, had neuroprotective effects in rats. This study aimed to further investigate the neuroprotection of delayed MB treatment (24 h postinjury) post-TBI as measured by lesion volume and functional outcomes. Comparisons were made with vehicle and acute MB treatment. Multi-modal magnetic resonance imaging and behavioral studies were performed at 1 and 3 h and 2, 7, and 14 days after an impact to the primary forelimb somatosensory cortex. We found that delaying MB treatment 24 h postinjury still minimized lesion volume and functional deficits, compared to vehicle-treated animals. The data further support the potential for MB as a neuroprotective treatment, especially when medical teatment is not readily available. MB has an excellent safety profile and is clinically approved for other indications. MB clinical trials on TBI can thus be readily explored. PMID:25961471

  19. 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)

  20. 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

    that has infarcted. There are no comparison of serial changes on ECG and DE-MRI measuring infarct size. AIM: The general aim of this study was to describe the acute, healing, and chronic phases of the changes in infarct size estimated by the ECG and DE-MRI. The specific aim was to compare estimates......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...... of the Selvester QRS scoring system and DE-MRI to identify the difference between the extent of left ventricle occupied by infarction in the acute and chronic phases. METHODS: In 31 patients (26 men, age 56 +/- 9) with reperfused ST-elevation MI (11 anterior, 20 inferior), standard 12-lead ECG and DE-MRI were...

  1. Delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC), after slipped capital femoral epiphysis

    International Nuclear Information System (INIS)

    Zilkens, Christoph; Miese, Falk; Bittersohl, Bernd; Jaeger, Marcus; Schultz, Johannes; Holstein, Arne; Kim, Young-jo; Millis, Michael B.; Mamisch, Tallal C.; Krauspe, Ruediger

    2011-01-01

    Objective: The aim of this study was to assess the glycosaminoglycan (GAG) content in hip joint cartilage in mature hips with a history of slipped capital femoral epiphysis (SCFE) using delayed gadolinium-enhanced MRI of cartilage (dGEMRIC). Methods: 28 young-adult subjects (32 hips) with a mean age of 23.8 ± 4.0 years (range: 18.1-30.5 years) who were treated for mild or moderate SCFE in adolescence were included into the study. Hip function and clinical symptoms were evaluated with the Harris hip score (HHS) system at the time of MRI. Plain radiographic evaluation included Tonnis grading, measurement of the minimal joint space width (JSW) and alpha-angle measurement. The alpha-angle values were used to classify three sub-groups: group 1 = subjects with normal femoral head-neck offset (alpha-angle o ), group 2 = subjects with mild offset decrease (alpha-angle 50 o -60 o ), and group 3 = subjects with severe offset decrease (alpha-angle >60 o ). Results: There was statistically significant difference noted for the T1 Gd values, lateral and central, between group 1 and group 3 (p-values = 0.038 and 0.041). The T1 Gd values measured within the lateral portion were slightly lower compared with the T1 Gd values measured within the central portion that was at a statistically significance level (p-value <0.001). HHS, Tonnis grades and JSW revealed no statistically significant difference. Conclusion: By using dGEMRIC in the mid-term follow-up of SCFE we were able to reveal degenerative changes even in the absence of joint space narrowing that seem to be related to the degree of offset pathology. The dGEMRIC technique may be a potential diagnostic modality in the follow-up evaluation of SCFE.

  2. Delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC), after slipped capital femoral epiphysis

    Energy Technology Data Exchange (ETDEWEB)

    Zilkens, Christoph, E-mail: Christoph.Zilkens@med.uni-duesseldorf.de [Department of Orthopaedics, Heinrich-Heine University Medical School, Moorenstrasse 5, 40225 Duesseldorf (Germany); Miese, Falk [Department of Radiology, Heinrich-Heine University Medical School, Moorenstrasse 5, 40225 Duesseldorf (Germany); Bittersohl, Bernd; Jaeger, Marcus; Schultz, Johannes [Department of Orthopaedics, Heinrich-Heine University Medical School, Moorenstrasse 5, 40225 Duesseldorf (Germany); Holstein, Arne [Department of Radiology, Heinrich-Heine University Medical School, Moorenstrasse 5, 40225 Duesseldorf (Germany); Kim, Young-jo; Millis, Michael B. [Department of Orthopaedic Surgery, Childrens Hospital Boston, Harvard Medical, School, 300 Longwood Avenue, Boston, MA 02115 (United States); Mamisch, Tallal C. [Department of Orthopaedic Surgery, Inselspital Bern, University Hospital, Bern (Switzerland); Krauspe, Ruediger [Department of Orthopaedics, Heinrich-Heine University Medical School, Moorenstrasse 5, 40225 Duesseldorf (Germany)

    2011-09-15

    Objective: The aim of this study was to assess the glycosaminoglycan (GAG) content in hip joint cartilage in mature hips with a history of slipped capital femoral epiphysis (SCFE) using delayed gadolinium-enhanced MRI of cartilage (dGEMRIC). Methods: 28 young-adult subjects (32 hips) with a mean age of 23.8 {+-} 4.0 years (range: 18.1-30.5 years) who were treated for mild or moderate SCFE in adolescence were included into the study. Hip function and clinical symptoms were evaluated with the Harris hip score (HHS) system at the time of MRI. Plain radiographic evaluation included Tonnis grading, measurement of the minimal joint space width (JSW) and alpha-angle measurement. The alpha-angle values were used to classify three sub-groups: group 1 = subjects with normal femoral head-neck offset (alpha-angle <50{sup o}), group 2 = subjects with mild offset decrease (alpha-angle 50{sup o}-60{sup o}), and group 3 = subjects with severe offset decrease (alpha-angle >60{sup o}). Results: There was statistically significant difference noted for the T1{sub Gd} values, lateral and central, between group 1 and group 3 (p-values = 0.038 and 0.041). The T1{sub Gd} values measured within the lateral portion were slightly lower compared with the T1{sub Gd} values measured within the central portion that was at a statistically significance level (p-value <0.001). HHS, Tonnis grades and JSW revealed no statistically significant difference. Conclusion: By using dGEMRIC in the mid-term follow-up of SCFE we were able to reveal degenerative changes even in the absence of joint space narrowing that seem to be related to the degree of offset pathology. The dGEMRIC technique may be a potential diagnostic modality in the follow-up evaluation of SCFE.

  3. Preoperative biliary MRSA infection in patients undergoing hepatobiliary resection with cholangiojejunostomy: incidence, antibiotic treatment, and surgical outcome.

    Science.gov (United States)

    Takara, Daisuke; Sugawara, Gen; Ebata, Tomoki; Yokoyama, Yukihiro; Igami, Tsuyoshi; Nagino, Masato

    2011-04-01

    There have been no reports on the impact of preoperative biliary MRSA infection on the outcome of major hepatectomy. The aim of this study was to review the surgical outcome of patients who underwent hepatobiliary resection after biliary drainage and to evaluate the impact of preoperative biliary MRSA infection. Medical records from 350 patients who underwent hepatobiliary resection with cholangiojejunostomy after external biliary drainage were retrospectively reviewed. Of the 350 study patients, 14 (4.0%) had MRSA-positive bile culture, 246 (70.3%) had positive bile culture without MRSA growth, and the remaining 90 (25.7%) had negative bile culture. In all of the patients with MRSA-positive bile culture, vancomycin was prophylactically administered after surgery. Of the 14 patients, 6 (42.9%) had surgical site infections, including wound infection in 5 patients and intra-abdominal abscess in 2 patients. The incidence of surgical site infection in the 14 MRSA-positive patients was higher but not statistically significant compared to the incidence in other patient groups. All 14 patients tolerated difficult hepatobiliary resection. Of the 350 study patients, 28 (8.0%) had postoperative MRSA infections. Multivariate analysis identified preoperative MRSA-positive bile culture as a significant independent risk factor for postoperative MRSA infection. Preoperative biliary MRSA infection is troublesome as it is an independent risk factor of postoperative MRSA infection. Even in such troublesome situations, however, difficult hepatobiliary resection can be performed with acceptable rates of morbidity and mortality using appropriate antibiotic prophylaxis, including vancomycin, based on bile culture.

  4. Hepatic clearance mechanism of /sup 99m/Tc-HIDA and its effect on quantitation of hepatobiliary function concise communication

    International Nuclear Information System (INIS)

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

    1979-01-01

    Parameters affecting the hepatobiliary clearance of /sup 99m/Tc N(2,6-dimethylphenylcarbamoylmethyl) iminodiacetic acid (Tc-HIDA) were evaluated in dogs. Competitive clearance studies were performed with Tc-HIDA after infusion to plasma saturation levels of an anion, sodium sulfobromophthalein (BSP), and a cation, oxyphenonium. The results demonstrated that Tc-HIDA is transported through hepatocytes by a carrier-mediated organic-anion pathway. The data are consistent with an alteration of the elimination kinetics of Tc-HIDA induced by elevations in the serum bilirubin level, and it is predicted that serum bilirubin at some increased concentration will dominate the distribution and elimination kinetics of Tc-HIDA independently of hepatobiliary status. A quantitative description of liver function in terms of regional distribution and elimination rate constants will require either a pharmacokinetic model that expressly includes the effects of bilirubin from transport binding sites, or the development of new hepatobiliary agents that use a different clearance mechanism from that used by bilirubin

  5. A Delayed Postoperative C5 Palsy due to Spinal Cord Lesion: A Typical Clinical Presentation but Unusual Imaging Findings

    Directory of Open Access Journals (Sweden)

    Nobuaki Tadokoro

    2016-01-01

    Full Text Available Postoperative C5 palsy (C5 palsy is a troublesome complication after cervical spine surgery and its etiology is still unclear. We experienced a case of C5 palsy after anterior decompression with fusion for cervical ossification of posterior longitudinal ligament with the typical clinical presentation of left deltoid and bicep weakness and left-arm pain without deterioration of myelopathy symptoms, albeit with the unusual imaging findings not shown preoperatively of a swelling in the spinal cord, and intramedullary high intensity change on T2-weighed MRI. The additional posterior surgery was carried out to decompress the swollen spinal cord. The abnormal findings disappear on MRI taken three weeks following the second surgery and the weakness improved fully within three months after the second surgery. This case report highlights the possibility of spinal cord lesion due to circulatory impairment as a cause of C5 palsy.

  6. Value of delayed gadolinium-enhanced magnetic resonance imaging of cartilage for the pre-operative assessment of cervical intervertebral discs.

    Science.gov (United States)

    Schleich, Christoph; Miese, Falk; Müller-Lutz, Anja; Boos, Johannes; Aissa, Joel; Nasca, Adrian; Zaucke, Frank; Bostelmann, Tamara; Schimmöller, Lars; Bittersohl, Bernd; Steiger, Hans-Jakob; Antoch, Gerald; Bostelmann, Richard

    2017-08-01

    The study was performed to preoperatively assess the cartilage integrity of cervical intervertebral discs (IVDs) using Delayed Gadolinium-Enhanced Magnetic Resonance Imaging of Cartilage (dGEMRIC). Therefore, 53 cervical intervertebral discs of nine preoperative patients with neck and shoulder/arm pain scheduled for discectomy (five females, four males; mean age: 47.1 ± 8.4 years; range: 36-58 years) were included for biochemical analysis in this retrospective study. The patients underwent 3T magnetic resonance imaging (MRI) including biochemical imaging with dGEMRIC and morphological, sagittal T2 weighted (T2w) imaging. Cervical IVDs were rated using an MRI based grading system for cervical IVDs on T2w images. Region-of-interest measurements were performed in the nucleus pulposus (NP) and annulus fibrosus (AF) and a dGEMRIC index was calculated. Our results demonstrated that IVDs scheduled for discectomy showed significantly lower dGEMRIC index compared to IVDs that did not require surgical intervention in NP and AF (NP: 898.4 ± 191.9 ms vs. 1,150.3 ± 320.7 ms, p = 0.008; AF: 738.7 ± 183.8 ms vs. 984.6 ± 178.9 ms, p = 0.008). For Miyazaki score 3, the dGEMRIC indices were significantly lower in IVDs scheduled for surgery compared to non-operated discs for NP (p = 0.043) and AF (p = 0.018). In conclusion we could demonstrate that biochemical imaging with dGEMRIC is feasible in cervical IVDs. Significantly lower dGEMRIC index suggested GAG depletion in degenerated cervical IVD, scheduled for discectomy. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:1824-1830, 2017. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

  7. 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.)

  8. 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

  9. 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

  10. 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.)

  11. 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)

  12. 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.

  13. 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.)

  14. 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.)

  15. 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

  16. Ultrasound tissue Doppler imaging reveals no delay in abdominal muscle feed-forward activity during rapid arm movements in patients with chronic low back pain.

    Science.gov (United States)

    Gubler, Deborah; Mannion, Anne F; Schenk, Peter; Gorelick, Mark; Helbling, Daniel; Gerber, Hans; Toma, Valeriu; Sprott, Haiko

    2010-07-15

    Cross-sectional study. Comparison of the timing of onset of lateral abdominal muscle activity during rapid arm movements in patients with nonspecific chronic low back pain (cLBP) and back-pain-free controls. Rapid movements of the arm are normally associated with prior activation of trunk-stabilizing muscles in readiness for the impending postural perturbation. Using invasive intramuscular electromyography techniques, studies have shown that this feed-forward function is delayed in some patients with low back pain (LBP). Ultrasound tissue Doppler imaging (TDI) provides an ultrasound method for quantifying muscle activation in a noninvasive manner, allowing investigation of larger groups of patients and controls. Ninety-six individuals participated (48 patients with cLBP and 48 matched LBP-free controls). During rapid shoulder flexion, abduction, and extension, surface electromyographic signals from the deltoid and motion-mode TDI images from the contralateral lateral abdominal muscles were recorded simultaneously. The onset of muscle activity was given by changes in the tissue velocity of the abdominal muscles, as measured with TDI. Pain and disability in the patients were assessed using standardized questionnaires. Data were analyzed using repeated measures analysis of variance. In both groups, feed-forward activity of the lateral abdominal muscles was recorded during arm movements in all directions. The main effect of "group membership" revealed no significant difference between the groups for the earliest onset of abdominal muscle activity (P = 0.398). However, a significant "group x body side" interaction (P = 0.015) was observed, and this was the result of earlier onsets in the cLBP group than controls for the abdominal muscles on the right (but not left) body side. No relationship was found between the time of onset of the earliest abdominal muscle activity and pain intensity, pain frequency, pain medication usage, or Roland Morris disability scores. Patients

  17. 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

  18. Delayed perfusion phenomenon in a rat stroke model at 1.5 T MR: An imaging sign parallel to spontaneous reperfusion and ischemic penumbra?

    Energy Technology Data Exchange (ETDEWEB)

    Chen Feng [Department of Radiology, University Hospitals, Catholic University of Leuven, Herestraat 49, B-3000 Leuven (Belgium); Department of Radiology, Zhong Da Hospital, Southeast University, 87 Ding Jia Qiao Road, Nanjing 210009, Jiangsu Province (China); Suzuki, Yasuhiro [Department of Molecular and Cellular Medicine, Faculty of Medicine, Catholic University of Leuven, Herestraat 49, B-3000 Leuven (Belgium); Department of Pharmacology, Hamamatsu University School of Medicine, 1-20-1 Handayama, 431-3192 Hamamatsu (Japan); Nagai, Nobuo [Department of Molecular and Cellular Medicine, Faculty of Medicine, Catholic University of Leuven, Herestraat 49, B-3000 Leuven (Belgium); Sun Xihe [Department of Radiology, University Hospitals, Catholic University of Leuven, Herestraat 49, B-3000 Leuven (Belgium); Department of Radiology, the Affiliated Hospital of Weifang Medical University, Weifang 261031, Shandong Province (China); Coudyzer, Walter [Department of Radiology, University Hospitals, Catholic University of Leuven, Herestraat 49, B-3000 Leuven (Belgium); Yu Jie [Department of Radiology, University Hospitals, Catholic University of Leuven, Herestraat 49, B-3000 Leuven (Belgium); Marchal, Guy [Department of Radiology, University Hospitals, Catholic University of Leuven, Herestraat 49, B-3000 Leuven (Belgium); Ni Yicheng [Department of Radiology, University Hospitals, Catholic University of Leuven, Herestraat 49, B-3000 Leuven (Belgium)]. E-mail: Yicheng.Ni@med.kuleuven.ac.be

    2007-01-15

    Introduction: Delayed perfusion (DP) sign at MR imaging was reported in stroke patients. We sought to experimentally elucidate its relation to spontaneous reperfusion and ischemic penumbra. Methods: Stroke was induced by photothrombotic occlusion of middle cerebral artery in eight rats and studied up to 72 h using a 1.5 T MR scanner with T2 weighted imaging (T2WI), diffusion weighted imaging (DWI), and dynamic susceptibility contrast-enhanced perfusion weighted imaging (DSC-PWI). Relative signal intensity (rSI), relative lesion volume (rLV), relative cerebral blood flow (rCBF), PWI{sub rLV}-DWI{sub rLV} mismatch (penumbra) and DP{sub rLV} were quantified and correlated with neurological deficit score (NDS), triphenyl tetrazolium chloride (TTC) staining, microangiography (MA) and histopathology. Results: The rSI and rLV characterized this stroke model on different MRI sequences and time points. DSC-PWI reproduced cortical DP in all rats, where rCBF evolved from 88.9% at 1 h through 64.9% at 6 h to 136.3% at 72 h. The PWI{sub rLV}-DWI{sub rLV} mismatch reached 10 {+-} 5.4% at 1 h, remained positive through 12 h and decreased to -3.3 {+-} 4.5% at 72 h. The incidence and rLV of the DP were well correlated with those of the penumbra (p < 0.01, r {sup 2} = 0.85 and p < 0.0001, r {sup 2} = 0.96, respectively). Shorter DP durations and more collateral arterioles occurred in rats without (n = 4) than with (n = 4) cortex involvement (p < 0.05). Rats without cortex involvement tended to earlier reperfusion and a lower NDS. Microscopy confirmed MRI, MA and TTC findings. Conclusions: In this rat stroke model, we reproduced clinically observed DP on DSC-PWI, confirmed spontaneous reperfusion, and identified the penumbra extending to 12 h post-ischemia, which appeared interrelated.

  19. Application of Acoustic Radiation Force Impulse (ARFI) Elastography in Imaging of Delayed Onset Muscle Soreness (DOMS): A Comparative Analysis With 3T MRI.

    Science.gov (United States)

    Hotfiel, Thilo; Kellermann, Marion; Swoboda, Bernd; Wildner, Dane; Golditz, Tobias; Grim, Casper; Raithel, Martin; Uder, Michael; Heiss, Rafael

    2017-05-17

    DOMS is one of the most common reasons for impaired muscle performance in sports and is associated with reduced muscle strength and frequently observed both in professional and recreational athletes. To emphasize the diagnostic value of Acoustic Radiation Force Impulse (ARFI) in imaging of Delayed Onset Muscle Soreness by comparing findings to high-resolution 3T MRI T2 weighted sequences. Case series. Laboratory environment. Fifteen healthy students (7 female, 8 male, age 24 ± 4 years, height 178 ± 10 cm, body weight 67 ± 12 kg). ARFI values, represented as shear wave velocities (SWV) of the gastrocnemius muscle (GM) and soleus muscle (SM), as well as conventional ultrasound, high-resolution 3T MRI, creatine kinase activity, extension range of the ankle joint, calf circumference and muscle soreness were assessed before (baseline) and 60 hours after (post-intervention, PI) a standardized eccentric exercise. ARFI SWV values of the GM revealed a statistically significant decrease of 19.1% between baseline (2.2 ± 0.26 m/s) and PI (1.78 ± 0.24 m/s); p = 0.008. At follow-up, the MRI investigations showed intramuscular oedema for the GM in all participants corresponding to a significant raise in T2 signal intensity (p = 0.001) and in T2-time values (p = 0.004). ARFI elastography seems to be an additional sensitive diagnostic modality in the diagnostic work up of DOMS. Intramuscular SWV could represent an additional imaging marker for the assessment and monitoring of ultrastructural muscle injuries and therefore be helpful for individual training composition in elite sports.

  20. Diagnostic value of the delayed phase image for iso-attenuating pancreatic carcinomas in the pancreatic parenchymal phase on multidetector computed tomography

    International Nuclear Information System (INIS)

    Ishigami, Kousei; Yoshimitsu, Kengo; Irie, Hiroyuki; Tajima, Tsuyoshi; Asayama, Yoshiki; Nishie, Akihiro; Hirakawa, Masakazu; Ushijima, Yasuhiro; Okamoto, Daisuke; Nagata, Shigenori; Nishihara, Yunosuke; Yamaguchi, Koji; Taketomi, Akinobu; Honda, Hiroshi

    2009-01-01

    Purpose: To assess the value of the delayed phase (DP) in pancreatic carcinomas which appear iso-attenuating in the pancreatic parenchymal phase (PPP). Materials and methods: Fifty-seven preoperative MDCT studies of pancreatic carcinomas were retrospectively reviewed. The size of the tumors, and the Hounsfield unit (HU) of the tumors and pancreatic parenchyma were measured. The tumor-to-pancreas contrast (TPC: |HU [tumor] - HU [normal pancreas]|) was calculated. Results: Eight cases (14.0%) showed iso-attenuation and 49 showed hypo-attenuation in the PPP. The DP images revealed seven of eight (87.5%) iso-attenuating tumors to be hyper-attenuating. The size of iso-attenuating tumors was smaller than that of hypo-attenuating tumors (mean ± S.D.: 12.4 ± 4.8 mm vs. 30.3 ± 9.0 mm, p < 0.0001). In hypo-attenuating tumors, TPC in the PPP (60.2 ± 24.6 HU) was higher than those in the portal venous phase (PVP, 40.5 ± 23.0 HU, p < 0.0001) and DP (18.3 ± 11.8 HU, p < 0.0001). In contrast, in iso-attenuating tumors, TPC in the DP (26.0 ± 4.9 HU) was higher than those in the PPP (9.2 ± 3.7 HU, p = 0.0003) and PVP (7.1 ± 4.7 HU, p = 0.001) phases. Conclusion: The DP image is helpful in depicting small iso-attenuating pancreatic carcinomas as slightly hyper-attenuating tumors

  1. 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.

  2. 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.

  3. 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.)

  4. 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.)

  5. 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.

  6. 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

    PURPOSE: Quantitative hepatobiliary scintigraphy, a noninvasive method frequently used to diagnose several biliary tract disorders, shows abnormalities in bile secretion and outflow. It is well known that there are wide variations in the normal pattern of bile emptying, but the effect of cholecys......PURPOSE: Quantitative hepatobiliary scintigraphy, a noninvasive method frequently used to diagnose several biliary tract disorders, shows abnormalities in bile secretion and outflow. It is well known that there are wide variations in the normal pattern of bile emptying, but the effect...

  7. Reproducibility of imaging human knee cartilage by delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) at 1.5 Tesla.

    Science.gov (United States)

    Multanen, J; Rauvala, E; Lammentausta, E; Ojala, R; Kiviranta, I; Häkkinen, A; Nieminen, M T; Heinonen, A

    2009-05-01

    The purpose of this study was to investigate the day-to-day reproducibility of the delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) measurement at different knee joint surfaces in healthy subjects at 1.5 Tesla (T). The dGEMRIC experiment was repeated for 10 asymptomatic volunteers three times with an average interval of 5 days between scans. The measurement was performed from a single sagittal slice through the center of the lateral femoral condyle and from the center of the patella in the axial plane. Cartilage was manually segmented into superficial, deep and full-thickness regions of interests (ROIs) at different topographical locations of the femur, tibia and patella. The reproducibility was evaluated separately for each ROI as well as for the entire bulk cartilage in the slice of each joint surface. The reproducibility at various ROIs expressed by root-mean-square average coefficient of variation (CV(RMS)) ranged between 4.7-12.9%. Thirty out of thirty-three ROIs showed a CV(RMS) less than 10%. Intraclass correlation coefficient (ICC) ranged between 0.45 and 0.98. The CV(RMS) and ICC for bulk dGEMRIC were 4.2% and 0.95 for femur, 5.5% and 0.87 for tibia, and 4.8% and 0.97 for patella. The dGEMRIC technique showed good day-to-day reproducibility, on the average 8% for small deep or superficial segments, 7% for full-thickness ROIs and 5% for bulk ROIs covering all visible cartilage in a single joint surface. We conclude that dGEMRIC imaging at field strength 1.5 T can be used as a reliable instrument for the assessment of articular cartilage when staff has been carefully trained.

  8. Delay before the hepatocyte phase of Gd-EOB-DTPA-enhanced MR imaging: Is it possible to shorten the examination time?

    International Nuclear Information System (INIS)

    Motosugi, Utaroh; Ichikawa, Tomoaki; Tominaga, Licht; Sou, Hironobu; Sano, Katsuhiro; Ichikawa, Shintaro; Araki, Tsutomu

    2009-01-01

    Aim: To examine if it is possible to shorten the examination time of gadolinium ethoxybenzyl diethylenetriaminepentaacetic acid (Gd-EOB)-enhanced MRI by omitting hepatocyte-phase images of 20-min delay time (Im-20) for detecting focal liver lesions. Four hundred ninety-five malignant focal liver lesions observed on Im-20 in 265 patients were included. The hepatocyte phase was obtained 10 min (Im-10) and 20 min (Im-20) after Gd-EOB injection. Liver enhancement was evaluated using a 4-point scale [excellent/good/poor/non-diagnostic; visual liver-spleen contrast (V-LSC)] and a quantitative liver-spleen contrast ratio (Q-LSC). Two radiologists evaluated lesion conspicuity for assessing the sensitivity of lesion detection. As Im-20 was used as the standard of reference for the lesions, Im-20 artificially had 100% sensitivity. The results showed that although sensitivities and Q-LSC significantly increased from Im-10 to Im-20 (sensitivity/mean Q-LSC: Im-5, 81%/1.4 Im-10, 96%/1.7: Im-20, 100%/1.9), the sensitivity of Im-10 achieved 100% (the same as Im-20) in patients with good/excellent V-LSC or Q-LSC of more than 1.5. On Im-10, 202 patients (77%) were assigned as having good/excellent V-LSC (78%), and 161 (61%) were assigned as having Q-LSC of more than 1.5. We concluded that Im-20 can be omitted in at least 61% of the patients. (orig.)

  9. Early phase detection of bile leak after hepatobiliary surgery: value of Gd-EOB-DTPA-enhanced MR cholangiography.

    Science.gov (United States)

    Alegre Castellanos, Alvaro; Molina Granados, Juan Felix; Escribano Fernandez, Jose; Gallardo Muñoz, Inmaculada; Triviño Tarradas, Francisco de Asis

    2012-10-01

    To assess the value of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced MR cholangiography for the detection of bile leaks after hepatobiliary surgery. Twenty-three patients with symptoms suggestive of bile leak underwent conventional fat-suppressed T1- and T2-weighted MR cholangiography followed by Gd-EOB-DTPA-enhanced MR cholangiography using gradient-echo (GRE) T2-weighted sequences and fat-suppressed T1-weighted 3D gradient-echo sequences 20 min after an intravenous bolus of Gd-EOB-DTPA. The results of Gd-EOB-DTPA-enhanced MR cholangiography correlated with clinical findings, surgical repair, and the results of endoscopic retrograde cholangiopancreatography and percutaneous transhepatic cholangiography. The results of Gd-EOB-DTPA-enhanced MR cholangiography were negative in 13 patients (cholecystectomy 5, liver transplantation 2, liver resection for focal lesions 2, cholangiocarcinoma 1, and partial hepatectomy after liver injury 1). In 10 patients in whom bile leaks were detected, this complication occurred after liver resection for focal lesions in 3, cholecystectomy in 4, liver transplantation in 2, and liver resection for intrahepatic cholangiocarcinoma in 1. The diagnostic accuracy of Gd-EOB-DTPA-enhanced MR for the detection or exclusion of bile leaks was 100%. Gd-EOB-DTPA-enhanced MR cholangiography is a highly reliable technique for the detection of bile leaks after hepatobiliary surgery and may avoid the use of other, potentially risky invasive diagnostic techniques.

  10. Noninvasive diagnosis of hepatocellular carcinoma on gadoxetic acid-enhanced MRI: can hypointensity on the hepatobiliary phase be used as an alternative to washout?

    Energy Technology Data Exchange (ETDEWEB)

    Joo, Ijin; Lee, Dong Ho; Jeon, Ju Hyeon [Seoul National University Hospital, Department of Radiology, 101 Daehak-ro, Jongno-gu, Seoul (Korea, Republic of); Seoul National University College of Medicine, Department of Radiology, 103 Daehak-ro, Jongno-gu, Seoul (Korea, Republic of); Lee, Jeong Min; Han, Joon Koo; Choi, Byung Ihn [Seoul National University Hospital, Department of Radiology, 101 Daehak-ro, Jongno-gu, Seoul (Korea, Republic of); Seoul National University College of Medicine, Department of Radiology, 103 Daehak-ro, Jongno-gu, Seoul (Korea, Republic of); Seoul National University Medical Research Center, Institute of Radiation Medicine, 103 Daehak-ro, Jongno-gu, Seoul (Korea, Republic of)

    2015-10-15

    To determine which dynamic phase(s) of gadoxetic acid-enhanced MRI is most appropriate to assess ''washout'' in the noninvasive diagnosis of hepatocellular carcinoma (HCC) based on hemodynamic pattern. In this retrospective cohort study, 288 consecutive patients with chronic liver disease presented with 387 arterially enhancing nodules (292 HCCs, 95 non-HCCs) (≥1 cm) on gadoxetic acid-enhanced MRI. All HCCs were confirmed by histopathology or by their typical enhancement pattern on dynamic liver CT. MR imaging diagnosis of HCC was made using criteria of arterial enhancement and hypointensity relative to the surrounding parenchyma (1) on the portal-venous phase (PVP), (2) on the PVP and/or transitional phase (TP), or (3) on the PVP and/or TP, and/or hepatobiliary phase (HBP). For the noninvasive diagnosis of HCC, criterion 1 provided significantly higher specificity (97.9 %; 95 % confidence interval, 92.6 - 99.7 %) than criteria 2 (86.3 %; 77.7 - 92.5 %), or 3 (48.4 %; 38.0 - 58.9 %). Conversely, higher sensitivity was obtained with criterion 3 (93.8 %; 90.4 - 96.3 %) than with criterion 2 (86.6 %; 82.2 - 90.3 %) or 1 (70.9 %; 65.3 - 76.0 %). To make a sufficiently specific diagnosis of HCC using gadoxetic acid-enhanced MRI based on typical enhancement features, washout should be determined on the PVP alone rather than combined with hypointensity on the TP or HBP. (orig.)

  11. Comparison of gadolinium Cy2DOTA, a new hepatobiliary agent, and gadolinium HP-DO3A, an extracellular agent, in healthy liver and metastatic disease

    International Nuclear Information System (INIS)

    Runge, V.M.; Wells, J.W.; Williams, N.M.

    1995-01-01

    A new gadolinium (Gd) chelate with preferential hepatobiliary uptake, Gd Cy 2 DOTA, was compared in two animal species with Gd HP-DO3A (gadoteridol), a clinically approved contrast agent with extracellular distribution. Liver enhancement was evaluated for these two contrast agents using magnetic resonance imaging, whereas an experimental model of metastatic disease was used to evaluate the agents' efficacy for liver-lesion delineation. The two agents were compared in four healthy Rhesus monkeys (eight studies) and five New Zealand White rabbits with implanted VX-2 liver tumors (ten studies). The contrast dose was 0.1 mmol/kg, with the agents given in random order and at least 72 hours between contrast injections. Breathhold T1-weighted spin echo scans were obtained at 1.5 tesla (T) before and after contrast was administered. Postcontrast scans were obtained 1 to 90 minutes after injection in the monkeys and 1 to 240 minutes after injection in the rabbits. Prolonged hepatic enhancement, superior in degree to that with Gd HP-DO3A, was noted to both monkeys and rabbits after injection of Gd Cy 2 DOTA. Two minutes after contrast, liver SI was 1.94 ± 0.05 with Gd Cy 2 DOTA compared with 1.5 ± 0.05 with Gd HP-DO3A in monkeys. Sixty minutes after contrast, liver SI was 1.60 ± 0.09 compared with 1.20 ± 0.02. The difference between agents was significant at all times from 2 to 60 minutes after contrast injection (P 2 DOTA but not with Gd HP-DO3A. The maximum improvement in lesion conspicuity (rabbit) occurred 45 minutes after injection of Gd Cy 2 DOTA and 5 minutes after injection of Gd HP-DO3A. 22 refs., 12 figs

  12. 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.)

  13. Dual radiopharmaceutical imaging in congenital asplenia syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Rao, B.K.; Shore, R.M.; Lieberman, L.M.; Polcyn, R.E.

    1982-12-01

    Asplenia was suspected in one patient with combined immunodeficiency syndrome and 5 with congenital cardiac anomalies who had Howell-Jolly bodies on peripheral blood smears. /sup 99m/Tc-sulfur colloid scans were equivocal for absence of the spleen. When they were compared with the /sup 99m/Tc-PIPIDA hepatobiliary images, a discrepancy in organ morphology between the two scans indicated that the spleen was present, whereas similarity of the two images suggested asplenia. This procedure was useful in establishing asplenia in 4 patients and confirming the presence of a rudimentary or ectopic spleen in 2 others. Unequivocal demonstration of the spleen on the sulfur colloid scans makes the hepatobiliary study unnecessary, while unequivocal demonstration of a normal-appearing liver without splenic activity may warrant a tagged red-cell study for a more complete evaluation.

  14. Dual radiopharmaceutical imaging in congenital asplenia syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Rao, B.K. (Univ. Hospital, Cleveland, OH); Shore, R.M.; Lieberman, L.M.; Polcyn, R.E.

    1982-12-01

    Asplenia was suspected in one patient with combined immunodeficiency syndrome and 5 with congenital cardiac anomalies who had Howell-Jolly bodies on peripheral blood smears. /sup 99//sup m/Tc-sulfur colloid scans were equivocal for absence of the spleen. When they were compared with the /sup 99//sup m/Tc-PIPIDA hepatobiliary images, a discrepancy in organ morphology between the two scans indicated that the spleen was present, whereas similarity of the two images suggested asplenia. This procedure was useful in establishing asplenia in 4 patients and confirming the presence of a rudimentary or ectopic spleen in 2 others. Unequivocal demonstration of the spleen on the sulfur colloid scans makes the hepatobiliary study unnecessary, while unequivocal demonstration of abnormal-appearing liver without splenic activity may warrant a tagged red-cell study for a more complete evaluation.

  15. 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

  16. 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

  17. Recursive Delay Calculation Unit for Parametric Beamformer

    DEFF Research Database (Denmark)

    Nikolov, Svetoslav; Jensen, Jørgen Arendt; Tomov, Borislav Gueorguiev

    2006-01-01

    This paper presents a recursive approach for parametric delay calculations for a beamformer. The suggested calculation procedure is capable of calculating the delays for any image line defined by an origin and arbitrary direction. It involves only add and shift operations making it suitable...

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

    Science.gov (United States)

    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

    2017-08-01

    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. • Recurrent HCCs after LT showed atypical enhancement on gadoxetic acid-enhanced MRI. •They showed absence of delayed wash-out or cholangiocarinoma-like features. • Enhancement patterns of recurrent HCCs did not affect OS and TTR.

  19. Initial and delayed stress phase imaging in a single-injection double-acquisition SPECT. The potential value of early {sup 99m}Tc-MIBI redistribution in assessment of myocardial perfusion reversibility in patients with coronary artery disease

    Energy Technology Data Exchange (ETDEWEB)

    Beiki, D. [Research Inst. for Nuclear Medicine, Tehran Univ. of Medical Sciences, Tehran (Iran); Dept. of Nuclear Pharmacy, Tehran Univ. of Medical Sciences, Tehran (Iran); Fallahi, B.; Fard-Esfahani, A.; Eftekhari, M. [Research Inst. for Nuclear Medicine, Tehran Univ. of Medical Sciences, Tehran (Iran); Mohseni, Z.; Khalaj, A. [Dept. of Nuclear Pharmacy, Tehran Univ. of Medical Sciences, Tehran (Iran)

    2010-07-01

    Some studies reported that {sup 99m}Tc-MIBI may redistribute in ischaemic myocardium and this phenomenon may have potential role for better assessment of viability by delayed {sup 99m}Tc-MIBI imaging. Some studies also suggested that infusion of low dose dobutamine during delayed imaging may enhance the value of {sup 99m}Tc-MIBI imaging for evaluation of viability. The aim of this study is to determine whether the observed changes of perfusion defects on delayed images are caused by early radiotracer redistribution or as a result of reversal partial volume effect secondary to inotropic stimulation. Patients, methods: 89 patients with angiographically proven coronary artery disease (CAD) were enrolled in this randomized clinical trial study. In all cases, gated-SPECT images were obtained 60 minutes after stress with dipyridamole injection. Subsequently the patients were randomly allocated in two groups and the second imaging was performed at 120{sup th} minute during low dose dobutamine (dobutamine group; 45 cases) or placebo infusion (placebo group; 44 cases). Difference between summed stress score of the first (SSS{sub 1}) and second (SSS{sub 2}) stress images ({delta}SSS) was considered as a marker of reversibility in single-injection double-acquisition (SIDA) protocol. Also summed difference score (SDS) was recorded as a marker of reversibility in standard stress/rest, double-injection double-acquisition (DIDA) protocol. {delta}SSS of the two studied groups were compared. Also the correlation and agreement between {delta}SSS and SDS were analyzed. Results: A significant difference was found between SSS{sub 1} (median 15, range 0-48) and SSS{sub 2} (median 11, range 0-42) in total patients (p < 0.0001). A significant correlation was noted between {delta}SSS and SDS in dobutamine group (r = 0.58, p = 0.002) as well as in placebo group (r = 0.57, p < 0.0001). Considering DIDA protocol as a standard reference method, the influence of dobutamine infusion was not

  20. 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

  1. 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.

  2. 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.

  3. Utility of Tc99m-Mebrofenin hepato-biliary scintigraphy (HIDA scan) for the diagnosis of biliary atresia.

    Science.gov (United States)

    Shah, Ira; Bhatnagar, Sushmita; Rangarajan, Venkatesh; Patankar, Nikhil

    2012-01-01

    To determine the utility of Tc99m-Mebrofenin hepato-biliary scintigraphy (HIDA scan) for diagnosis of biliary atresia in patients with neonatal cholestasis. Our study involves the retrospective analysis of 46 patients with neonatal cholestasis who underwent HIDA scans at the Pediatric Hepatobiliary Clinic, BJ Wadia Hospital for Children from May 2005 to July 2007. Biliary atresia (BA) was diagnosed on the basis of intra-operative cholangiogram. Non-BA patients were included in the neonatal hepatitis (NH) group. All patients received phenobarbitone and ursodeoxycholic acid for 5 days, prior to the HIDA scan. The HIDA scan was evaluated on the basis of uptake of the radioactive tracer by the liver at 5 minutes after intravenous injection; retention of radioactive tracer within the liver at 24 hours after injection and visualization of excretion of tracer into the intestine upto 24 hours after administration. The results of the HIDA scans were analyzed and correlated with the final diagnosis, gender and age of the patients. Chi-square test was employed for statistical analysis. The age of presentation of our patients ranged from 5 days to 6 months. The male: female ratio was 37:9. Of the total 46 patients, 28 had BA and 18 had NH. All 28 (100%) patients diagnosed with BA showed persistent radiotracer in the liver at 24 hours whereas 17 (94.4%) of the 18 NH patients showed hepatic radiotracer retention (p = 0.207), the difference being statistically insignificant. Twenty two (78.6%) patients of BA showed no excretion of the radiotracer at 24 hours whereas only 7 (38.9%) of the NH group did not excrete the radiotracer (p = 0.007), which was statistically significant. Neither the sex nor the age of the child contributed to any difference on the hepatic retention (p = 0.618 and 0.235, respectively) or on the intestinal excretion (p = 0.307 and 0.9, respectively) of the radiotracer. HIDA scan is a useful tool for screening of biliary atresia in patients with neonatal

  4. 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.)

  5. 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)

  6. Images

    Data.gov (United States)

    National Aeronautics and Space Administration — Images for the website main pages and all configurations. The upload and access points for the other images are: Website Template RSW images BSCW Images HIRENASD...

  7. Epidemiology and risk factors associated with surgical site infection after different types of hepatobiliary and pancreatic surgery.

    Science.gov (United States)

    Morikane, Keita

    2017-10-01

    Surgical site infection (SSI) is one of the most common healthcare-associated infections (HAIs); however, SSI after hepatobiliary and pancreatic surgery (HBPS) has not been well investigated in a large cohort of patients. This study analyzed the factors associated with SSI following HBPS in Japan, using a Japanese national database. Data on HBPS performed between 2012 and 2014 were extracted from a national monitoring system for HAI: The Japan Nosocomial Infections Surveillance. Using multivariate logistic regression, I assessed the factors associated with SSI. The cumulative incidence of SSI following HBPS was 15.6% (2873/18,398). The incidence of SSI after pancreatoduodenectomy was 28.0%, which was significantly higher than that after liver resection and other types of HBPS (8.8 and 15.5%, respectively). Among the four traditional risk factors, the American Society of Anesthesiologists score was ineffective for predicting SSI in the final model of all three types of surgery. Additional risk factors were identified, including age and male gender. The incidence of and factors associated with SSI after the three types of HBPS analyzed differed significantly. To accurately compare hospital performance in relation to SSI following HBPS, the operative procedure category in the surveillance system must be divided into three types.

  8. From Clinical Standards to Translating Next-Generation Sequencing Research into Patient Care Improvement for Hepatobiliary and Pancreatic Cancers.

    Science.gov (United States)

    Kyrochristos, Ioannis D; Glantzounis, Georgios K; Ziogas, Demosthenes E; Gizas, Ioannis; Schizas, Dimitrios; Lykoudis, Efstathios G; Felekouras, Evangelos; Machairas, Anastasios; Katsios, Christos; Liakakos, Theodoros; Cho, William C; Roukos, Dimitrios H

    2017-01-18

    Hepatobiliary and pancreatic (HBP) cancers are associated with high cancer-related death rates. Surgery aiming for complete tumor resection (R0) remains the cornerstone of the treatment for HBP cancers. The current progress in the adjuvant treatment is quite slow, with gemcitabine chemotherapy available only for pancreatic ductal adenocarcinoma (PDA). In the advanced and metastatic setting, only two targeted drugs have been approved by the Food & Drug Administration (FDA), which are sorafenib for hepatocellular carcinoma and erlotinib for PDA. It is a pity that multiple Phase III randomized control trials testing the efficacy of targeted agents have negative results. Failure in the development of effective drugs probably reflects the poor understanding of genome-wide alterations and molecular mechanisms orchestrating therapeutic resistance and recurrence. In the post-ENCODE (Encyclopedia of DNA Elements) era, cancer is referred to as a highly heterogeneous and systemic disease of the genome. The unprecedented potential of next-generation sequencing (NGS) technologies to accurately identify genetic and genomic variations has attracted major research and clinical interest. The applications of NGS include targeted NGS with potential clinical implications, while whole-exome and whole-genome sequencing focus on the discovery of both novel cancer driver genes and therapeutic targets. These advances dictate new designs for clinical trials to validate biomarkers and drugs. This review discusses the findings of available NGS studies on HBP cancers and the limitations of genome sequencing analysis to translate genome-based biomarkers and drugs into patient care in the clinic.

  9. From Clinical Standards to Translating Next-Generation Sequencing Research into Patient Care Improvement for Hepatobiliary and Pancreatic Cancers

    Directory of Open Access Journals (Sweden)

    Ioannis D. Kyrochristos

    2017-01-01

    Full Text Available Hepatobiliary and pancreatic (HBP cancers are associated with high cancer-related death rates. Surgery aiming for complete tumor resection (R0 remains the cornerstone of the treatment for HBP cancers. The current progress in the adjuvant treatment is quite slow, with gemcitabine chemotherapy available only for pancreatic ductal adenocarcinoma (PDA. In the advanced and metastatic setting, only two targeted drugs have been approved by the Food & Drug Administration (FDA, which are sorafenib for hepatocellular carcinoma and erlotinib for PDA. It is a pity that multiple Phase III randomized control trials testing the efficacy of targeted agents have negative results. Failure in the development of effective drugs probably reflects the poor understanding of genome-wide alterations and molecular mechanisms orchestrating therapeutic resistance and recurrence. In the post-ENCODE (Encyclopedia of DNA Elements era, cancer is referred to as a highly heterogeneous and systemic disease of the genome. The unprecedented potential of next-generation sequencing (NGS technologies to accurately identify genetic and genomic variations has attracted major research and clinical interest. The applications of NGS include targeted NGS with potential clinical implications, while whole-exome and whole-genome sequencing focus on the discovery of both novel cancer driver genes and therapeutic targets. These advances dictate new designs for clinical trials to validate biomarkers and drugs. This review discusses the findings of available NGS studies on HBP cancers and the limitations of genome sequencing analysis to translate genome-based biomarkers and drugs into patient care in the clinic.

  10. 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

  11. 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.

  12. Modified response evaluation criteria in solid tumors and European Association for The Study of the Liver criteria using delayed-phase imaging at an early time point predict survival in patients with unresectable intrahepatic cholangiocarcinoma following yttrium-90 radioembolization.

    Science.gov (United States)

    Camacho, Juan C; Kokabi, Nima; Xing, Minzhi; Prajapati, Hasmukh J; El-Rayes, Bassel; Kim, Hyun S

    2014-02-01

    To investigate early imaging prognostic factors in unresectable intrahepatic cholangiocarcinoma (ICC) refractory to standard chemotherapy after yttrium-90 ((90)Y) radioembolization therapy. In an institutional review board-approved prospective correlative study, 21 consecutive patients with ICC refractory to standard chemotherapy underwent (90)Y radioembolization therapy. Target and overall Response Evaluation Criteria In Solid Tumors (RECIST), modified RECIST (mRECIST), and European Association for the Study of the Liver (EASL) treatment responses were assessed. The mRECIST and EASL criteria were modified for application on delayed phases of dynamic contrast-enhanced cross-sectional imaging studies. Conventional definitions for complete and partial response were applied; these responses comprised objective response. Restaging imaging was obtained at 1- and 3-month intervals until patient death. Survival analyses by Kaplan-Meier and log-rank proportional models including application of the landmark method to avoid lead-time bias were performed from the day of treatment. Significance was set at P 90)Y therapy was 16.3 months (95% confidence interval, 7.2-25.4 mo). Significant differences between mRECIST and EASL versus RECIST were found when categorizing patients into responders and nonresponders (P 90)Y radioembolization therapy for ICC predicted OS. RECIST did not correlate with survival. © 2014 Published by SIR on behalf of SIR.

  13. Cross delay line sensor characterization

    Energy Technology Data Exchange (ETDEWEB)

    Owens, Israel J [Los Alamos National Laboratory; Remelius, Dennis K [Los Alamos National Laboratory; Tiee, Joe J [Los Alamos National Laboratory; Buck, Steven E [Los Alamos National Laboratory; Whittemore, Stephen R [Los Alamos National Laboratory; Thompson, David C [Los Alamos National Laboratory; Shirey, Robert [Los Alamos National Laboratory

    2010-01-01

    There exists a wealth of information in the scientific literature on the physical properties and device characterization procedures for complementary metal oxide semiconductor (CMOS), charge coupled device (CCD) and avalanche photodiode (APD) format detectors. Numerous papers and books have also treated photocathode operation in the context of photomultiplier tube (PMT) operation for either non imaging applications or limited night vision capability. However, much less information has been reported in the literature about the characterization procedures and properties of photocathode detectors with novel cross delay line (XDL) anode structures. These allow one to detect single photons and create images by recording space and time coordinate (X, Y & T) information. In this paper, we report on the physical characteristics and performance of a cross delay line anode sensor with an enhanced near infrared wavelength response photocathode and high dynamic range micro channel plate (MCP) gain (> 10{sup 6}) multiplier stage. Measurement procedures and results including the device dark event rate (DER), pulse height distribution, quantum and electronic device efficiency (QE & DQE) and spatial resolution per effective pixel region in a 25 mm sensor array are presented. The overall knowledge and information obtained from XDL sensor characterization allow us to optimize device performance and assess capability. These device performance properties and capabilities make XDL detectors ideal for remote sensing field applications that require single photon detection, imaging, sub nano-second timing response, high spatial resolution (10's of microns) and large effective image format.

  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. Use of a 3-Telsa magnet to perform delayed gadolinium-enhanced magnetic resonance imaging of the distal interphalangeal joint of horses with and without naturally occurring osteoarthritis.

    Science.gov (United States)

    Bischofberger, Andrea S; Fürst, Anton E; Torgerson, Paul R; Carstens, Ann; Hilbe, Monika; Kircher, Patrick

    2018-03-01

    OBJECTIVE To characterize delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) features of healthy hyaline cartilage of the distal interphalangeal joint (DIPJ) of horses, to determine whether dGEMRIC can be used to differentiate various stages of naturally occurring osteoarthritis of the DIPJ, and to correlate relaxation times determined by dGEMRIC with the glycosaminoglycan concentration, water content, and macroscopic and histologic findings of hyaline cartilage of DIPJs with and without osteoarthritis. SAMPLE 1 cadaveric forelimb DIPJ from each of 12 adult warmblood horses. PROCEDURES T1-weighted cartilage relaxation times were obtained for predetermined sites of the DIPJ before (T1 preGd ) and after (T1 postGd ) intra-articular gadolinium administration. Corresponding cartilage sites underwent macroscopic, histologic, and immunohistochemical evaluation, and cartilage glycosaminoglycan concentration and water content were determined. Median T1 preGd and T1 postGd were correlated with macroscopic, histologic, and biochemical data. Mixed generalized linear models were created to evaluate the effects of cartilage site, articular surface, and macroscopic and histologic scores on relaxation times. RESULTS 122 cartilage specimens were analyzed. Median T1 postGd was lower than the median T1 preGd for normal and diseased cartilage. Both T1 preGd and T1 postGd were correlated with macroscopic and histologic scores, whereby T1 preGd increased and T1 postGd decreased as osteoarthritis progressed. There was topographic variation of T1 preGd and T1 postGd within the DIPJ. Cartilage glycosaminoglycan concentration and water content were significantly correlated with T1 preGd and macroscopic and histologic scores but were not correlated with T1 postGd . CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that dGEMRIC relaxation times varied for DIPJs with various degrees of osteoarthritis. These findings may help facilitate early detection of osteoarthritis.

  16. The enhanced value of combining conventional and 'omics' analyses in early assessment of drug-induced hepatobiliary injury

    International Nuclear Information System (INIS)

    Ellinger-Ziegelbauer, Heidrun; Adler, Melanie; Amberg, Alexander; Brandenburg, Arnd; Callanan, John J.; Connor, Susan; Fountoulakis, Michael; Gmuender, Hans; Gruhler, Albrecht; Hewitt, Philip; Hodson, Mark; Matheis, Katja A.; McCarthy, Diane; Raschke, Marian; Riefke, Bjoern; Schmitt, Christina S.; Sieber, Max; Sposny, Alexandra; Suter, Laura; Sweatman, Brian

    2011-01-01

    The InnoMed PredTox consortium was formed to evaluate whether conventional preclinical safety assessment can be significantly enhanced by incorporation of molecular profiling ('omics') technologies. In short-term toxicological studies in rats, transcriptomics, proteomics and metabolomics data were collected and analyzed in relation to routine clinical chemistry and histopathology. Four of the sixteen hepato- and/or nephrotoxicants given to rats for 1, 3, or 14 days at two dose levels induced similar histopathological effects. These were characterized by bile duct necrosis and hyperplasia and/or increased bilirubin and cholestasis, in addition to hepatocyte necrosis and regeneration, hepatocyte hypertrophy, and hepatic inflammation. Combined analysis of liver transcriptomics data from these studies revealed common gene expression changes which allowed the development of a potential sequence of events on a mechanistic level in accordance with classical endpoint observations. This included genes implicated in early stress responses, regenerative processes, inflammation with inflammatory cell immigration, fibrotic processes, and cholestasis encompassing deregulation of certain membrane transporters. Furthermore, a preliminary classification analysis using transcriptomics data suggested that prediction of cholestasis may be possible based on gene expression changes seen at earlier time-points. Targeted bile acid analysis, based on LC-MS metabonomics data demonstrating increased levels of conjugated or unconjugated bile acids in response to individual compounds, did not provide earlier detection of toxicity as compared to conventional parameters, but may allow distinction of different types of hepatobiliary toxicity. Overall, liver transcriptomics data delivered mechanistic and molecular details in addition to the classical endpoint observations which were further enhanced by targeted bile acid analysis using LC/MS metabonomics.

  17. The role of hepatobiliary scintigraphy and MR cholangiography in the assessment of bile duct obstruction after biliary surgery

    International Nuclear Information System (INIS)

    Kim, Jae Seung; Moon, Dae Hyuk; Lee, Moon Gyu; Lee, Sung Gyu; Lee, Hee Kyung

    1998-01-01

    The aim of our study was to determine the role of MR cholangiography (MRC) and hepatobiliary scintigraphy (HBS) in the assessemtn of recurrent bile duct obstruction after biliary surgery. Twenty-three patients (15 men and 8 women: mean age 49.8) with post-biliary operation state (16 biliary-enteric anastomoses and seven cholecystectomy) underwent a total of 28 MRC and 28 HBS using Tc-99m DISIDA within 3 days of each other. Interval between surgery and MRC or HBS ranged from 2 wk to 15 yr (median: 14 mon). MRC and HBS were analyzed for the presence of bile duct obstruction. The final diagnoses were cofirmed by percutaneous transhepatic biliary drainage or surgical operation in 11 of 28 cases and by the follow-up clinical course in the rests. Of 14 instances with bile duct obstruction (13 intrahepatic bile duct obstruction and 1 common bile duct obstruction), HBS showed complete intrahepatic bile duct (IHD) obstruction in 7, incomplete IHD obstruction in 5, parenchymal dysfuction in 1, and IHD dilation without obstructon in 1, resulting in sensitivity of 86% (12/14). MRC showed stone in 6, stricture in 4, IHD dilatation in 3, and normal in 1. The sensitivity of MRC was 71% (10/14). Fourteen instances were without obstruction. HBS showed no evidence of obstruction in all 14 instances (specificity 100%). However, stricture on MRC was found in 4 instances, resulting in specificity of 71% (10/14). HBS is useful in the diagnosis of recurrent bile duct obstruction after surgery. MRC is a useful modality for assessing the diagnosis of obstruction itself as well as the cause and location of bile duct obstruction. However, the specificity of MRC appears to be lower because of possible overestimation of stricture

  18. Role of Hepatobiliary Scintigraphy and Preoperative Liver Biopsy for Exclusion of Biliary Atresia in Neonatal Cholestasis Syndrome.

    Science.gov (United States)

    Mandelia, Ankur; Lal, Richa; Mutt, Nijagal

    2017-09-01

    All diagnostic algorithms for Neonatal Cholestasis Syndrome (NCS) focus on differentiating numerous medical causes from Biliary Atresia (BA). No preoperative diagnostic algorithm has 100% diagnostic accuracy for BA and yet, timely diagnosis is crucial to optimize surgical outcome. Markers for high index of clinical suspicion for BA are: a "usually" well thriving infant with conjugated hyperbilirubinemia, raised gamma glutamyl transpeptidase, persistently "acholic" stools, firm hepatomegaly with dysmorphic, hypoplastic gall bladder. In the presence of above 'red flag' signs, there has been much debate on diagnostic accuracy of percutaneous liver biopsy (PLB) vs. hepatobiliary scintigraphy (HBS) to substantiate or exclude BA. Recent guidelines suggest a shift towards PLB (91.6% overall diagnostic accuracy) as the diagnostic cornerstone with key differentiating feature being 'bile ductular proliferation'. HBS has a high (98.7%) sensitivity but low specificity (37-74%) with an overall diagnostic accuracy of 67% for BA. Severe hepatocellular disease without anatomic obstruction would also have a non-excretory scan. Thus, while excretory HBS excludes BA, non-excretion does not confirm BA. Hence, diagnostic algorithms relying on non-excretory HBS as the primary standalone benchmark for surgical exploration would be mired by a high negative laparotomy rate revealing a normal peroperative cholangiogram (POC). However, an excretory HBS obviates need for laparotomy in case of equivocal stool color or PLB. A POC continues to be the ultimate gold standard. Hence, with high index of clinical suspicion but equivocal ultrasonography or PLB and a non-excretory HBS, the baby should not be denied a POC within time frame crucial for successful hepatoportoenterostomy.

  19. Increased Delay Between Gadolinium Chelate Administration and T1-Weighted Magnetic Resonance Imaging Acquisition Increases Contrast-Enhancing Tumor Volumes and T1 Intensities in Brain Tumor Patients.

    Science.gov (United States)

    Piechotta, Paula L; Bonekamp, David; Sill, Martin; Wick, Antje; Wick, Wolfgang; Bendszus, Martin; Kickingereder, Philipp

    2018-04-01

    The aim of this study was to evaluate the impact of delayed T1-weighted (T1-w) MRI acquisition after gadolinium chelate administration on brain tumor volumes and T1-w intensities. Fifty-five patients with histologically confirmed, contrast-enhancing intra-axial brain tumors were analyzed in this prospective test-retest study. Patients underwent 2 consecutive 3 T MRI scans (separated by a 1-minute break) during routine follow-up with contrast-enhanced T1 (ceT1-w), T2, and FLAIR acquisition. Macrocyclic gadolinium chelate-based contrast agent was only administered before the first ceT1-w acquisition; median latency to ceT1-w acquisition was 6.72 minutes (IQR, 6.53-6.92) in the first and 16.27 minutes (IQR, 15.49-17.26) in the second scan. Changes in tumor volumes and relative ceT1-w intensities between the 2 acquisitions were quantitatively assessed following semiautomated tumor segmentation (separately for contrast-enhancement [CE], necrosis [NEC], and nonenhancing [NE] tumor). Semiautomatically segmented CE tumor volumes were significantly larger in the second acquisition (median +32% [1.2 cm]; IQR, 16%-62%; P < 0.01), which corresponded to a 10% increase in CE tumor diameter (+0.3 cm). Contrarily, NEC and NE tumor volumes were significantly smaller (median -24% [IQR, -36% to -54%], P < 0.01 for NEC and -2% [IQR, -1% to -3%], P = 0.02 for NE tumor). Bland-Altman plots confirmed a proportional bias toward higher CE and lower NEC volumes for the second ceT1-w acquisition. Relative ceT1-w intensities for both early- (regions already enhancing in the first scan) and late-enhancing (newly enhancing regions in the second scan) tumor were significantly increased in the second acquisition (by 5.8% and 27.3% [P < 0.01, respectively]). Linear-mixed effects modeling confirmed that the increase in CE volumes and CE intensities is a function of the interval between contrast agent injection and ceT1-w acquisition (P < 0.01 each). Our study indicates that the maximum extent of CE

  20. Microvascular obstruction on delayed enhancement cardiac magnetic resonance imaging after acute myocardial infarction, compared with myocardial {sup 201}Tl and {sup 123}I-BMIPP dual SPECT findings

    Energy Technology Data Exchange (ETDEWEB)

    Mori, Hiroaki [Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya (Japan); Department of Cardiology, Kainan Hospital, Yatomi (Japan); Isobe, Satoshi, E-mail: sisobe@med.nagoya-u.ac.jp [Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya (Japan); Sakai, Shinichi [Department of Cardiology, Kainan Hospital, Yatomi (Japan); Yamada, Takashi [Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya (Japan); Watanabe, Naoki; Miura, Manabu [Department of Cardiology, Kainan Hospital, Yatomi (Japan); Uchida, Yasuhiro; Kanashiro, Masaaki; Ichimiya, Satoshi [Department of Cardiology, Yokkaichi Municipal Hospital, Yokkaichi (Japan); Okumura, Takahiro; Murohara, Toyoaki [Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya (Japan)

    2015-08-15

    Highlights: • The percentage infarct size (%IS) was significantly greater in the microvascular obstruction (MO) group than in the non-MO group. • The percentage mismatch score (%MMS) on dual scintigraphy significantly correlated with the %IS and the percentage MO. • The %MMS was significantly greater in the non-MO group than in the MO group, and was an independent predictor for MO. - Abstract: Background: The hypo-enhanced regions within the hyper-enhanced infarct areas detected by cardiac magnetic resonance (CMR) imaging reflect microvascular obstruction (MO) after acute myocardial infarction (AMI). The combined myocardial thallium-201 ({sup 201}Tl)/iodine-123-15-(p-iodophenyl)-3-(R,S)-methylpentadecanoic acid ({sup 123}I-BMIPP) dual single-photon emission computed tomography (SPECT) is a useful tool for detecting myocardial reversibility after AMI. We evaluated whether MO could be an early predictor of irreversible myocardial damage in comparison with {sup 201}Tl and {sup 123}I-BMIPP dual SPECT findings in AMI patients. Methods: Sixty-two patients with initial AMI who successfully underwent coronary revascularization were enrolled. MO was defined by CMR imaging. Patients were divided into 2 groups as follows: MO group (n = 32) and non-MO group (n = 30). Scintigraphic defect scores were calculated using a 17-segment model with a 5-point scoring system. The mismatch score (MMS) was calculated as follows: the total sum of (Σ) {sup 123}I-BMIPP defect score minus Σ{sup 201}Tl defect score. The percentage mismatch score (%MMS) was calculated as follows: MMS/(Σ{sup 123}I-BMIPP score) × 100 (%). Results: The percentage infarct size (%IS) was significantly greater in the MO group than in the non-MO group (32.2 ± 13.8% vs. 18.3 ± 12.1%, p < 0.001). The %MMS significantly correlated with the %IS and the percentage MO (r = −0.26, p = 0.03; r = −0.45, p < 0.001, respectively). The %MMS was significantly greater in the non-MO group than in the MO group (45.4

  1. Digital time delay

    Science.gov (United States)

    Martin, A.D.

    1986-05-09

    Method and apparatus are provided for generating an output pulse following a trigger pulse at a time delay interval preset with a resolution which is high relative to a low resolution available from supplied clock pulses. A first lumped constant delay provides a first output signal at predetermined interpolation intervals corresponding to the desired high resolution time interval. Latching circuits latch the high resolution data to form a first synchronizing data set. A selected time interval has been preset to internal counters and corrected for circuit propagation delay times having the same order of magnitude as the desired high resolution. Internal system clock pulses count down the counters to generate an internal pulse delayed by an internal which is functionally related to the preset time interval. A second LCD corrects the internal signal with the high resolution time delay. A second internal pulse is then applied to a third LCD to generate a second set of synchronizing data which is complementary with the first set of synchronizing data for presentation to logic circuits. The logic circuits further delay the internal output signal with the internal pulses. The final delayed output signal thereafter enables the output pulse generator to produce the desired output pulse at the preset time delay interval following input of the trigger pulse.

  2. Delayed Sequence Intubation

    DEFF Research Database (Denmark)

    Weingart, Scott D; Trueger, N Seth; Wong, Nelson

    2015-01-01

    assessed. RESULTS: A total of 62 patients were enrolled: 19 patients required delayed sequence intubation to allow nonrebreather mask, 39 patients required it to allow NIPPV, and 4 patients required it for nasogastric tube placement. Saturations increased from a mean of 89.9% before delayed sequence...

  3. American Dream Delayed

    DEFF Research Database (Denmark)

    Khorunzhina, Natalia; Miller, Robert A.

    This paper investigates the delay in homeownership and a subsequent reduction in homeownership rate observed over the past decades. We focus on the delay in giving birth to children and increased labor market participation as contributing factors to homeownership dynamics for prime-age female hou......, fertility decisions and labor supply alternatives faced by the individuals over different stages of the life cycle. The delays in giving birth and buying first home arise endogenously.......This paper investigates the delay in homeownership and a subsequent reduction in homeownership rate observed over the past decades. We focus on the delay in giving birth to children and increased labor market participation as contributing factors to homeownership dynamics for prime-age female...

  4. 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.

  5. 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

  6. A prospective, single-centre, randomised study evaluating the clinical, imaging and immunological depth of remission achieved by very early versus delayed Etanercept in patients with Rheumatoid Arthritis (VEDERA).

    Science.gov (United States)

    Dumitru, Raluca B; Horton, Sarah; Hodgson, Richard; Wakefield, Richard J; Hensor, Elizabeth M A; Emery, Paul; Buch, Maya H

    2016-02-05

    Rheumatoid arthritis (RA) is a chronic inflammatory arthritis, with significant impact on quality of life and functional status. Whilst biologic disease modifying anti-rheumatic drugs (bDMARD) such as tumour necrosis factor-inhibitor (TNFi) agents have revolutionised outcomes in RA, early diagnosis with immediate conventional therapy, titrated in a treat to target approach is also associated with high remission rates. The main aim of the VEDERA study (Very Early versus Delayed Etanercept in Rheumatoid Arthritis) is to assess the depth of remission, sustainability of remission and immunological normalisation induced by very early TNFi with etanercept (ETN) or standard of care +/- delayed ETN. VEDERA is a pragmatic, phase IV single-centre open-label randomised superiority trial of 120 patients with early, treatment-naive RA. Patients will be randomised 1:1 to first-line ETN and methotrexate (MTX) or MTX with additional synthetic disease modifying anti-rheumatic drugs (sDMARDs) according to a treat to target (TT) protocol with further step up to ETN and MTX after 24 weeks if remission is not achieved. Participants will have regular disease activity assessments and imaging evaluation including musculoskeletal ultrasound and MRI. The main objective of this study is to assess the proportion of patients with early RA that achieve clinical remission at 48 weeks, following either treatment strategy. In addition, the participants are invited to take part in a cardio-vascular sub-study (Coronary Artery Disease in RA, CADERA), which aims to identify the incidence of cardiovascular abnormalities in early RA. The hypothesis underlining this study is that very early treatment with first-line ETN increases the proportion of patients with rheumatoid arthritis achieving clinical remission, in comparison to conventional therapy. NCT02433184 , 23/04/2015.

  7. Interest of delayed images in the detection of small size lesions in positron emission tomography (PET): about a case of peritoneal carcinosis evaluation; Interet des images tardives dans la detection de lesion de petite taille en tomographie par emission de positons (TEP): a propos d'un cas de bilan de carcinose peritoneale

    Energy Technology Data Exchange (ETDEWEB)

    Rakotonirina, H.; Berthelot, C.; Vervueren, L.; Agius, C.; Jeanguillaume, C.; Couturier, O. [Service de medecine nucleaire, CHU d' Angers, (France)

    2009-05-15

    Because of the effect of partial volume, the small injuries (under 1 cm) are not the most often seen in F.D.G.-PET. however, if the gradient tumor/background noise is important, it is sometimes possible to visualize them. To increase this gradient, we can increase the tumor captation of F.D.G. by increasing the time of captation, or reduce the vascular background noise by making easy the urinary excretion. through a clinical case, we remind the interest of delayed images ( 2 hours after injection) associated to the injection of furosemide in the detection of small injuries of peritoneal carcinosis. (N.C.)

  8. 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)

  9. The Phantom Menace for Patients with Hepatobiliary Diseases: Shewanella haliotis, Often Misidentified as Shewanella algae in Biochemical Tests and MALDI-TOF Analysis.

    Science.gov (United States)

    Byun, Jung-Hyun; Park, Hyunwoong; Kim, Sunjoo

    2017-03-24

    Although Shewanella algae has been known to have weak pathogenicity, case reports on infections with this species have been steadily increasing. S. algae and S. haliotis are difficult to distinguish from each other with conventional phenotypic methods. We reviewed the microbiological and clinical features of S. algae and S. haliotis infections at our institute. Bacterial culture and identification reports from patient samples from 2010 to 2014 were reviewed to screen the cases of Shewanella infections. In addition to conventional biochemical tests, 16S rRNA gene sequence analysis and matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) mass spectrometry were performed for 19 stored bacterial isolates. Medical records were reviewed for clinical characteristics and laboratory findings. All isolates were identified as S. algae by using VITEK 2. MALDI-TOF also identified all isolates as S. algae with a 99.9 confidence value. In contrast, 16S rRNA analysis identified 10 isolates as S. algae and 9 isolates as S. haliotis. Both S. algae (60%) and S. haliotis (77%) infections were strongly associated with diseases of the hepatobiliary tract and pancreas. To distinguish between S. algae and S. haliotis, 16S rRNA gene sequence analysis seems more accurate than biochemical tests or MALDI-TOF. Patients with underlying diseases in the hepatobiliary tract and pancreas seem to be susceptible to these marine pathogens.

  10. Evaluation of results of the prostigmine-morphine test with quantitative hepatobiliary scintigraphy: a new method for the diagnosis of sphincter of Oddi dyskinesia

    International Nuclear Information System (INIS)

    Madacsy, L.; Veloesy, B.; Lonovics, J.; Csernay, L.

    1995-01-01

    We have visualized SO spasms during prostigmine-morphine provocation by means of quantitative hepatobiliary scintigraphy (QHBS). Twenty-two cholecystectomized patients with typical postprandial biliary pain were included in this study. In the first series of studies, QHBS with technetium-99m 2,6-diethylphenylcarbamoylmethyl-diacetic acid was performed in each patient 2 days before prostigmine-morphine provocation. The time to peak activity and the half-time of excretion over the liver parenchyma, hepatic hilum and common bile duct, and the duodenum appearance time, were determined and served as control values. In the second series of experiments, sphincter spasms were evoked by prostigmine-morphine administration and visualized by means of QHBS. The same parameters were evaluated and serum levels of aspartate aminotransferase (AST) were determined simultaneously at regular intervals. In 12 patients who responded to prostigmine-morphine provocation with typical biliary pain and a significant AST elevation (Nardi positive group) the hepatobiliary scintigram demonstrated a marked biliary obstruction. Four of the remaining ten patients indicated atypical abdominal pain during prostigmine-morphine provocation, but the AST level remained unchanged in all ten (Nardi negative group). In this group, QHBS revealed a slower, but free transpapillary flow of the tracer. QHBS combined with the prostigmine-morphine provocation test proved to be a useful non-invasive method for the detection of pathological sphincter spasms in patients with SO dyskinesia. (orig./MG)

  11. Delayed puberty in boys

    Science.gov (United States)

    ... In most cases, delayed puberty is simply a matter of growth changes beginning later than usual, sometimes ... ADAM Health Solutions. About MedlinePlus Site Map FAQs Customer Support Get email updates Subscribe to RSS Follow ...

  12. Delayed puberty in girls

    Science.gov (United States)

    ... with too little body fat, gaining a bit of weight may help trigger puberty. If delayed puberty is caused by a disease or an eating disorder, treating the cause may help puberty to develop normally. If puberty ...

  13. Vernier Delay Unit

    Energy Technology Data Exchange (ETDEWEB)

    Pierce, W.B.

    1984-10-01

    This module will accept differential ECL pulses from the auxiliary rear panel or NIM level pulses from the front panel. The pulses are produced at the output with a fixed delay that is software programmable in steps of 0.1 ns over the range of 0.1 to 10.5 ns. Multiple outputs are available at the front panel. Minimum delay through the module is 9 ns.

  14. Choice and reinforcement delay

    OpenAIRE

    Gentry, G. David; Marr, M. Jackson

    1980-01-01

    Previous studies of choice between two delayed reinforcers have indicated that the relative immediacy of the reinforcer is a major determinant of the relative frequency of responding. Parallel studies of choice between two interresponse times have found exceptions to this generality. The present study looked at the choice by pigeons between two delays, one of which was always four times longer than the other, but whose absolute durations were varied across conditions. The results indicated th...

  15. Modelling delays in pharmacokinetics

    International Nuclear Information System (INIS)

    Farooqi, Z.H.; Lambrecht, R.M.

    1990-01-01

    Linear system analysis has come to form the backbone of pharmacokinetics. Natural systems usually involve time delays, thus models incorporating them would be an order closer approximation to the real world compared to those that do not. Delays may be modelled in several ways. The approach considered in this study is to have a discrete-time delay dependent rate with the delay respresenting the duration between the entry of a drug into a compartment and its release in some form (may be as a metabolite) from the compartment. Such a delay may be because of one or more of several physiological reasons, like, formation of a reservoir, slow metabolism, or receptor binding. The mathematical structure this gives rise to is a system of delay-differential equations. Examples are given of simple one and two compartment systems with drugs like bumetanide, carbamazepine, and quinolone-caffeine interaction. In these examples generally a good fit is obtained and the suggested models form a good approximation. 21 refs., 6 figs

  16. 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

  17. Gd-EOB-DTPA-enhanced MR imaging findings of hepatocellular adenoma: correlation with pathological findings.

    Science.gov (United States)

    Takara, Kenichi; Saito, Kazuhiro; Kusama, Hiroshi; Tsuchida, Akihiko; Aoki, Tatsuya; Nagao, Toshitaka; Imai, Yasuharu; Taira, Junichi; Moriyasu, Fuminori; Tokuuye, Koichi

    2011-01-01

    We report a case of a 28-year-old woman with hepatocellular adenoma and correlate findings of pathology and magnetic resonance (MR) imaging with gadolinium ethoxybenzyl diethylenetriaminepentaacetic acid (Gd-EOB-DTPA) enhancement. In the hepatobiliary phase, the peripheral region of the tumor that corresponded with proliferating hepatocytes with steatosis showed slight hypointensity compared with the surrounding liver parenchyma, and the central region of the tumor that corresponded with cellular areas showed isointensity.

  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. BOLD delay times using group delay in sickle cell disease

    Science.gov (United States)

    Coloigner, Julie; Vu, Chau; Bush, Adam; Borzage, Matt; Rajagopalan, Vidya; Lepore, Natasha; Wood, John

    2016-03-01

    Sickle cell disease (SCD) is an inherited blood disorder that effects red blood cells, which can lead to vasoocclusion, ischemia and infarct. This disease often results in neurological damage and strokes, leading to morbidity and mortality. Functional Magnetic Resonance Imaging (fMRI) is a non-invasive technique for measuring and mapping the brain activity. Blood Oxygenation Level-Dependent (BOLD) signals contain also information about the neurovascular coupling, vascular reactivity, oxygenation and blood propagation. Temporal relationship between BOLD fluctuations in different parts of the brain provides also a mean to investigate the blood delay information. We used the induced desaturation as a label to profile transit times through different brain areas, reflecting oxygen utilization of tissue. In this study, we aimed to compare blood flow propagation delay times between these patients and healthy subjects in areas vascularized by anterior, middle and posterior cerebral arteries. In a group comparison analysis with control subjects, BOLD changes in these areas were found to be almost simultaneous and shorter in the SCD patients, because of their increased brain blood flow. Secondly, the analysis of a patient with a stenosis on the anterior cerebral artery indicated that signal of the area vascularized by this artery lagged the MCA signal. These findings suggest that sickle cell disease causes blood propagation modifications, and that these changes could be used as a biomarker of vascular damage.

  20. Delayed breast implant reconstruction

    DEFF Research Database (Denmark)

    Hvilsom, Gitte B.; Hölmich, Lisbet R.; Steding-Jessen, Marianne

    2011-01-01

    Studies of complications following reconstructive surgery with implants among women with breast cancer are needed. As the, to our knowledge, first prospective long-term study we evaluated the occurrence of complications following delayed breast reconstruction separately for one- and two......-stage procedures. From the Danish Registry for Plastic Surgery of the Breast, which has prospectively registered data for women undergoing breast implantations since 1999, we identified 559 women without a history of radiation therapy undergoing 592 delayed breast reconstructions following breast cancer during...... of reoperation was significantly higher following the one-stage procedure. For both procedures, the majority of reoperations were due to asymmetry or displacement of the implant. In conclusion, non-radiated one- and two-stage delayed breast implant reconstructions are associated with substantial risks...

  1. Evaluation of the endothelin receptor antagonists ambrisentan, bosentan, macitentan, and sitaxsentan as hepatobiliary transporter inhibitors and substrates in sandwich-cultured human hepatocytes.

    Directory of Open Access Journals (Sweden)

    Eve-Irene Lepist

    Full Text Available Inhibition of the transporter-mediated hepatobiliary elimination of bile salts is a putative mechanism for liver toxicity observed with some endothelin receptor antagonists (ERAs.Sandwich-cultured human hepatocytes were used to study the hepatobiliary distribution and accumulation of exogenous taurocholate, ERAs and endogenous bile acids. The molecular mechanisms for findings in hepatocytes or clinical observations were further explored using either vesicular assays (efflux transporters or transfected cell-lines (uptake transporters. Inhibition constants (IC50 were measured for the human hepatobiliary transporters bile salt export pump (BSEP, sodium taurocholate cotransporting polypeptide (NTCP, multidrug resistance protein 2 (MRP2, P-glycoprotein (Pgp, breast cancer resistance protein (BCRP, organic anion-transporting polypeptide 1B1 (OATP1B1 and OATP1B3.The ERAs showed dose-dependent reductions in exogenous taurocholate cellular accumulation in human hepatocytes, with macitentan having the greatest effect. Consistent with their effects on bile acids, the ERAs inhibited bile transporters. IC50 values for OATP1B1 and OATP1B3 ranged from 2 µM for macitentan to 47 µM for ambrisentan. Macitentan and bosentan also inhibited NTCP with IC50 values of 10 and 36 µM, respectively. Similar to previously reported findings with sitaxsentan, BSEP inhibition was observed for bosentan and macitentan with IC50 values of 42 and 12 µM, respectively. In contrast, ambrisentan showed little or no inhibition of these transporters. Other transporters tested were weakly inhibited by the ERAs. Accumulation in hepatocytes was also a factor in the effects on bile transport. Macitentan demonstrated the greatest accumulation in human hepatocytes (∼100x followed by sitaxsentan (∼40x, bosentan (∼20x and ambrisentan (∼2x.Significant differences in the inhibition of hepatic transporters were observed between the evaluated ERAs in vitro. Macitentan had the highest

  2. Delayed photon selfinterference

    International Nuclear Information System (INIS)

    Kessel', A.R.; Moiseev, S.A.

    1993-01-01

    Delayed photon selfinterference on a sample containing resonant two-level atoms is considered when the difference in the lengths in two optical paths exceeds the photon 'length'. It is shown that a reading pulse of the electromagnetic field can induce photon echo

  3. Permissible Delay in Payments

    Directory of Open Access Journals (Sweden)

    Yung-Fu Huang

    2007-01-01

    Full Text Available The main purpose of this paper wants to investigate the optimal retailer's lot-sizing policy with two warehouses under partially permissible delay in payments within the economic order quantity (EOQ framework. In this paper, we want to extend that fully permissible delay in payments to the supplier would offer the retailer partially permissible delay in payments. That is, the retailer must make a partial payment to the supplier when the order is received. Then the retailer must pay off the remaining balance at the end of the permissible delay period. In addition, we want to add the assumption that the retailer's storage space is limited. That is, the retailer will rent the warehouse to store these exceeding items when the order quantity is larger than retailer's storage space. Under these conditions, we model the retailer's inventory system as a cost minimization problem to determine the retailer's optimal cycle time and optimal order quantity. Three theorems are developed to efficiently determine the optimal replenishment policy for the retailer. Finally, numerical examples are given to illustrate these theorems and obtained a lot of managerial insights.

  4. Estimating Delays In ASIC's

    Science.gov (United States)

    Burke, Gary; Nesheiwat, Jeffrey; Su, Ling

    1994-01-01

    Verification is important aspect of process of designing application-specific integrated circuit (ASIC). Design must not only be functionally accurate, but must also maintain correct timing. IFA, Intelligent Front Annotation program, assists in verifying timing of ASIC early in design process. This program speeds design-and-verification cycle by estimating delays before layouts completed. Written in C language.

  5. Delays of Interconnected Flows

    Science.gov (United States)

    Sorger, U.; Suchanecki, Z.

    2011-07-01

    A rigorous approach to flows of particles in networks is presented. Under the assumption of independence of the transversal flows the asymptotic distributions of inter-delay times between particles are shown to be log-normal. In the case of dependent transversal traffic the ARCH and GARCH time series models, as well as martingale approach, have been applied.

  6. Plasmas for Transition Delay

    NARCIS (Netherlands)

    Kotsonis, M.; Boon, P.; Veldhuis, L.

    2009-01-01

    This paper describes the experimental investigation of the properties of Dielectric Barrier Discharge (DBD) actuators aimed at transition delay techniques. A wide range of geometrical configurations are tested as well as several electrical operational conditions. For the majority of the measurements

  7. 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.

  8. Delayed Reduction of Nasal Bone Fractures.

    Science.gov (United States)

    Yoon, Han Young; Han, Dong Gil

    2016-06-01

    Nasal bone fractures are managed by closed reduction within the 2-week period, and are managed by secondary correction after this time. There is little literature on the delayed reduction for nasal bone fractures beyond the 2-week duration. We report our experience with nasal fractures, which were reduced beyond this period. A retrospective review was performed for all patients who had undergone closed reduction of isolated nasal bone fracture. Patients were included for having undergone reduction of nasal bone fractures at or more than 2 weeks after the injury. Medical records were reviewed for demographic information, injury mechanism, fracture type, delay in treatment, and cause for delay. Postoperative outcomes were evaluated using computed tomography images. The review identified 10 patients. The average reduction time was 22.1 days. Five of patients underwent reduction between days 15 and 20, and the remaining five patients underwent reduction between days 21 and 41. The postoperative outcomes were excellent in 8 patients and good in 2 patients. Outcomes were superior for nasal fractures with displaced end plates and multiple fracture segments. Our study results appears to support delayed reduction of isolated nasal fractures in the presence of factors that delay bony reunion.

  9. Images.

    Science.gov (United States)

    Barr, Catherine, Ed.

    1997-01-01

    The theme of this month's issue is "Images"--from early paintings and statuary to computer-generated design. Resources on the theme include Web sites, CD-ROMs and software, videos, books, and others. A page of reproducible activities is also provided. Features include photojournalism, inspirational Web sites, art history, pop art, and myths. (AEF)

  10. Time-Delay Interferometry

    Directory of Open Access Journals (Sweden)

    Massimo Tinto

    2014-08-01

    Full Text Available Equal-arm detectors of gravitational radiation allow phase measurements many orders of magnitude below the intrinsic phase stability of the laser injecting light into their arms. This is because the noise in the laser light is common to both arms, experiencing exactly the same delay, and thus cancels when it is differenced at the photo detector. In this situation, much lower level secondary noises then set the overall performance. If, however, the two arms have different lengths (as will necessarily be the case with space-borne interferometers, the laser noise experiences different delays in the two arms and will hence not directly cancel at the detector. In order to solve this problem, a technique involving heterodyne interferometry with unequal arm lengths and independent phase-difference readouts has been proposed. It relies on properly time-shifting and linearly combining independent Doppler measurements, and for this reason it has been called time-delay interferometry (TDI. This article provides an overview of the theory, mathematical foundations, and experimental aspects associated with the implementation of TDI. Although emphasis on the application of TDI to the Laser Interferometer Space Antenna (LISA mission appears throughout this article, TDI can be incorporated into the design of any future space-based mission aiming to search for gravitational waves via interferometric measurements. We have purposely left out all theoretical aspects that data analysts will need to account for when analyzing the TDI data combinations.

  11. Delayed Speech or Language Development

    Science.gov (United States)

    ... Safe Videos for Educators Search English Español Delayed Speech or Language Development KidsHealth / For Parents / Delayed Speech ... their child is right on schedule. How Are Speech and Language Different? Speech is the verbal expression ...

  12. 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.

  13. Imaging

    International Nuclear Information System (INIS)

    Kellum, C.D.; Fisher, L.M.; Tegtmeyer, C.J.

    1987-01-01

    This paper examines the advantages of the use of excretory urography for diagnosis. According to the authors, excretory urography remains the basic radiologic examination of the urinary tract and is the foundation for the evaluation of suspected urologic disease. Despite development of the newer diagnostic modalities such as isotope scanning, ultrasonography, CT, and magnetic resonsance imaging (MRI), excretory urography has maintained a prominent role in ruorradiology. Some indications have been altered and will continue to change with the newer imaging modalities, but the initial evaluation of suspected urinary tract structural abnormalities; hematuria, pyuria, and calculus disease is best performed with excretory urography. The examination is relatively inexpensive and simple to perform, with few contraindictions. Excretory urography, when properly performed, can provide valuable information about the renal parenchyma, pelvicalyceal system, ureters, and urinary bladder

  14. Delayed Macular Hole Closure

    Directory of Open Access Journals (Sweden)

    Peter Distelmaier

    2014-04-01

    Full Text Available Purpose: The presented case raises questions regarding the favorable scheduling of planned postoperative care and the ideal observation interval to decide for reoperations in macular hole surgery. Furthermore a discussion about the use of short- and long-acting gas tamponades in macular hole surgery is encouraged. Methods: We present an interventional case report and a short review of the pertinent literature. Results: We report a case of spontaneous delayed macular hole closure after vitreoretinal surgery had been performed initially without the expected success. A 73-year-old male Caucasian patient presented at our clinic with a stage 2 macular hole in his left eye. He underwent 23-gauge pars plana vitrectomy and internal limiting membrane peeling with a 20% C2F6-gas tamponade. Sixteen days after the procedure, an OCT scan revealed a persistent stage 2 macular hole, and the patient was scheduled for reoperation. Surprisingly, at the date of planned surgery, which was another 11 days later, the macular hole had resolved spontaneously without any further intervention. Conclusions: So far no common opinion exists regarding the use of short- or long-acting gas in macular hole surgery. Our case of delayed macular hole closure after complete resorption of the gas tamponade raises questions about the need and duration of strict prone positioning after surgery. Furthermore short-acting gas might be as efficient as long-acting gas. We suggest to wait with a second intervention at least 4 weeks after the initial surgery, since a delayed macular hole closure is possible.

  15. Organophosphate induced delayed polyneuropathy.

    Science.gov (United States)

    Qureshi, Asif; Ali, Rajab; Yaqoob, M Yousuf; Saleem, Omema

    2007-07-01

    Organophosphate induced delayed polyneuropathy (OPIDP) is a rare sensory-motor distal axonopathy, which usually occur after ingestion of large doses of certain organophosphate insecticide. The clinical picture is characterized by the distal paresis in lower limb associated with sensory symptoms. Electrodiagnostic studies show a motor axonal neuropathy. This case occurred in a 14 years old girl who developed cramping pain in both calves associated with lower limbs paresis 6 weeks after accidental organophosphate poisoning. After another week, she also developed weakness in both hands. Electrophysiological study was characterized by an axonal polyneuropathy pattern. Patient improved upon oral multivitamin therapy and physiotherapy.

  16. Delayed breast implant reconstruction

    DEFF Research Database (Denmark)

    Hvilsom, Gitte B.; Hölmich, Lisbet R.; Steding-Jessen, Marianne

    2012-01-01

    We evaluated the association between radiation therapy and severe capsular contracture or reoperation after 717 delayed breast implant reconstruction procedures (288 1- and 429 2-stage procedures) identified in the prospective database of the Danish Registry for Plastic Surgery of the Breast during...... of radiation therapy was associated with a non-significantly increased risk of reoperation after both 1-stage (HR = 1.4; 95% CI: 0.7-2.5) and 2-stage (HR = 1.6; 95% CI: 0.9-3.1) procedures. Reconstruction failure was highest (13.2%) in the 2-stage procedures with a history of radiation therapy. Breast...

  17. Concurrent Delay in Construction Disputes

    DEFF Research Database (Denmark)

    Cavaleri, Sylvie Cécile

    period of delay can potentially be attributed to several events falling within both parties' spheres of responsibility, commonly termed concurrent delay, is rarely regulated in construction contracts in spite of its common occurrence. This book analyses both the theoretical foundations and the practical......Delay is one of the issues most frequently encountered in today’s construction industry; it causes significant economic damage to all parties involved. Construction contracts, standard and bespoke, almost invariably consider delay from a perspective of single liability. If the event causing...... solutions to the issue of concurrent delay in a comparative perspective between common and civil law systems, with an emphasis on Danish and English law....

  18. Vehicle barrier with access delay

    Science.gov (United States)

    Swahlan, David J; Wilke, Jason

    2013-09-03

    An access delay vehicle barrier for stopping unauthorized entry into secure areas by a vehicle ramming attack includes access delay features for preventing and/or delaying an adversary from defeating or compromising the barrier. A horizontally deployed barrier member can include an exterior steel casing, an interior steel reinforcing member and access delay members disposed within the casing and between the casing and the interior reinforcing member. Access delay members can include wooden structural lumber, concrete and/or polymeric members that in combination with the exterior casing and interior reinforcing member act cooperatively to impair an adversarial attach by thermal, mechanical and/or explosive tools.

  19. Patient delay in cancer studies

    DEFF Research Database (Denmark)

    Andersen, Rikke Sand; Vedsted, Peter; Olesen, Frede

    2009-01-01

    BACKGROUND: There is no validated way of measuring the prevalence and duration of patient delay, and we do not know how people perceive and define the time intervals they are asked to report in patient delay studies. This lack of a validated measure hampers research in patient delay...... as symptoms related to a specific cancer diagnosis is embedded within a social and cultural context. We therefore cannot assume that respondents define delay periods in identical ways. SUMMARY: In order to improve the validity of patient delay studies, it is suggested that research be strengthened on three...

  20. 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

  1. Epidemiology of delayed ejaculation.

    Science.gov (United States)

    Di Sante, Stefania; Mollaioli, Daniele; Gravina, Giovanni Luca; Ciocca, Giacomo; Limoncin, Erika; Carosa, Eleonora; Lenzi, Andrea; Jannini, Emmanuele A

    2016-08-01

    A large body of literature on diminished ejaculatory disorders has been generated without the use of a clear diagnostic definition. Many studies have not distinguished between the orgasm and ejaculation disorders leading to doubtful results. Delayed ejaculation (DE) is one of the diminished ejaculatory disorders, which range from varying delays in ejaculatory latency to a complete inability to ejaculate. The present review is aimed at providing a comprehensive overview of the current knowledge on the definition and epidemiology of diminished ejaculatory disorders. We focus on the acquired diseases, such as benign prostatic hyperplasia (BPH) and specific drug regimens that may cause an iatrogenic form of ejaculatory disorder. In addition, the impact of aging is discussed since the prevalence of DE appears to be moderately but positively related to age. Finally, we also focus on the importance of the hormonal milieu on male ejaculation. To date, evidence on the endocrine control of ejaculation is derived from small clinical trials, but the evidence suggests that hormones modulate the ejaculatory process by altering its overall latency.

  2. 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.)

  3. Gadolinium-based contrast agents in pediatric magnetic resonance imaging

    International Nuclear Information System (INIS)

    Gale, Eric M.; Caravan, Peter; Rao, Anil G.; McDonald, Robert J.; Winfeld, Matthew; Fleck, Robert J.; Gee, Michael S.

    2017-01-01

    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.)

  4. FINANCIAL PERFORMANCE, AUDIT DELAY AND FIRM VALUES BANKING IN INDONESIA

    Directory of Open Access Journals (Sweden)

    Stephanus Dwiarso Utomo

    2017-04-01

    Full Text Available Fraud cases in capital market concerning financial report delay were the main issues of the research. The aim of this research was to investigate the effect of financial performance,audit delay, and firm value. Population of the research was all companies listed in Indonesian Stock Exchange, from 2011-2013. The total of research samples were 38 banking companies with 97 annual reports done by using purposive sampling method.Data analyses used were classical assumption test and hypothesis test with multiple linear regression analysis. The result of the research showed that financial performance had a significant influence to audit delay, while financial performance had a significant influence to firm value. Meanwhile audit delay did not significantly influence to firm value. The practical implication of the research suggested the delay of the financial report’s delivery had an impact toward company’s image in front of the stakeholders.

  5. Technetium-99m DISIDA hepatobiliary agent in diagnosis of hepatocellular carcinoma: relationship between detectability and tumor differentiation

    International Nuclear Information System (INIS)

    Calvet, X.; Pons, F.; Bruix, J.; Bru, C.; Lomena, F.; Herranz, R.; Brugera, M.; Faus, R.; Rodes, J.

    1988-01-01

    The present investigation was aimed to assess the usefulness of biliary agents scintigraphy in the diagnosis of hepatocellular carcinoma (HCC) and to ascertain the relationship between the uptake of these agents and the degree of HCC differentiation. Forty-four patients with this hepatic cancer were included in the study. Liver scans were performed 20 min and 3 hr after the administration of 99mTc diisopropyliminodiacetic acid (DISIDA). DISIDA scintigraphy could not be assessed in six cases. In 16 (42%) out of the remaining 38 patients, the tumor exhibited equal or greater radioactivity uptake than the surrounding liver. In six out of these 16 patients, tumor uptake was apparent in the early and delayed hepatic scans, while in the other ten subjects radioactivity uptake by the HCC could only be detected in the 3-hr delayed scans. In the remaining 22 patients, HCC appeared as a cold area. Tumor location by this technique did not differ from that observed by 99mTc-sulfur colloid scan or ultrasound. DISIDA uptake was significantly related to tumor differentiation: 70% of those well differentiated tumors exhibited DISIDA uptake, whereas it was found in only 30% of those moderately differentiated and in none of those poorly differentiated (p less than 0.05). These results show that DISIDA scintigraphy can be useful in the diagnosis of HCC. Since its sensitivity is related to the degree of tumor differentiation, it may be indicated when aspiration cytology is unable to distinguish between well differentiated HCC and reactive changes due to hepatic cirrhosis

  6. Delayed cure bismaleimide resins

    Science.gov (United States)

    Adams, Johnnie E.; Jamieson, Donald R.

    1984-08-07

    Polybismaleimides prepared by delayed curing of bis-imides having the formula ##STR1## wherein R.sub.1 and R.sub.2 each independently is H, C.sub.1-4 -alkyl, C.sub.1-4 -alkoxy, Cl or Br, or R.sub.1 and R.sub.2 together form a fused 6-membered hydrocarbon aromatic ring, with the proviso that R.sub.1 and R.sub.2 are not t-butyl or t-butoxy; X is O, S or Se; n is 1-3; and the --(CH.sub.2).sub.n -- group, optionally, is substituted by 1-3 methyl groups or by fluorine.

  7. Transfer delay audit.

    Science.gov (United States)

    Alraqi, S; Coughlan, R

    2007-05-01

    The purpose was to determine the average transfer time taken for acute patients to arrive to the medical unit from the time of referral by an A/E officer. We included the first 200 consecutive patients with completed records. 86 were men and 114 women, aged between 14 and 96 years. Transfer time was calculated as the difference from the time of referral by the A/E officer in UCHG to the time of arrival to the medical unit in MPH. The average transfer time for all patients was 91.5 minutes. The longest was in the second (17:00-24:00) interval with a mean of 105 minutes. 26.5% of patients arrived later than 2 hours after referral. Our findings confirm the existence of unacceptably long transfer time for a significant number of patients. Causes for this delay should be searched for to help find and implement solutions.

  8. Delay tolerant networks

    CERN Document Server

    Gao, Longxiang; Luan, Tom H

    2015-01-01

    This brief presents emerging and promising communication methods for network reliability via delay tolerant networks (DTNs). Different from traditional networks, DTNs possess unique features, such as long latency and unstable network topology. As a result, DTNs can be widely applied to critical applications, such as space communications, disaster rescue, and battlefield communications. The brief provides a complete investigation of DTNs and their current applications, from an overview to the latest development in the area. The core issue of data forward in DTNs is tackled, including the importance of social characteristics, which is an essential feature if the mobile devices are used for human communication. Security and privacy issues in DTNs are discussed, and future work is also discussed.

  9. Delayed Tamponade after Traumatic Wound with Left Ventricular Compression

    OpenAIRE

    Almehmadi, Fahad; Chandy, Mark; Connelly, Kim A.; Edwards, Jeremy

    2016-01-01

    Delayed cardiac tamponade after a penetrating chest injury is a rare complication. The clinical diagnosis of tamponade is facilitated with imaging. We present a case report of a 23-year-old male who was brought to emergency after multiple stab wounds to the chest. After resuscitation and repair of laceration of right internal mammary artery and right ventricle, he was discharged but later returned with shortness of breath. Echocardiography revealed a rare case of delayed pericardial tamponade...

  10. 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.

  11. Disorders of Bone Mineral Density and Secondary Osteoporosis in Pathology of Hepatobiliary System and Gastrointestinal Tract: at the Crossing of Problems

    Directory of Open Access Journals (Sweden)

    I.Yu. Golovach

    2012-08-01

    Full Text Available This review article covers the issues of development of osteoporosis and disorders of bone mineral density in patients with various gastroenterological and hepatobiliary diseases. The article emphasized that the osteoporosis may be associated with many somatic diseases, especially of the digestive tract. Such situation requires participation of therapeutists and gastroenterologists in rehabilitation health care programs. According to the practical guidelines of the World Organization of Gastroenterology (OMGE, 2004 list of chronic diseases of the digestive system triggering the dangerous development of osteoporosis includes short bowel syndrome, postgastrectomy syndrome, inflammatory bowel disease, celiac disease, cholestatic liver disease, as well as glucocorticoid-induced osteoporosis. The etiology and pathogenesis of lower bone mineral density in patients with chronic diseases of the digestive system include, besides population-based risk factors, processes associated with disorders of vitamin D conversion, which leads to reduction of the absorption of calcium, magnesium and phosphorus in the intestine and increase of their excretion by the kidneys. Hypocalcemia results in activation of the parathyroid glands and secondary hyperparathyroidism, and against the background of chronic inflammation increases the activity of cytokines, in particular tumor necrosis factor α and interleukins-1, -6, having bone resorptive action. The main risk factors for osteoporosis for various diseases associated with the peculiarities of the digestive tract’ disease were identified.

  12. Diagnosis of hepatobiliary disease by Technetium-99m-HIDA and BIDA cholecystography in 210 patients treated at ''Soroka Medical Center'' between 1977 - 1979

    International Nuclear Information System (INIS)

    Garty, I.; Silberman, C.

    1979-01-01

    Cholescintigraphy experience with Tc 99 m-HIDA and BIDA in 210 patients with gallbladder disease treated at the Soroka Medical Center between the years 1977 - 1979 is described. In this work the utility of the method in both acute and chronic cholecystitis and hepatobiliary disease in the presence of jaundice up to 26 mg% of Bilirubin is demosntrated. Four patients were diagnosed as suffering from Atresia of biliary duct. The most common findings in our series are: all normal gallbladders exhibited filling; absence of visualization indicated gallbladder disease and/or cystic duct obstruction; visualization of the gallbladder after a fatty meal-induced emptying excluded an obstructed cystic duct and acute cholecystitis; a definite diagnosis of hepato-cellular disease, partial and complete obstruction, is possible in jaundiced patients with hyperbilirubinemia. No diagnostic failures due to too low concentration of the tracer in the biliary tract, were observed. Radiation exposure is somewhat greater than in cholecystography and cholangiography. Cholescintigraphy is a suitable complementary or alternative investigation to intravenous cholangiography, especially when poor excretion of the contrast medium or adverse reaction impair the result of the latter. In some of our cases this method proved to be the first choice non invasive procedure, especially in cases with high serum bilirubin up to 26 mg%. (B.G.)

  13. Assessment of Liver Function Using 99mTc-Mebrofenin Hepatobiliary Scintigraphy in ALPPS (Associating Liver Partition and Portal Vein Ligation for Staged Hepatectomy

    Directory of Open Access Journals (Sweden)

    Kasia P. Cieslak

    2015-11-01

    Full Text Available ALPPS (associating liver partition and portal vein ligation for staged hepatectomy is a new surgical technique for patients in whom conventional treatment is not feasible due to insufficient future remnant liver (FRL. During the first stage of ALPPS, accelerated hypertrophy of the FRL is induced by ligation of the portal vein and in situ split of the liver. In the second stage, the deportalized liver is removed when the FRL volume has reached ≥25% of total liver volume. However, FRL volume does not necessarily reflect FRL function. 99mTc-mebrofenin hepatobiliary scintigraphy (HBS with SPECT-CT is a quantitative test enabling regional assessment of parenchymal uptake function using a validated cut-off value for the prediction of postoperative liver failure (2.7%/min/m2. This paper describes the changes in FRL function and FRL volume in a 79-year-old patient diagnosed with metachronous colonic liver metastases who underwent ALPPS. We have observed a substantial difference between the increase in FRL volume and FRL function suggesting that HBS with SPECT-CT enables monitoring of the FRL function and could be a useful tool in the timing of resection in the second stage of the ALPPS procedure.

  14. Location Estimation using Delayed Measurements

    DEFF Research Database (Denmark)

    Bak, Martin; Larsen, Thomas Dall; Nørgård, Peter Magnus

    1998-01-01

    When combining data from various sensors it is vital to acknowledge possible measurement delays. Furthermore, the sensor fusion algorithm, often a Kalman filter, should be modified in order to handle the delay. The paper examines different possibilities for handling delays and applies a new techn...... technique to a sensor fusion system for estimating the location of an autonomous guided vehicle. The system fuses encoder and vision measurements in an extended Kalman filter. Results from experiments in a real environment are reported......When combining data from various sensors it is vital to acknowledge possible measurement delays. Furthermore, the sensor fusion algorithm, often a Kalman filter, should be modified in order to handle the delay. The paper examines different possibilities for handling delays and applies a new...

  15. 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

  16. Control systems with network delay

    OpenAIRE

    Şabanoviç, Asif; Sabanovic, Asif; Ohnishi, Kouhei; Yashiro, Daisuke; Acer, Merve; Ş.-Behliloviç, Nadira; S.-Behlilovic, Nadira

    2009-01-01

    In this paper motion control systems with delay in measurement and control channels are discussed and a new structure of the observer-predictor is proposed. The feature of the proposed system is enforcement of the convergence in both the estimation and the prediction of the plant output in the presence of the variable, unknown delay in both measurement and in the control channels. The estimation is based on the available data – undelayed control input, the delayed measurement of position o...

  17. 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

  18. 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.

  19. PRECISION TIME-DELAY CIRCUIT

    Science.gov (United States)

    Creveling, R.

    1959-03-17

    A tine-delay circuit which produces a delay time in d. The circuit a capacitor, an te back resistance, connected serially with the anode of the diode going to ground. At the start of the time delay a negative stepfunction is applied to the series circuit and initiates a half-cycle transient oscillatory voltage terminated by a transient oscillatory voltage of substantially higher frequency. The output of the delay circuit is taken at the junction of the inductor and diode where a sudden voltage rise appears after the initiation of the higher frequency transient oscillations.

  20. Systematic of delayed neutron parameters

    International Nuclear Information System (INIS)

    Isaev, S.G.; Piksaikin, V.M.

    2000-01-01

    The experimental studies of the energy dependence of the delayed neutron (DN) parameters for various fission systems has shown that the behaviour of a some combination of delayed neutron parameters has a similar features. On the basis of this findings the systematics of delayed neutron experimental data for thorium, uranium, plutonium and americium isotopes have been investigated with the purpose to find a correlation of DN parameters with characteristics of fissioning system as well as a correlation between the delayed neutron parameters themselves. It was presented the preliminary results which were obtained during study the physics interpretation of the results [ru

  1. Time Delay of CGM Sensors

    Science.gov (United States)

    Schmelzeisen-Redeker, Günther; Schoemaker, Michael; Kirchsteiger, Harald; Freckmann, Guido; Heinemann, Lutz; del Re, Luigi

    2015-01-01

    Background: Continuous glucose monitoring (CGM) is a powerful tool to support the optimization of glucose control of patients with diabetes. However, CGM systems measure glucose in interstitial fluid but not in blood. Rapid changes in one compartment are not accompanied by similar changes in the other, but follow with some delay. Such time delays hamper detection of, for example, hypoglycemic events. Our aim is to discuss the causes and extent of time delays and approaches to compensate for these. Methods: CGM data were obtained in a clinical study with 37 patients with a prototype glucose sensor. The study was divided into 5 phases over 2 years. In all, 8 patients participated in 2 phases separated by 8 months. A total number of 108 CGM data sets including raw signals were used for data analysis and were processed by statistical methods to obtain estimates of the time delay. Results: Overall mean (SD) time delay of the raw signals with respect to blood glucose was 9.5 (3.7) min, median was 9 min (interquartile range 4 min). Analysis of time delays observed in the same patients separated by 8 months suggests a patient dependent delay. No significant correlation was observed between delay and anamnestic or anthropometric data. The use of a prediction algorithm reduced the delay by 4 minutes on average. Conclusions: Prediction algorithms should be used to provide real-time CGM readings more consistent with simultaneous measurements by SMBG. Patient specificity may play an important role in improving prediction quality. PMID:26243773

  2. 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.

  3. 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)

  4. 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.

  5. Arterial Transit Time Mapping Obtained by Pulsed Continuous 3D ASL Imaging with Multiple Post-Label Delay Acquisitions: Comparative Study with PET-CBF in Patients with Chronic Occlusive Cerebrovascular Disease.

    Science.gov (United States)

    Tsujikawa, Tetsuya; Kimura, Hirohiko; Matsuda, Tsuyoshi; Fujiwara, Yasuhiro; Isozaki, Makoto; Kikuta, Ken-Ichiro; Okazawa, Hidehiko

    2016-01-01

    Arterial transit time (ATT) is most crucial for measuring absolute cerebral blood flow (CBF) by arterial spin labeling (ASL), a noninvasive magnetic resonance (MR) perfusion assessment technique, in patients with chronic occlusive cerebrovascular disease. We validated ASL-CBF and ASL-ATT maps calculated by pulsed continuous ASL (pCASL) with multiple post-label delay acquisitions in patients with occlusive cerebrovascular disease. Fifteen patients underwent MR scans, including pCASL, and positron emission tomography (PET) scans with 15O-water to obtain PET-CBF. MR acquisitions with different post-label delays (1.0, 1.5, 2.0, 2.5 and 3.0 sec) were also obtained for ATT correction. The theoretical framework of 2-compartmental model (2CM) was also used for the delay compensation. ASL-CBF and ASL-ATT were calculated based on the proposed 2CM, and the effect on the CBF values and the ATT correction characteristics were discussed. Linear regression analyses were performed both on pixel-by-pixel and region-of-interest bases in the middle cerebral artery (MCA) territory. There were significant correlations between ASL-CBF and PET-CBF both for voxel values (r = 0.74 ± 0.08, slope: 0.87 ± 0.22, intercept: 6.1 ± 4.9) and for the MCA territorial comparison in both affected (R2 = 0.67, y = 0.83x + 6.3) and contralateral sides (R2 = 0.66, y = 0.74x + 6.3). ASL-ATTs in the affected side were significantly longer than those in the contralateral side (1.51 ± 0.41 sec and 1.12 ± 0.30 sec, respectively, p <0.0005). CBF measurement using pCASL with delay compensation was feasible and fairly accurate even in altered hemodynamic states.

  6. [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.

  7. High resolution digital delay timer

    Science.gov (United States)

    Martin, Albert D.

    1988-01-01

    Method and apparatus are provided for generating an output pulse following a trigger pulse at a time delay interval preset with a resolution which is high relative to a low resolution available from supplied clock pulses. A first lumped constant delay (20) provides a first output signal (24) at predetermined interpolation intervals corresponding to the desired high resolution time interval. Latching circuits (26, 28) latch the high resolution data (24) to form a first synchronizing data set (60). A selected time interval has been preset to internal counters (142, 146, 154) and corrected for circuit propagation delay times having the same order of magnitude as the desired high resolution. Internal system clock pulses (32, 34) count down the counters to generate an internal pulse delayed by an interval which is functionally related to the preset time interval. A second LCD (184) corrects the internal signal with the high resolution time delay. A second internal pulse is then applied to a third LCD (74) to generate a second set of synchronizing data (76) which is complementary with the first set of synchronizing data (60) for presentation to logic circuits (64). The logic circuits (64) further delay the internal output signal (72) to obtain a proper phase relationship of an output signal (80) with the internal pulses (32, 34). The final delayed output signal (80) thereafter enables the output pulse generator (82) to produce the desired output pulse (84) at the preset time delay interval following input of the trigger pulse (10, 12).

  8. System delays in breast cancer

    African Journals Online (AJOL)

    we notice a discrepancy in incidence rates between various ethnic/race .... Thailand. 180. 2. 3. 5 to diagnosis NOT treatment‡. This study. South Africa 45. -. 2.5. 3. 1.25. 3. -. 10. *Total delay refers to totals for available datasets and not necessarily mean delay to treatment/surgery commencement. †Montella et al. presented ...

  9. Magnetic bearing optical delay line

    NARCIS (Netherlands)

    Dool, T.C. van den; Kamphues, F.G.; Fouss, B.; Henrioulle, K.; Hogenhuis, H.

    2004-01-01

    TNO TPD, in close cooperation with Micromega-Dynamics and Dutch Space, has developed an advanced Optical Delay Line (ODL) for use in PRIMA, GENIE and other ground based interferometers. The delay line design is modular and flexible, which makes scaling for other applications a relatively easy task.

  10. #FakeNobelDelayReasons

    CERN Multimedia

    2013-01-01

    Tuesday’s hour-long delay of the Nobel Prize in Physics announcement was (and still is) quite the cause for speculation. But on the Twittersphere, it was simply the catalyst for some fantastic puns, so-bad-they're-good physics jokes and other shenanigans. Here are some of our favourite #FakeNobelDelayReasons.    

  11. Picosecond resolution programmable delay line

    International Nuclear Information System (INIS)

    Suchenek, Mariusz

    2009-01-01

    The note presents implementation of a programmable delay line for digital signals. The tested circuit has a subnanosecond delay range programmable with a resolution of picoseconds. Implementation of the circuit was based on low-cost components, easily available on the market. (technical design note)

  12. Project delay analysis of HRSG

    Science.gov (United States)

    Silvianita; Novega, A. S.; Rosyid, D. M.; Suntoyo

    2017-08-01

    Completion of HRSG (Heat Recovery Steam Generator) fabrication project sometimes is not sufficient with the targeted time written on the contract. The delay on fabrication process can cause some disadvantages for fabricator, including forfeit payment, delay on HRSG construction process up until HRSG trials delay. In this paper, the author is using semi quantitative on HRSG pressure part fabrication delay with configuration plant 1 GT (Gas Turbine) + 1 HRSG + 1 STG (Steam Turbine Generator) using bow-tie analysis method. Bow-tie analysis method is a combination from FTA (Fault tree analysis) and ETA (Event tree analysis) to develop the risk matrix of HRSG. The result from FTA analysis is use as a threat for preventive measure. The result from ETA analysis is use as impact from fabrication delay.

  13. Delay discounting of different commodities.

    Science.gov (United States)

    Weatherly, Jeffrey N; Terrell, Heather K; Derenne, Adam

    2010-01-01

    When outcomes are delayed, their value is decreased. Delay discounting is a much-studied topic because it is correlated with certain disorders (e.g., pathological gambling). The present study attempts to determine how people would delay discount a number of different commodities, ranging from money to dating partners to federal education legislation. Participants completed delay discounting tasks pertaining to 5 different commodities, with a different set of 5 commodities for 2 groups. Results showed that different commodities were often discounted differently. Both data sets were also subjected to factor analysis. A 2-factor solution was found for both, suggesting that there are multiple "domains" of commodities. This finding is of interest because it suggests that measuring delay discounting for one commodity within a particular domain of commodities will be predictive of how people discount other commodities within that domain but will not be predictive of how they discount commodities within another domain.

  14. Delayed radiation neuropathy

    International Nuclear Information System (INIS)

    Nagashima, Toshiko; Miyamoto, Kazuto; Beppu, Hirokuni; Hirose, Kazuhiko; Yamada, Katsuhiro

    1981-01-01

    A case of cervical plexus neuropathy was reported in association with chronic radio-dermatitis, myxedema with thyroid adenoma and epiglottic tumor. A 38-year-old man has noticed muscle weakness and wasting of the right shoulder girdle since age 33. A detailed history taking revealed a previous irradiation to the neck because of the cervical lymphadenopathy at age 10 (X-ray 3,000 rads), keroid skin change at age 19, obesity and edema since 26, and hoarseness at 34. Laryngoscopic examination revealed a tumor on the right vocal cord, diagnosed as benign papilloma by histological study. In addition, there were chronic radio-dermatitis around the neck, primary hypothyroidism with a benign functioning adenoma on the right lobe of the thyroid, the right phrenic nerve palsy and the right recurrent nerve palsy. All these lesions were considered to be the late sequellae of radiation to the neck in childhood. Other neurological signs were weakness and amyotrophy of the right shoulder girdle with patchy sensory loss, and areflexia of the right arm. Gross power was fairly well preserved in the right hand. EMG showed neurogenic changes in the tested muscles, suggesting a peripheral nerve lesion. Nerve conduction velocities were normal. No abnormal findings were revealed by myelography and spinal CT. The neurological findings of the patient were compatible with the diagnosis of middle cervical plexus palsy apparently due to late radiation effect. In the literature eight cases of post-radiation neuropathy with a long latency have been reported. The present case with the longest latency after the radiation should be included in the series of the reported cases of ''delayed radiation neuropathy.'' (author)

  15. Delayed radiation neuropathy

    Energy Technology Data Exchange (ETDEWEB)

    Nagashima, T.; Miyamoto, K.; Beppu, H.; Hirose, K.; Yamada, K. (Tokyo Metropolitan Neurological Hospital (Japan))

    1981-07-01

    A case of cervical plexus neuropathy was reported in association with chronic radio-dermatitis, myxedema with thyroid adenoma and epiglottic tumor. A 38-year-old man has noticed muscle weakness and wasting of the right shoulder girdle since age 33. A detailed history taking revealed a previous irradiation to the neck because of the cervical lymphadenopathy at age 10 (X-ray 3,000 rads), keroid skin change at age 19, obesity and edema since 26, and hoarseness at 34. Laryngoscopic examination revealed a tumor on the right vocal cord, diagnosed as benign papilloma by histological study. In addition, there were chronic radio-dermatitis around the neck, primary hypothyroidism with a benign functioning adenoma on the right lobe of the thyroid, the right phrenic nerve palsy and the right recurrent nerve palsy. All these lesions were considered to be the late sequellae of radiation to the neck in childhood. Other neurological signs were weakness and amyotrophy of the right shoulder girdle with patchy sensory loss, and areflexia of the right arm. Gross power was fairly well preserved in the right hand. EMG showed neurogenic changes in the tested muscles, suggesting a peripheral nerve lesion. Nerve conduction velocities were normal. No abnormal findings were revealed by myelography and spinal CT. The neurological findings of the patient were compatible with the diagnosis of middle cervical plexus palsy apparently due to late radiation effect. In the literature eight cases of post-radiation neuropathy with a long latency have been reported. The present case with the longest latency after the radiation should be included in the series of the reported cases of ''delayed radiation neuropathy.'' (author).

  16. The role of organic anion transporters in diagnosing liver diseases by magnetic resonance imaging.

    Science.gov (United States)

    Pastor, Catherine M; Müllhaupt, Beat; Stieger, Bruno

    2014-04-01

    The expression and transport functions of organic anion transporters are modified in liver diseases, and therefore the vascular clearances of endogenous and exogenous organic anions that are taken up by these transporters have been used to assess liver diseases in patients. More recently, liver imaging with hepatobiliary contrast agents, tracers, and dyes that cross hepatocytes through the organic anion transporting polypeptides (OATPs)-multidrug resistance-associated proteins (MRPs) pathway were developed to detect and characterize focal lesions and to assess the severity of diffuse liver diseases. This review focuses mainly on magnetic resonance imaging and highlights the growing interest in imaging the OATPs-MRP2 pathway to better understand liver diseases. Imaging provides noninvasive measurements of tissue concentrations that result from the interplay between influx and efflux membrane transport systems in normal or injured hepatocytes. Imaging with magnetic resonance hepatobiliary contrast agents improves the detection and the characterization of hepatic focal lesions. New developments of imaging to assess liver function and understand the hepatocellular concentrations of contrast agents are discussed.

  17. Inhibition of P-glycoprotein and multidrug resistance-associated protein 2 regulates the hepatobiliary excretion and plasma exposure of thienorphine and its glucuronide conjugate

    Directory of Open Access Journals (Sweden)

    Ling-Lei Kong

    2016-08-01

    Full Text Available Thienorphine (TNP is a novel partial opioid agonist that has completed phase II clinical evaluation as a promising drug candidate for the treatment of opioid dependence. Previous studies have shown that TNP and its glucuronide conjugate (TNP-G undergo significant bile excretion. The purpose of this study was to investigate the roles of efflux transporters in regulating biliary excretion and plasma exposure of TNP and TNP-G. An ATPase assay suggested that TNP and TNP-G were substrates of P-gp and MRP2, respectively. The in vitro data from rat hepatocytes showed that bile excretion of TNP and TNP-G was regulated by the P-gp and MRP2 modulators. The accumulation of TNP and TNP-G in HepG2 cells significantly increased by the treatment of mdr1a or MRP2 siRNA for P-gp or MRP2 modulation. In intact rats, the bile excretion and pharmacokinetic profiles of TNP and TNP-G were remarkably changed with tariquidar and probenecid pretreatment, respectively. Tariquidar increased the Cmax and AUC0-t and decreased MRT and T1/2 of TNP, whereas probenecid decreased the plasma exposure of TNP-G and increased its T1/2. Knockdown P-gp and MRP2 function using siRNA significantly increased the plasma exposure of TNP and TNP-G and reduced their mean retention time in mice. These results indicated the important roles of P-gp and MRP2 in hepatobiliary excretion and plasma exposure of TNP and TNP-G. Inhibition of the efflux transporters may affect the pharmacokinetics of TNP and result in a drug-drug interaction between TNP and the concomitant transporter inhibitor or inducer in clinic.

  18. Hepato-biliary effects of mucoviscidosis: use of Mebrofenine scintigraphy; Atteinte hepato-biliaire de la mucoviscidose: interet de la scintigraphie a la Mebrofenine

    Energy Technology Data Exchange (ETDEWEB)

    Perrin-Fayolle, O.; Morelec, I. [Medecine Nucleaire, C.H. Lyon-Sud, Lyon (France); Gilly, R. [Pediatrie, C.H. Lyon-Sud, Lyon (France); Roche, S.; Sappey-Marinier, D.; Briere, J.; Bonmartin, A. [Medecine Nucleaire, C.H. Lyon-Sud, Lyon (France); Bellon, G. [Pediatrie, C.H. Lyon-Sud, Lyon (France)

    1997-12-31

    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{sub 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

  19. Utility of hepatobiliary scintigraphy in diagnosing or excluding biliary atresia in premature neonates and full-term infants with conjugated hyperbilirubinemia who received parenteral nutrition.

    Science.gov (United States)

    Barseghyan, Karine; Ramanathan, Rangasamy; Chavez, Thomas; Harlan, Susan; Lin, Chuan-Hao; Mitsinikos, Tania; McLean, Claire

    2017-08-31

    Hepatobiliary scintigraphy (HBS) is used to aid in the diagnosis of Biliary Atresia in full-term infants with conjugated hyperbilirubinemia. There is little information on the utility of the HBS in premature infants with conjugated hyperbilirubinemia and infants with parenteral nutrition associated cholestasis (PNAC). The purpose of this study is to assess the utility of HBS in differentiating Biliary Atresia and PNAC in premature neonates and full-term infants who received parenteral nutrition (PN). Retrospective data collection and analysis on infants who developed conjugated hyperbilirubinemia and had HBS performed during their stay at level IV neonatal intensive care unit between 2005 and 2015. A total of 20 patients with exposure to PN had HBS; two patients were confirmed to have Biliary Atresia. There were no statistically significant differences between patients with Biliary Atresia versus PNAC in demographics, days on PN, or gamma glutamyl-transferase levels. Stool color was statistically significantly different between the two groups; patients with Biliary Atresia had acholic stools more consistently than patients without Biliary Atresia. HBS had 100% sensitivity, 17% specificity, positive-predictive value of 12%, and a negative-predictive value (NPV) of 100%. These data indicate that the ability of HBS to aid in diagnosing Biliary Atresia is poor in a population of preterm neonates and full-term infants with PNAC. Although there is 100% sensitivity, the poor specificity (17%) should be acknowledged when utilizing HBS to diagnose Biliary Atresia in this vulnerable patient population. NPV of 100% is helpful in ruling out Biliary Atresia in this population.

  20. 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.)

  1. 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)

  2. Gd-EOB-DTPA-enhanced magnetic resonance imaging for bile duct intraductal papillary mucinous neoplasms

    Science.gov (United States)

    Ying, Shi-Hong; Teng, Xiao-Dong; Wang, Zhao-Ming; Wang, Qi-Dong; Zhao, Yi-Lei; Chen, Feng; Xiao, Wen-Bo

    2015-01-01

    AIM: To investigate gadolinium-ethoxybenzyl-diethylenetriamine-pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) of intraductal papillary mucinous neoplasms of the bile duct (IPMN-B). METHODS: The imaging findings of five cases of IPMN-B which were pathologically confirmed at our hospital between March 2012 and May 2013 were retrospectively analyzed. Three of these cases were diagnosed by duodenal endoscopy and biopsy pathology, and two cases were diagnosed by surgical pathology. All five patients underwent enhanced and non-enhanced computed tomography (CT), magnetic resonance cholangiopancreatography, and Gd-EOB-DTPA-enhanced MRI; one case underwent both Gd-EOB-DTPA-enhanced MRI and positron emission tomography-CT. The clinical data and imaging results for these cases were compared and are presented. RESULTS: Conventional imaging showed diffuse dilatation of bile ducts and multiple intraductal polypoid and papillary neoplasms or serrated changes along the bile ducts. In two cases, Gd-EOB-DTPA-enhanced MRI revealed dilated biliary ducts and intraductal tumors, as well as filling defects caused by mucin in the dilated bile ducts in the hepatobiliary phase. Gd-EOB-DTPA-enhanced MRI in one case clearly showed a low-signal tumor in the hepatobiliary phase, similar to what was seen by positron emission tomography-CT. In two patients, routine inspection was unable to discern whether the lesions were inflammation or tumors. However, Gd-EOB-DTPA-enhanced MRI revealed a pattern of gradual enhancement during the hepatobiliary phase, and the signal intensity of the lesions was lower than the surrounding liver parenchyma, suggesting tissue inflammation in both cases, which were confirmed by surgical pathology. CONCLUSION: Gd-EOB-DTPA-enhanced MRI reveals the intraductal mucin component of IPMN-B in some cases and the extent of tumor infiltration beyond the bile ducts in invasive cases. PMID:26167082

  3. 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...

  4. Terahertz imaging for styrofoam inspection

    Science.gov (United States)

    Pradarutti, B.; Riehemann, S.; Notni, G.; Tünnermann, A.

    2007-09-01

    Imaging of styrofoam with the help of ultrashort Terahertz pulses is investigated. With a combination of pulse amplitude and time delay imaging it is possible to speed up the measurement about two orders of magnitudes.

  5. Fractional delayed damped Mathieu equation

    Science.gov (United States)

    Mesbahi, Afshin; Haeri, Mohammad; Nazari, Morad; Butcher, Eric A.

    2015-03-01

    This paper investigates the dynamical behaviour of the fractional delayed damped Mathieu equation. This system includes three different phenomena (fractional order, time delay, parametric resonance). The method of harmonic balance is employed to achieve approximate expressions for the transition curves in the parameter plane. The n = 0 and n = 1 transition curves (both lower and higher order approximations) are obtained. The dependencies of these curves on the system parameters and fractional orders are determined. Previous results for the transition curves reported for the damped Mathieu equation, delayed second-order oscillator, and fractional Mathieu equation are confirmed as special cases of the results for the current system.

  6. Ergodic Interference Alignment with Delayed Feedback

    OpenAIRE

    Kang, Myung Gil; Choi, Wan

    2013-01-01

    We propose new ergodic interference alignment techniques for $K$-user interference channels with delayed feedback. Two delayed feedback scenarios are considered -- delayed channel information at transmitter (CIT) and delayed output feedback. It is proved that the proposed techniques achieve total $2K/(K+2)$ DoF which is higher than that by the retrospective interference alignment for the delayed feedback scenarios.

  7. 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

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

    International Nuclear Information System (INIS)

    Chavhan, Govind B.; Mann, Erika; Kamath, Binita M.; Babyn, Paul S.

    2014-01-01

    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.)

  10. Fractional variational principles with delay

    International Nuclear Information System (INIS)

    Baleanu, Dumitru; Abdeljawad, Thabet Maaraba; Jarad, Fahd

    2008-01-01

    The fractional variational principles within Riemann-Liouville fractional derivatives in the presence of delay are analyzed. The corresponding Euler-Lagrange equations are obtained and one example is analyzed in detail

  11. Linear rotary optical delay lines

    Science.gov (United States)

    Guerboukha, Hichem; Qu, Hang; Skorobogatiy, Maksim

    2016-03-01

    We present a semi-analytical solution for the design of a high-speed rotary optical delay line that use a combination of two rotating curvilinear reflectors. We demonstrate that it is possible to design an infinite variety of the optical delay lines featuring linear dependence of the optical delay on the rotation angle. This is achieved via shape optimization of the rotating reflector surfaces. Moreover, a convenient spatial separation of the incoming and outgoing beams is possible. For the sake of example, we present blades that fit into a circle of 10cm diameter. Finally, a prototype of a rotary delay line is fabricated using CNC machining, and its optical properties are characterized.

  12. Delays and networked control systems

    CERN Document Server

    Hetel, Laurentiu; Daafouz, Jamal; Johansson, Karl

    2016-01-01

    This edited monograph includes state-of-the-art contributions on continuous time dynamical networks with delays. The book is divided into four parts. The first part presents tools and methods for the analysis of time-delay systems with a particular attention on control problems of large scale or infinite-dimensional systems with delays. The second part of the book is dedicated to the use of time-delay models for the analysis and design of Networked Control Systems. The third part of the book focuses on the analysis and design of systems with asynchronous sampling intervals which occur in Networked Control Systems. The last part of the book exposes several contributions dealing with the design of cooperative control and observation laws for networked control systems. The target audience primarily comprises researchers and experts in the field of control theory, but the book may also be beneficial for graduate students. .

  13. Systematics in delayed neutron yields

    Energy Technology Data Exchange (ETDEWEB)

    Ohsawa, Takaaki [Kinki Univ., Higashi-Osaka, Osaka (Japan). Atomic Energy Research Inst.

    1998-03-01

    An attempt was made to reproduce the systematic trend observed in the delayed neutron yields for actinides on the basis of the five-Gaussian representation of the fission yield together with available data sets for delayed neutron emission probability. It was found that systematic decrease in DNY for heavier actinides is mainly due to decrease of fission yields of precursors in the lighter side of the light fragment region. (author)

  14. System delays in breast cancer | Dalwai | South African Journal of ...

    African Journals Online (AJOL)

    Data extraction included demographic data, time to diagnosis and initial staging using a standardised data sheet. Specific care steps were identified, namely delays to initial imaging with mammography, pathology confirmation, staging work-up and eventual referral to a centralised breast clinic. Results: A total of 45 patients ...

  15. 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.

  16. Analytical applications for delayed neutrons

    International Nuclear Information System (INIS)

    Eccleston, G.W.

    1983-01-01

    Analytical formulations that describe the time dependence of neutron populations in nuclear materials contain delayed-neutron dependent terms. These terms are important because the delayed neutrons, even though their yields in fission are small, permit control of the fission chain reaction process. Analytical applications that use delayed neutrons range from simple problems that can be solved with the point reactor kinetics equations to complex problems that can only be solved with large codes that couple fluid calculations with the neutron dynamics. Reactor safety codes, such as SIMMER, model transients of the entire reactor core using coupled space-time neutronics and comprehensive thermal-fluid dynamics. Nondestructive delayed-neutron assay instruments are designed and modeled using a three-dimensional continuous-energy Monte Carlo code. Calculations on high-burnup spent fuels and other materials that contain a mix of uranium and plutonium isotopes require accurate and complete information on the delayed-neutron periods, yields, and energy spectra. A continuing need exists for delayed-neutron parameters for all the fissioning isotopes

  17. Language Delays in Toddlers: Information for Parents

    Science.gov (United States)

    ... Stages Listen Español Text Size Email Print Share Language Delays in Toddlers: Information for Parents Page Content ... situation or repeats scripts from TV Delays in language Delays in language are the most common types ...

  18. New imaging techniques for liver diseases.

    Science.gov (United States)

    Van Beers, Bernard E; Daire, Jean-Luc; Garteiser, Philippe

    2015-03-01

    Newly developed or advanced methods of ultrasonography and MR imaging provide combined anatomical and quantitative functional information about diffuse and focal liver diseases. Ultrasound elastography has a central role for staging liver fibrosis and an increasing role in grading portal hypertension; dynamic contrast-enhanced ultrasonography may improve tumor characterization. In clinical practice, MR imaging examinations currently include diffusion-weighted and dynamic MR imaging, enhanced with extracellular or hepatobiliary contrast agents. Moreover, quantitative parameters obtained with diffusion-weighted MR imaging, dynamic contrast-enhanced MR imaging and MR elastography have the potential to characterize further diffuse and focal liver diseases, by adding information about tissue cellularity, perfusion, hepatocyte transport function and visco-elasticity. The multiparametric capability of ultrasonography and more markedly of MR imaging gives the opportunity for high diagnostic performance by combining imaging biomarkers. However, image acquisition and post-processing methods should be further standardized and validated in multicenter trials. Copyright © 2014 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

  19. 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...

  20. The phantom robot - Predictive displays for teleoperation with time delay

    Science.gov (United States)

    Bejczy, Antal K.; Kim, Won S.; Venema, Steven C.

    1990-01-01

    An enhanced teleoperation technique for time-delayed bilateral teleoperator control is discussed. The control technique selected for time delay is based on the use of a high-fidelity graphics phantom robot that is being controlled in real time (without time delay) against the static task image. Thus, the motion of the phantom robot image on the monitor predicts the motion of the real robot. The real robot's motion will follow the phantom robot's motion on the monitor with the communication time delay implied in the task. Real-time high-fidelity graphics simulation of a PUMA arm is generated and overlaid on the actual camera view of the arm. A simple camera calibration technique is used for calibrated graphics overlay. A preliminary experiment is performed with the predictive display by using a very simple tapping task. The results with this simple task indicate that predictive display enhances the human operator's telemanipulation task performance significantly during free motion when there is a long time delay. It appears, however, that either two-view or stereoscopic predictive displays are necessary for general three-dimensional tasks.

  1. Development and intra-institutional and inter-institutional validation of a comprehensive new hepatobiliary software: Part 1--Liver and gallbladder function.

    Science.gov (United States)

    Krishnamurthy, Gerbail T; Krishnamurthy, Shakuntala; Gambhir, Sanjiv Sam; Rodrigues, Cesar; Rosenberg, Jarrett; Schiepers, Christiaan; Buxton-Thomas, Muriel

    2009-12-01

    Food and Drug Administration-approved personal computer-based Krishnamurthy Hepato-Biliary Software for quantification of the liver and gallbladder function shows promise for consistently repeatable and reproducible results both within and between institutions, and may help to promote universal standardization of data acquisition and analysis in nuclear hepatology.

  2. Quantitative Expression of Hepatobiliary Transporters and Functional Uptake of Substrates in Hepatic Two-Dimensional Sandwich Cultures: A Comparative Evaluation of Upcyte and Primary Human Hepatocytes.

    Science.gov (United States)

    Schaefer, Michelle; Morinaga, Gaku; Matsui, Akiko; Schänzle, Gerhard; Bischoff, Daniel; Süssmuth, Roderich D

    2018-02-01

    Deficient functional expression of drug transporters incapacitates most hepatic cell lines as a reliable tool for evaluating transporter-mediated drug-drug interactions. Recently, genetically modified cells (referred to as upcyte hepatocytes) have emerged as an expandable, noncancerous source of human hepatic cells. Herein, we quantified mRNA and protein levels of key hepatobiliary transporters and we assessed associated uptake activity in short- and long-term cultures of upcyte human hepatocytes (UHH) in comparison to cryopreserved primary human hepatocytes (cPHH). Expression of canalicular efflux pumps, such as MRD1/ ABCB1 , MATE1/ SLC47A1 , and MRP2/ ABCC2 , was relatively well preserved in UHH. By contrast, long-term cultivation of UHH in a two-dimensional sandwich configuration [sandwich-cultured upcyte human hepatocytes (SCUHH)] was required to upregulate organic anion-transporting polypeptide OATP1B1/ SLCO1B1 , OATP2B1/ SLCO2B1 , NTCP/ SLC10A1 , and OCT1/ SLC22A1 mRNA expression, which correlated well with respective protein abundances. However, mRNA and protein levels of sinusoidal solute carrier transporters, except for NTCP and OATP2B1, remained low in SCUHH compared to sandwich-cultured cPHH. OCT1- and NTCP-mediated uptake of N -methyl-4-phenylpyridinium acetate and taurocholate was demonstrated in both hepatic models, whereas active uptake of OATP1B1/1B3-selective marker substrates, paralleled by markedly reduced SLCO1B1/1B3 expression, were not detectable in SCUHH. Uptake studies under Na + -depletion and excess of taurocholate confirmed the presence of functional NTCP protein and indicated that NTCP, apart from OATP2B1, contributed substantially to the overall hepatic uptake of rosuvastatin in SCUHH. In conclusion, our data suggest that SCUHH, despite their limitation for evaluating OATP1B1/1B3-mediated transport processes, retain NTCP, OATP2B1, and OCT1 transport activities and thus may be considered as a tool for elucidating compensatory uptake

  3. 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

  4. UWB delay and multiply receiver

    Energy Technology Data Exchange (ETDEWEB)

    Dallum, Gregory E.; Pratt, Garth C.; Haugen, Peter C.; Romero, Carlos E.

    2013-09-10

    An ultra-wideband (UWB) delay and multiply receiver is formed of a receive antenna; a variable gain attenuator connected to the receive antenna; a signal splitter connected to the variable gain attenuator; a multiplier having one input connected to an undelayed signal from the signal splitter and another input connected to a delayed signal from the signal splitter, the delay between the splitter signals being equal to the spacing between pulses from a transmitter whose pulses are being received by the receive antenna; a peak detection circuit connected to the output of the multiplier and connected to the variable gain attenuator to control the variable gain attenuator to maintain a constant amplitude output from the multiplier; and a digital output circuit connected to the output of the multiplier.

  5. Time delay in quantum scattering

    International Nuclear Information System (INIS)

    Tee, R.G.

    1978-01-01

    As is well known, the knowledge of the scattering cross section and its angular dependence, as a function of energy, is insufficient to determine the phase shifts uniquely. This led Eisenbud and Wigner to propose the measurement of the scattering lifetime or time delay as an additional independent datum. A rigorous time-dependent study of time delay within the framework of Hilbert space formalism is presented. Specifically, Martin's theory of time delay and the validity of the Eisenbud-Wigner time delay formula are extended to spherically symmetric potentials satisfying the asymptotic fall-off rate V(r) → O(r/sup -2-epsilon/). This extension is obtained by use of a maximal estimate of the rate of convergence of the asymptotic condition and the elimination of Martin's requirement that the scattering operator S be three times differentiable with respect to the free-particle Hamiltonian H 0 . Also presented are related results on the total time a quantum particle spends inside some bounded regions in position space. It is then proved that any two free particles having identical distributions of energy and angular momentum take exactly identical expectation values for the transit time across an arbitrary spherical region centered at the origin in position space. Ways to extend this result to nonfree Hamiltonians are indicated. Finally, the relationship between the position operator and the Eisenbud-Wigner time delay operator is examined. It is shown that the usual method of calculating time delay based on the classical analysis of the position operator is not exact

  6. Delayed Tamponade after Traumatic Wound with Left Ventricular Compression

    Directory of Open Access Journals (Sweden)

    Fahad Almehmadi

    2016-01-01

    Full Text Available Delayed cardiac tamponade after a penetrating chest injury is a rare complication. The clinical diagnosis of tamponade is facilitated with imaging. We present a case report of a 23-year-old male who was brought to emergency after multiple stab wounds to the chest. After resuscitation and repair of laceration of right internal mammary artery and right ventricle, he was discharged but later returned with shortness of breath. Echocardiography revealed a rare case of delayed pericardial tamponade causing left ventricular collapse. The pericardial effusion was treated with emergent pericardiocentesis and later required a thoracoscopy guided pericardial window for definitive management.

  7. Delayed Tamponade after Traumatic Wound with Left Ventricular Compression.

    Science.gov (United States)

    Almehmadi, Fahad; Chandy, Mark; Connelly, Kim A; Edwards, Jeremy

    2016-01-01

    Delayed cardiac tamponade after a penetrating chest injury is a rare complication. The clinical diagnosis of tamponade is facilitated with imaging. We present a case report of a 23-year-old male who was brought to emergency after multiple stab wounds to the chest. After resuscitation and repair of laceration of right internal mammary artery and right ventricle, he was discharged but later returned with shortness of breath. Echocardiography revealed a rare case of delayed pericardial tamponade causing left ventricular collapse. The pericardial effusion was treated with emergent pericardiocentesis and later required a thoracoscopy guided pericardial window for definitive management.

  8. Stochastic modelling of train delays and delay propagation in stations

    NARCIS (Netherlands)

    Yuan, J.

    2006-01-01

    A trade-off exists between efficiently utilizing the capacity of railway networks and improving the reliability and punctuality of train operations. This dissertation presents a new analytical probability model based on blocking time theory which estimates the knock-on delays of trains caused by

  9. 49 CFR 236.563 - Delay time.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Delay time. 236.563 Section 236.563 Transportation... Cab Signal Systems Rules and Instructions; Locomotives § 236.563 Delay time. Delay time of automatic... requirements of § 236.24 shall take into consideration the delay time. ...

  10. 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.

  11. 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...

  12. 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.

  13. EAMJ Delayed April 10.indd

    African Journals Online (AJOL)

    2010-04-04

    Apr 4, 2010 ... and Director, Kenyatta National Hospital, P.O. Box 19961-00202, Nairobi, Kenya, S.K. Kimende, MBChB, MMed (Surg.) Lecturer, Department of Surgery, ... For purposes of management, breast cancer is clinically divided into early .... delays inherent in out healthcare systems (18,19). Indeed, one of the most ...

  14. Early-delayed radiation rhombencephalopathy

    International Nuclear Information System (INIS)

    Nightingale, S.; Dawes, P.J.D.K.; Cartlidge, N.E.F.; Newcastle upon Tyne Univ.

    1982-01-01

    A 37-year-old woman developed an early-delayed rhombencephalopathy 7 weeks after completing a course of radiotherapy to a glomus jugulare tumour. The clinical features, comprising nystagmus, skew strabismus, unilateral facial weakness, dysarthria and ataxia, are compared with four previously reported patients with this syndrome. (author)

  15. Advanced optical delay line demonstrator

    NARCIS (Netherlands)

    Dool, T.C. van den; Kamphues, F.G.; Fouss, B.; Henrioulle, K.; Hogenhuis, H.

    2004-01-01

    TNO TPD, in cooperation with Micromega-Dynamics and Dutch Space, has designed an advanced Optical Delay Line (ODL) for use in future ground based and space interferometry missions. The work is performed under NIVR contract in preparation for GENIE and DARWIN. Using the ESO PRIMA DDL requirements as

  16. Diagnostic Delay in Rheumatoid Arthritis

    DEFF Research Database (Denmark)

    Mølbaek, Karen; Hørslev-Petersen, Kim; Primdahl, Jette

    2016-01-01

    to approach their general practitioner (GP) with joint pain, and also how GPs respond to patients' complaints. METHODS: The study was based on qualitative data collected using 11 semi-structured individual interviews. RESULTS: When symptoms were obvious to patients, there was a shorter delay between symptom...

  17. Livermore blasted for project delay

    CERN Multimedia

    1999-01-01

    In a 12 page report issued last week, a review committee set up by the University of California has concluded that mismanagement and poor planning are to blame for significant cost overruns and delays in the construction of NIF, the worlds largest laser (1 page).

  18. Weather delay costs to trucking.

    Science.gov (United States)

    2012-11-01

    Estimates of the nations freight sector of transportation range to upwards of $600 billion of total gross domestic product with 70 percent of total value and 60 percent of total weight moving by truck. Weather-related delays can add significantly ...

  19. Another definition for time delay

    International Nuclear Information System (INIS)

    Narnhofer, H.

    1980-01-01

    Time delay is defined by geometrical considerations which work in classical as well as in quantum mechanics, and its connection with the S-matrix and the virial is proven for potentials with V(x vector) and x vector V(x vector) vanishing as rsup(-1-epsilon) for r -> infinity. (Author)

  20. Early-delayed radiation rhombencephalopathy

    Energy Technology Data Exchange (ETDEWEB)

    Nightingale, S.; Dawes, P.J.D.K.; Cartlidge, N.E.F. (Royal Victoria Infirmary, Newcastle upon Tyne (UK); Newcastle upon Tyne Univ. (UK). Newcastle General Hospital)

    1982-03-01

    A 37-year-old woman developed an early-delayed rhombencephalopathy 7 weeks after completing a course of radiotherapy to a glomus jugulare tumour. The clinical features, comprising nystagmus, skew strabismus, unilateral facial weakness, dysarthria and ataxia, are compared with four previously reported patients with this syndrome.

  1. Delayed School Entry in Uganda

    Science.gov (United States)

    Moyi, Peter

    2011-01-01

    Since 1997 Uganda has seen a large increase in school enrolment. Despite this increased enrolment, universal education has remained elusive. Many children enrol in school, but not at the recommended age, and they drop out before completing school. This article focuses on one of these problems--delayed school entry. What household factors are…

  2. Providing delay guarantees in Bluetooth

    NARCIS (Netherlands)

    Ait Yaiz, R.; Heijenk, Geert; Titsworth, F.

    2003-01-01

    Bluetooth polling, also referred to as Bluetooth MAC scheduling or intra-piconet scheduling, is the mechanism that schedules the traffic between the participants in a Bluetooth network. Hence, this mechanism is highly determining with respect to the delay packets experience in a Bluetooth network.

  3. 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.

  4. Molecular aspects of hepatobiliary transport

    NARCIS (Netherlands)

    Muller, M; Jansen, PLM

    Generation of bile flow is a regulated, ATP-dependent process and depends on the coordinated action of a number of transporter proteins in the sinusoidal and canalicular domains of the hepatocyte. Dysfunction of any of these proteins leads to retention of substrates, with conjugated

  5. How to Differentiate Borderline Hepatic Nodules in Hepatocarcinogenesis: Emphasis on Imaging Diagnosis.

    Science.gov (United States)

    Park, Hyun Jeong; Choi, Byung Ihn; Lee, Eun Sun; Park, Sung Bin; Lee, Jong Beum

    2017-06-01

    Rapid advances in liver imaging have improved the evaluation of hepatocarcinogenesis and early diagnosis and treatment of hepatocellular carcinoma (HCC). In this situation, detection of early-stage HCC in its development is important for the improvement of patient survival and optimal treatment strategies. Because early HCCs are considered precursors of progressed HCC, precise differentiation between a dysplastic nodule (DN), especially a high-grade DN, and early HCC is important. In clinical practice, these nodules are frequently called "borderline hepatic nodules." This article discusses radiological and pathological characteristics of these borderline hepatic nodules and offers an understanding of multistep hepatocarcinogenesis by focusing on the descriptions of the imaging changes in the progression of DN and early HCC. Detection and accurate diagnosis of borderline hepatic nodules are still a challenge with contrast enhanced ultrasonography, CT, and MRI with extracellular contrast agents. However, gadoxetic acid-enhanced MRI may be useful for improving the diagnosis of these borderline nodules. Since there is a net effect of incomplete neoangiogenesis and decreased portal venous flow in the early stage of hepatocarcinogenesis, borderline hepatic nodules commonly show iso- or hypovascularity. Therefore, precise differentiation of these nodules remains a challenging issue. In MRI using hepatobiliary contrast agents, signal intensity of HCCs on hepatobiliary phase (HBP) is regarded as a potential imaging biomarker. Borderline hepatic nodules are seen as nonhypervascular and hypointense nodules on the HBP, which is important for predicting tumor behavior and determining appropriate therapeutic strategies.

  6. Analysis of a first-order delay differential-delay equation containing two delays

    Science.gov (United States)

    Marriott, C.; Vallée, R.; Delisle, C.

    1989-09-01

    An experimental and numerical analysis of the behavior of a two-delay differential equation is presented. It is shown that much of the system's behavior can be related to the stability behavior of the underlying linearized modes. A new phenomenon, mode crossing, is explored.

  7. Air congestion delay: a review

    Directory of Open Access Journals (Sweden)

    Daniel Alberto Pamplona

    2016-04-01

    Full Text Available This article is a literature review of the air congestion delay and its costs. Air congestion is a worldwide problem. Its existence brings costs for airlines and discomfort for passengers. With the increasing demand for air transport, the study of air congestion has attracted the attention of many researchers around the world. The cause for the delays is erroneously attributed only to the lack of infrastructure investments. The literature review shows that other factors such as population growth, increasing standards of living, lack of operational planning and environmental issues exercise decisive influence. Several studies have been conducted in order to analyze and propose solutions to this problem that affects society as a whole.

  8. Minimum Delay Moving Object Detection

    KAUST Repository

    Lao, Dong

    2017-01-08

    We present a general framework and method for detection of an object in a video based on apparent motion. The object moves relative to background motion at some unknown time in the video, and the goal is to detect and segment the object as soon it moves in an online manner. Due to unreliability of motion between frames, more than two frames are needed to reliably detect the object. Our method is designed to detect the object(s) with minimum delay, i.e., frames after the object moves, constraining the false alarms. Experiments on a new extensive dataset for moving object detection show that our method achieves less delay for all false alarm constraints than existing state-of-the-art.

  9. Minimum Delay Moving Object Detection

    KAUST Repository

    Lao, Dong

    2017-11-09

    We present a general framework and method for detection of an object in a video based on apparent motion. The object moves relative to background motion at some unknown time in the video, and the goal is to detect and segment the object as soon it moves in an online manner. Due to unreliability of motion between frames, more than two frames are needed to reliably detect the object. Our method is designed to detect the object(s) with minimum delay, i.e., frames after the object moves, constraining the false alarms. Experiments on a new extensive dataset for moving object detection show that our method achieves less delay for all false alarm constraints than existing state-of-the-art.

  10. Reconfigurable Reduced Delay Universal Adder

    OpenAIRE

    Mohit Tyagi,; Samender Singh,; Kavita Khare

    2011-01-01

    This paper introduces a novel architecture for least latency universal adder using pipeline and parallel computing technique. The proposed architecture implemented in reconfigurable technology as arun time reconfigurable unit. The proposed 32-bit Universal adder design and compared with previously proposed adder designs in terms of area and delay after synthesis targeting on 4vfx60ff672-12 Xilinxvirtex-4 FPGA and have high hardware resource sharing up to 42% for the binary and BCD arithmetic ...

  11. [Determinants of induced abortion delay].

    Science.gov (United States)

    Font-Ribera, Laia; Pérez, Glòria; Espelt, Albert; Salvador, Joaquin; Borrell, Carme

    2009-01-01

    In induced abortion, the method, the risk of complications and the economic cost of the abortion are determined by gestational age. The aim of this study was to describe the determinants of induced abortion delay until the second trimester of pregnancy in Barcelona. We performed a cross-sectional study of induced abortions due to the physical or mental health of the woman (Barcelona, 2004-2005; N=9,175). The city's induced abortion register provided data on gestational age at abortion (dependent variable), educational level, age, cohabitation with the partner, number of children previous abortions, and type of center. Adjusted prevalence ratios (aPR) were calculated with log-binomial regression models. A total of 7.7% of induced abortions were second-trimester abortions and 99.3% were performed in private centers. Compared with women with a university education, those with primary education or less had an aPR of 1.8 (95% confidence interval [95%CI]: 1.4-2.2) of delaying the abortion until the second trimester. A higher proportion of second-trimester abortions were also recorded in women aged less than 18 years old (aPR=2.6; 95%CI: 2.0-3.4), women not cohabiting with their partners (aRP=1.4; 95% CI: 1.2-1.6) and in public centers (aPR=2.8; 95% CI: 2.2-3.7). No differences were found in induced abortion delay among women with previous abortions and those without. Induced abortion delay until the second trimester of pregnancy was associated with low educational level, young ages, not cohabiting with a partner, and public centers. This study demonstrates the existence of socioeconomic inequalities in access conditions to abortion services.

  12. Assembly delay line pulse generators

    CERN Multimedia

    CERN PhotoLab

    1971-01-01

    Assembly of six of the ten delay line pulse generators that will power the ten kicker magnet modules. One modulator part contains two pulse generators. Capacitors, inductances, and voltage dividers are in the oil tank on the left. Triggered high-pressure spark gap switches are on the platforms on the right. High voltage pulse cables to the kicker magnet emerge under the spark gaps. In the centre background are the assembled master gaps.

  13. Teriparatide Induced Delayed Persistent Hypercalcemia

    OpenAIRE

    Thiruchelvam, Nirosshan; Randhawa, Jaskirat; Sadiek, Happy; Kistangari, Gaurav

    2014-01-01

    Teriparatide, a recombinant PTH, is an anabolic treatment for osteoporosis that increases bone density. Transient hypercalcemia is a reported side effect of teriparatide that is seen few hours following administration of teriparatide and resolves usually within 16 hours of drug administration. Persistent hypercalcemia, although not observed in clinical trials, is rarely reported. The current case describes a rare complication of teriparatide induced delayed persistent hypercalcemia.

  14. Teriparatide Induced Delayed Persistent Hypercalcemia

    Directory of Open Access Journals (Sweden)

    Nirosshan Thiruchelvam

    2014-01-01

    Full Text Available Teriparatide, a recombinant PTH, is an anabolic treatment for osteoporosis that increases bone density. Transient hypercalcemia is a reported side effect of teriparatide that is seen few hours following administration of teriparatide and resolves usually within 16 hours of drug administration. Persistent hypercalcemia, although not observed in clinical trials, is rarely reported. The current case describes a rare complication of teriparatide induced delayed persistent hypercalcemia.

  15. ATLAS calibration delay chip study

    CERN Document Server

    Massol, N

    2003-01-01

    The delay chip is an ASIC developed to precisely adjust signals within the range of 0-24ns in steps of 1ns. In this note, we report the study of the characteristics of this chip like the linearity and the jitter. We describe the influence of temperature and supply voltage on its behavior. Finally, we study its dependency due to the variations in process on a whole production.

  16. Minimum Delay Moving Object Detection

    KAUST Repository

    Lao, Dong

    2017-05-14

    This thesis presents a general framework and method for detection of an object in a video based on apparent motion. The object moves, at some unknown time, differently than the “background” motion, which can be induced from camera motion. The goal of proposed method is to detect and segment the object as soon it moves in an online manner. Since motion estimation can be unreliable between frames, more than two frames are needed to reliably detect the object. Observing more frames before declaring a detection may lead to a more accurate detection and segmentation, since more motion may be observed leading to a stronger motion cue. However, this leads to greater delay. The proposed method is designed to detect the object(s) with minimum delay, i.e., frames after the object moves, constraining the false alarms, defined as declarations of detection before the object moves or incorrect or inaccurate segmentation at the detection time. Experiments on a new extensive dataset for moving object detection show that our method achieves less delay for all false alarm constraints than existing state-of-the-art.

  17. 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.

  18. 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.

  19. The effect of delayed auditory feedback on activity in the temporal lobe while speaking: a positron emission tomography study.

    Science.gov (United States)

    Takaso, Hideki; Eisner, Frank; Wise, Richard Js; Scott, Sophie K

    2010-04-01

    Delayed auditory feedback is a technique that can improve fluency in stutterers, while disrupting fluency in many nonstuttering individuals. The aim of this study was to determine the neural basis for the detection of and compensation for such a delay, and the effects of increases in the delay duration. Positron emission tomography was used to image regional cerebral blood flow changes, an index of neural activity, and to assess the influence of increasing amounts of delay. Delayed auditory feedback led to increased activation in the bilateral superior temporal lobes, extending into posterior-medial auditory areas. Similar peaks in the temporal lobe were sensitive to increases in the amount of delay. A single peak in the temporal parietal junction responded to the amount of delay but not to the presence of a delay (relative to no delay). This study permitted distinctions to be made between the neural response to hearing one's voice at a delay and the neural activity that correlates with this delay. Notably, all the peaks showed some influence of the amount of delay. This result confirms a role for the posterior, sensorimotor "how" system in the production of speech under conditions of delayed auditory feedback.

  20. Takotsubo cardiomyopathy in the case of 72-year-old teacher after work-related psychological stress. Evolution of left ventricular longitudinal strain - Delayed but complete recovery in automated function imaging (AFI).

    Science.gov (United States)

    Wierzbowska-Drabik, Karina; Marcinkiewicz, Andrzej; Hamala, Piotr; Trzos, Ewa; Lipiec, Piotr; Kurpesa, Małgorzata; Kręcki, Radosław; Plewka, Michał; Kasprzak, Jarosław D

    2017-06-19

    Takotsubo cardiomyopathy (TC) is related to a transient systolic dysfunction of left ventricle (LV), accompanied by clinical and electrocardiographic symptoms of myocardial ischemia in the absence of hemodynamically significant coronary artery disease. Takotsubo cardiomyopathy is usually provoked by a psychologically or/and physically stressful event which may be related to occupational activities. Although visually assessed evolution of LV function is well documented, the data concerning strain changes is sparse and various patterns of deformation abnormalities are suggested. We have described a 72-year-old woman with chest pain related to a lecture given at the meeting of the Senior University, fulfilling all the Mayo Clinic criteria of the TC. The longitudinal strain analysis with automated function imaging (AFI) documented severe impairment and stepwise recovery of regional and global LV contractility. The case described confirms that accurate diagnosis, treatment and documenting of functional improvement in takotsubo cardiomyopathy may enable the return to occupational activities even for elderly persons. Int J Occup Med Environ Health 2017;30(4):681-683. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

  1. Schwannoma of the median nerve: diagnosis sometimes delayed.

    Science.gov (United States)

    Boufettal, Monsef; Azouz, Mohamed; Rhanim, Abdelkarim; Abouzahir, Mohamed; Mahfoud, Mustapha; Bardouni, Ahmed El; Berrada, Mohamed S; Yaacoubi, Moradh El

    2014-01-01

    Schwannoma is a tumor that develops from nerve sheath. The authors report an unusual case of schwannoma of the median nerve (MN) that remained asymptomatic for four years. The diagnosis was based on MRI (magnetic resonance imaging) and histopathological examination. Surgical removal is usually curative. The asymptomatic character of the tumor and its slow evolution remain an essential factor in diagnosis delays. This tumor has a good prognosis with a low recurrence rate and potential for malignant transformation.

  2. Synchronization in networks with heterogeneous coupling delays

    Science.gov (United States)

    Otto, Andreas; Radons, Günter; Bachrathy, Dániel; Orosz, Gábor

    2018-01-01

    Synchronization in networks of identical oscillators with heterogeneous coupling delays is studied. A decomposition of the network dynamics is obtained by block diagonalizing a newly introduced adjacency lag operator which contains the topology of the network as well as the corresponding coupling delays. This generalizes the master stability function approach, which was developed for homogenous delays. As a result the network dynamics can be analyzed by delay differential equations with distributed delay, where different delay distributions emerge for different network modes. Frequency domain methods are used for the stability analysis of synchronized equilibria and synchronized periodic orbits. As an example, the synchronization behavior in a system of delay-coupled Hodgkin-Huxley neurons is investigated. It is shown that the parameter regions where synchronized periodic spiking is unstable expand when increasing the delay heterogeneity.

  3. 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.

  4. Dynamic Cournot Duopoly Game with Delay

    Directory of Open Access Journals (Sweden)

    A. A. Elsadany

    2014-01-01

    Full Text Available The delay Cournot duopoly game is studied. Dynamical behaviors of the game are studied. Equilibrium points and their stability are studied. The results show that the delayed system has the same Nash equilibrium point and the delay can increase the local stability region.

  5. Synchronization analysis of coloured delayed networks under ...

    Indian Academy of Sciences (India)

    This paper investigates synchronization of coloured delayed networks under decentralized pinning intermittent control. To begin with, the time delays are taken into account in the coloured networks. In addition, we propose a decentralized pinning intermittent control for coloured delayed networks, which is different from that ...

  6. Image, Image, Image

    Science.gov (United States)

    Howell, Robert T.

    2004-01-01

    With all the talk today about accountability, budget cuts, and the closing of programs in public education, teachers cannot overlook the importance of image in the field of industrial technology. It is very easy for administrators to cut ITE (industrial technology education) programs to save school money--money they might shift to teaching the…

  7. Reactor shutdown delays medical procedures

    Science.gov (United States)

    Gwynne, Peter

    2008-01-01

    A longer-than-expected maintenance shutdown of the Canadian nuclear reactor that produces North America's entire supply of molybdenum-99 - from which the radioactive isotopes technetium-99 and iodine-131 are made - caused delays to the diagnosis and treatment of thousands of seriously ill patients last month. Technetium-99 is a key component of nuclear-medicine scans, while iodine-131 is used to treat cancer and other diseases of the thyroid. Production eventually resumed, but only after the Canadian government had overruled the Canadian Nuclear Safety Commission (CNSC), which was still concerned about the reactor's safety.

  8. Magnetic resonance imaging assessment of intraventricular dyssynchrony and delayed enhancement as predictors of response to cardiac resynchronization therapy in patients with heart failure of ischaemic and non-ischaemic etiologies

    Energy Technology Data Exchange (ETDEWEB)

    Petryka, Joanna, E-mail: joannapetryka@hotmail.com [Department of Coronary Artery Disease and Structural Heart Diseases, Institute of Cardiology, Warsaw (Poland); Cardiovascular Magnetic Resonance Unit, Institute of Cardiology, Warsaw (Poland); Miśko, Jolanta [Cardiovascular Magnetic Resonance Unit, Institute of Cardiology, Warsaw (Poland); Department of Radiology, Institute of Cardiology, Warsaw (Poland); Przybylski, Andrzej [Department of Arrhythmia, Institute of Cardiology, Warsaw (Poland); Śpiewak, Mateusz [Department of Coronary Artery Disease and Structural Heart Diseases, Institute of Cardiology, Warsaw (Poland); Cardiovascular Magnetic Resonance Unit, Institute of Cardiology, Warsaw (Poland); Małek, Łukasz A. [Cardiovascular Magnetic Resonance Unit, Institute of Cardiology, Warsaw (Poland); Department of Cardiology and Interventional Angiology, Institute of Cardiology, Warsaw (Poland); Werys, Konrad [Cardiovascular Magnetic Resonance Unit, Institute of Cardiology, Warsaw (Poland); Mazurkiewicz, Łukasz [Cardiovascular Magnetic Resonance Unit, Institute of Cardiology, Warsaw (Poland); Department of Cardiomyopathy, Institute of Cardiology, Warsaw (Poland); Gepner, Katarzyna [Department of Coronary Artery Disease, Institute of Cardiology, Warsaw (Poland); Croisille, Pierre [Creatis Laboratory, UMR CNRS 5515, INSERM, U1044, CHU Saint-Etienne, Universite de Lyon (France); Demkow, Marcin [Department of Coronary Artery Disease and Structural Heart Diseases, Institute of Cardiology, Warsaw (Poland); Rużyłło, Witold [Institute of Cardiology, Warsaw (Poland)

    2012-10-15

    Purpose: To assess the value of dyssynchrony and myocardial viability assessment by cardiac magnetic resonance (CMR) in prediction of response to cardiac resynchronization therapy (CRT) in patients with heart failure (HF) of both ischaemic and non-ischaemic etiologies. Materials and methods: Patients scheduled for CRT in NYHA class II–IV, left ventricular ejection fraction <35%, QRS ≥ 120 ms were included. Tagged cine and late gadolinium enhancement (LGE) images were performed. Dyssynchrony was assessed with inTag toolbox and LGE was quantified using cutoff value at half of maximal signal in the scar. Cardiopulmonary exercise test, echocardiography and blood testing for NT-proBNP levels were done at baseline and 6 months after CRT. Results: 52 patients (age 60.3 ± 13 years) were included. 26 patients (50%) met response criteria. The ischaemic etiology of HF was more frequent (69% vs. 31%, p = 0.002), the percent of LGE was higher (7.7% [0–13.5%] vs. 19.0% (0–31.9%], p = 0.013), regional vector of circumferential strain variance (RVV) was lower (0.27 ± 0.08 vs. 0.34 ± 0.09, p = 0.009) and uniformity of radial strain was higher (0.72 ± 0.25 vs. 0.56 ± 0.29, p = 0.046) in non-responders vs. responders. Multivariate logistic regression showed that RVV predicted response to CRT (HR 2.3, 95% CI 1.02–5.02, p = 0.0430) independently of LGE and the etiology of heart failure. In the subgroup of patients with ischaemic HF the extend of transmural scar within myocardium was higher in non-responders vs. responders (26.3% vs. 15.0% respectively, p = 0.01) and was a predictor of response to CRT in univariable analysis (HR 0.87, 95% CI 0.77–0.98, p = 0.025) providing the sensitivity of 76% and specificity of 75% at the cutoff point of 18% in the prediction of poor response to CRT. In patients with non-ischaemic HF QRS was wider (162 ms vs. 140 ms, p = 0.04), regional vector of strain variance (RVV) was higher (0.39 vs. 0.25, p = 0.002) and uniformity of radial

  9. Corrected tetralogy of Fallot: delayed enhancement in right ventricular outflow tract

    NARCIS (Netherlands)

    Oosterhof, Thomas; Mulder, Barbara J. M.; Vliegen, Hubert W.; de Roos, Albert

    2005-01-01

    PURPOSE: To evaluate retrospectively the presence of fibrosis and largest diameter of the right ventricular outflow tract (RVOT) by using delayed enhancement magnetic resonance (MR) imaging in patients who had undergone initial correction for tetralogy of Fallot. MATERIALS AND METHODS: MR imaging

  10. 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.

  11. Delay Variation Model with Two Service Queues

    Directory of Open Access Journals (Sweden)

    Filip Rezac

    2010-01-01

    Full Text Available Delay in VoIP technology is very unpleasant issue and therefore a voice packets prioritization must be ensured. To maintain the high call quality a maximum information delivery time from the sender to the recipient is set to 150 ms. This paper focuses on the design of a mathematical model of end-to-end delay of a VoIP connection, in particular on a delay variation. It describes all partial delay components and mechanisms, their generation, facilities and mathematical formulations. A new approach to the delay variation model is presented and its validation has been done by experimention.

  12. 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.

  13. Myocardial delayed-enhancement CT: initial experience in children and young adults.

    Science.gov (United States)

    Goo, Hyun Woo

    2017-10-01

    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, Pthallium 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.

  14. 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.

  15. Multiuser Delay-Tracking CDMA Receiver

    Directory of Open Access Journals (Sweden)

    Zha Wei

    2002-01-01

    Full Text Available We propose to integrate delay tracking into a successive interference cancellation (SIC code division multiple access (CDMA multiuser detector. Delay-robust SIC was initially proposed for CDMA multiuser detection when there exist time delay estimation errors. When the delay error is small, the true user signature vector can be approximately expanded around the estimated time delay as a linear combination of an estimated signature vector and an error vector. The amplitude of the error signal can be recursively estimated and cancelled in the multistage SIC iterations by using the tentative feedback decisions. Since the relative amplitude of the error signal provides information about the delay error, we propose the application of error signal feedback to improve the delay estimation. In a sliding window implementation, the delay-robust SIC is used to track multiple time varying user delays. For constant or slowly varying channels, a soft-decision function can be used to improve the delay-robust SIC. For fast fading channels, a linear decision function is used. Delay-tracking results for both rectangular chip pulses and band-limited chip pulses are shown.

  16. PRECISION TIME-DELAY GENERATOR

    Science.gov (United States)

    Carr, B.J.; Peckham, V.D.

    1959-06-16

    A precision time-delay generator circuit with low jitter is described. The first thyratron has a series resonant circuit and a diode which is connected to the second thyratron. The first thyratron is triggered at the begin-ning of a time delay and a capacitor is discharged through the first thyratron and the diode, thereby, triggering the second thyratron. (T.R.H.) l6l9O The instrument described can measure pressures between sea level and 300,000 ft. The pressure- sensing transducer of the instrument is a small cylindrical tube with a thin foil of titanium-tritium fastened around the inside of the tube. Output is a digital signal which can be used for storage or telemetering more conveniently than an analog signal. (W.D.M.) l6l9l An experimental study was made on rolling contacts in the temperature range of 550 to 1000 deg F. Variables such as material composition, hardness, and operating conditions were investigated in a rolling test stand. Ball bearing tests were run to determine the effect of design parameters, bearing materials, lubricants, and operating conditions. (auth)

  17. Delayed auditory feedback and aphasia.

    Science.gov (United States)

    Boller, F; Vrtunski, P B; Kim, Y; Mack, J L

    1978-06-01

    The effect of Delayed Auditory Feedback (DAF) was evaluated in three groups of subjects: 10 normal controls, 10 non-fluent aphasics, and 10 fluent aphasics. Speec production tasks consisted of (1) repeating sound and words; (2) naming objects; (3) producing sentences from given stimulus words; (4) answering questions; (5) reciting nursery rhymes; and (6) reading. Two delays were used, 180 and 360 msec. Two independent judges rated patients' responses for changes in intensity, duration, and quality of speech. Inter-judge reliability was considered satisfactory. Contrary to some previous reports, all subjects, including all the fluent aphasics, showed some DAF effect. Fluent aphasics, however, showed a significantly smaller DAF effect than non-fluent aphasics. Patient with conduction aphasia appeared to be the least impaired. Overall DAF effect was greater with 180 msec. than with 360 msec. The largest DAF effect occurred during answering question, followed by repeating, reading, nursery rhymes, sentence production, and naming, in that order. Repetition of a complex word produced a greater DAF effect than repetition of a simple sound. Finally, we found a differential effect of DAF on the three measures used in the study. We hypothesize that DAF effects result from changes in two separate monitoring systems. One systems is related to changes in the intensity of speech and does not appear to be affected by aphasia. The other is responsible for duration and qualitative changes in speech and is differentially affected in relation to pathology producing aphasia.

  18. Delayed coker fractionator advanced control

    Energy Technology Data Exchange (ETDEWEB)

    Jaisinghani, R.; Minter, B. (ABB SIMCON Inc., Houston, TX (United States)); Tica, A.; Puglesi, A.; Ojeda, R. (Yacimentos Petroliferos Fiscales, Mendoza (Argentina))

    1993-08-01

    In a delayed coking process, as coke drum switches are made, rapid changes occur in both the fractionator feed rate and composition. With conventional control, it is not unusual to see long transient behavior of large swings in both quality and flowrates of coker gas oils. This can extract a heavy economic toll, not only in coker operation, but in the operation of downstream units as the upset is propagated. An advanced process control application (APC) was recently implemented on the coker fractionator at the Yacimentos Petroliferos Fiscales (YPF), Lujan de Cuyo Refinery, in Mendoza, Argentina. This coker fractionator control design was unique as it handled two different operating objectives: control of product qualities via tower temperature profile during normal operation and control of gas oil product flow ratio during drum switch. This combination of control objectives in one multivariable predictive control program was achieved by including special logic to decouple the individual tuning requirements. Also, additional logic was included to unambiguously detect and identify drum switch and drum steam out as discrete events within 30 seconds of their actual occurrence. These discrete events were then used as disturbance variables to minimize fractionator transient behavior. As a performance measure, the overhead temperature was controlled within 2 C to 2.5 C of its target, gas oil flows were stabilized during drum switches and steam generation via pump around was maximized. Overall, implementing advanced control for the delayed coker fractionator resulted in substantial benefits from product quality control, product flow control and minimized energy consumption.

  19. Reasons for diagnostic delay in gynecological malignancies

    DEFF Research Database (Denmark)

    Vandborg, Mai Partridge; Christensen, René dePont Christensen; Kragstrup, Jakob

    2011-01-01

    Aim The primary aim of this study was to identify and describe different delay types in women with gynecologic cancer, and to analyze the relationship between diagnostic delay and a number of characteristics for patients, cancers and the health care system. Setting A cohort study of women newly......) and The Danish Gynecological Cancer Database (DGCD). 161 women were included; ovarian cancer: 63, endometrial cancer: 50, cervical cancer: 34 and vulvar cancer: 14. Outcome measures were different delay types counted in days and the influence of four clinical important variables: Presence of alarm symptoms, age...... (≤ or > 60 years), performance of gynecological examination by the GP and notification of cancer suspicion on first referral from GP’s on the diagnostic delay (short delay ≤90 days and long delay >90 days). Results Across cancer type a median total delay of 101 days was observed. The 10% of women...

  20. Large Deviations for Gaussian Diffusions with Delay

    Science.gov (United States)

    Azencott, Robert; Geiger, Brett; Ott, William

    2018-01-01

    Dynamical systems driven by nonlinear delay SDEs with small noise can exhibit important rare events on long timescales. When there is no delay, classical large deviations theory quantifies rare events such as escapes from metastable fixed points. Near such fixed points, one can approximate nonlinear delay SDEs by linear delay SDEs. Here, we develop a fully explicit large deviations framework for (necessarily Gaussian) processes X_t driven by linear delay SDEs with small diffusion coefficients. Our approach enables fast numerical computation of the action functional controlling rare events for X_t and of the most likely paths transiting from X_0 = p to X_T=q. Via linear noise local approximations, we can then compute most likely routes of escape from metastable states for nonlinear delay SDEs. We apply our methodology to the detailed dynamics of a genetic regulatory circuit, namely the co-repressive toggle switch, which may be described by a nonlinear chemical Langevin SDE with delay.

  1. 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.

  2. IMAGES, IMAGES, IMAGES

    Energy Technology Data Exchange (ETDEWEB)

    Marcus, A.

    1980-07-01

    The role of images of information (charts, diagrams, maps, and symbols) for effective presentation of facts and concepts is expanding dramatically because of advances in computer graphics technology, increasingly hetero-lingual, hetero-cultural world target populations of information providers, the urgent need to convey more efficiently vast amounts of information, the broadening population of (non-expert) computer users, the decrease of available time for reading texts and for decision making, and the general level of literacy. A coalition of visual performance experts, human engineering specialists, computer scientists, and graphic designers/artists is required to resolve human factors aspects of images of information. The need for, nature of, and benefits of interdisciplinary effort are discussed. The results of an interdisciplinary collaboration are demonstrated in a product for visualizing complex information about global energy interdependence. An invited panel will respond to the presentation.

  3. FDG-PET/CT for differentiating between aseptic and septic delayed union in the lower extremity.

    Science.gov (United States)

    van Vliet, Kirsten E; de Jong, Vincent M; Termaat, M Frank; Schepers, Tim; van Eck-Smit, Berthe L F; Goslings, J Carel; Schep, Niels W L

    2018-02-01

    18 F-fluorodeoxyglucose ( 18 F-FDG) positron emission tomography (PET)/computed tomography (CT) has proven to have a high diagnostic accuracy for the detection of bone infections. In patients with delayed union it may be clinically important to differentiate between aseptic and septic delayed union. The aim of this study was to evaluate the efficacy and to assess the optimal diagnostic accuracy of FDG-PET/CT in differentiating between aseptic and septic delayed union in the lower extremity. This is a retrospective study of consecutive patients who underwent FDG-PET/CT scanning for suspicion of septic delayed union of the lower extremity. Diagnosis of aseptic delayed union or septic delayed union was made based on surgical deep cultures following PET/CT scanning and information on clinical follow-up. FDG-uptake values were measured at the fractured site by use of the maximum standardized uptake value (SUV max ). Sensitivity, specificity and diagnostic accuracy of FDG-PET/CT were calculated at various SUV max cut-off points. A total of 30 patients were included; 13 patients with aseptic delayed unions and 17 patients with septic delayed unions. Mean SUV max in aseptic delayed union patients was 3.23 (SD ± 1.21). Mean SUV max in septic delayed union patients was 4.77 (SD ± 1.87). A cut-off SUV max set at 4.0 showed sensitivity, specificity and diagnostic accuracy of FDG-PET/CT were 65, 77 and 70% to differentiate between aseptic and septic delayed union, respectively. Using a semi-quantitative measure (SUV max ) for interpretation of FDG-PET/CT imaging seems to be a promising tool for the discrimination between aseptic and septic delayed union.

  4. Delayed response in ipilimumab therapy.

    Science.gov (United States)

    Megahed, Ahmed; Faulhaber, Peter; Phillips, Tycel; Koon, Henry

    2014-03-01

    Metastatic melanoma is a deadly disease with a 5-year survival rate lower than 20%. In 2011, ipilimumab, a fully humanized antibody that binds to cytotoxic T-lymphocyte-associated antigen 4 (CTLA4) was approved by the US Food and Drug Administration based on improved survival in a pivotal trial. CTLA4 is a molecule on cytotoxic T-lymphocytes that plays a critical role in attenuating immune responses. Ipilimumab blocks the binding of B7, the ligand of CTLA4, thereby blocking the activation of CTLA4 and sustaining antitumor immune responses. The time course to response can be variable with immunotherapeutics. We report on a patient who experienced a considerable delay before responding to ipilimumab.

  5. Delayed Posthypoxic Leukoencephalopathy: Improvement with Antioxidant Therapy

    Directory of Open Access Journals (Sweden)

    Franklin King

    2015-12-01

    Full Text Available Introduction: Delayed posthypoxic leukoencephalopathy (DPHL may result from a variety of hypoxic insults, including respiratory depression from an opiate overdose. The underlying pathophysiological mechanism of DPHL remains uncertain. We describe a patient with a typical case of DPHL who responded clinically to antioxidant treatment. Methods: Clinical, serological, and radiographic investigations were undertaken in the evaluation of the patient. Results: A 63-year-old man developed altered mental status 10 days following recovery from an opiate overdose and aspiration pneumonia that required intubation. The clinical course and brain imaging were consistent with DPHL. Initiation of antioxidant therapy with vitamin E, vitamin C, B-complex vitamins, and coenzyme Q10 coincided with the prompt reversal of clinical deterioration. Conclusions: The potential therapeutic effect of antioxidants on DPHL needs to be explored in future cases. If this relationship indeed holds true, it would be consistent with the hypothesis that formation of reactive oxygen species during reperfusion plays a role in the pathophysiology of this disorder.

  6. 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.

  7. Time Delay Estimation Algoritms for Echo Cancellation

    Directory of Open Access Journals (Sweden)

    Kirill Sakhnov

    2011-01-01

    Full Text Available The following case study describes how to eliminate echo in a VoIP network using delay estimation algorithms. It is known that echo with long transmission delays becomes more noticeable to users. Thus, time delay estimation, as a part of echo cancellation, is an important topic during transmission of voice signals over packetswitching telecommunication systems. An echo delay problem associated with IP-based transport networks is discussed in the following text. The paper introduces the comparative study of time delay estimation algorithm, used for estimation of the true time delay between two speech signals. Experimental results of MATLab simulations that describe the performance of several methods based on cross-correlation, normalized crosscorrelation and generalized cross-correlation are also presented in the paper.

  8. Delays in the management of retroperitoneal sarcomas

    DEFF Research Database (Denmark)

    Seinen, Jojanneke; Almquist, Martin; Styring, Emelie

    2010-01-01

    Retroperitoneal sarcomas are rare and treatment should optimally be centralized. Despite successful centralization with 90% of the patients referred prior to surgery, delays occur, which led us to assess lead times in a population-based series. Method. Patients diagnosed with retroperitoneal...... sarcoma in the southern Sweden health care region 2003-2009 were eligible for the study. Data on referrals and diagnostic investigations were collected from clinical files from primary health care, local hospitals, and from the sarcoma centre. Lead times were divided into patient delays and health care...... delays caused by primary health care, local hospitals, or procedures at the sarcoma centre. Results. Complete data were available from 33 patients and demonstrated a median patient delay of 23¿days (0-17¿months) and median health care delay of 94¿days (1-40¿months) with delays of median 15¿days...

  9. Delays in the management of retroperitoneal sarcomas

    DEFF Research Database (Denmark)

    Seinen, Jojanneke; Almquist, Martin; Styring, Emelie

    2010-01-01

    Retroperitoneal sarcomas are rare and treatment should optimally be centralized. Despite successful centralization with 90% of the patients referred prior to surgery, delays occur, which led us to assess lead times in a population-based series. Method. Patients diagnosed with retroperitoneal...... sarcoma in the southern Sweden health care region 2003-2009 were eligible for the study. Data on referrals and diagnostic investigations were collected from clinical files from primary health care, local hospitals, and from the sarcoma centre. Lead times were divided into patient delays and health care...... delays caused by primary health care, local hospitals, or procedures at the sarcoma centre. Results. Complete data were available from 33 patients and demonstrated a median patient delay of 23 days (0-17 months) and median health care delay of 94 days (1-40 months) with delays of median 15 days...

  10. Memorized discrete systems and time-delay

    CERN Document Server

    Luo, Albert C J

    2017-01-01

    This book examines discrete dynamical systems with memory—nonlinear systems that exist extensively in biological organisms and financial and economic organizations, and time-delay systems that can be discretized into the memorized, discrete dynamical systems. It book further discusses stability and bifurcations of time-delay dynamical systems that can be investigated through memorized dynamical systems as well as bifurcations of memorized nonlinear dynamical systems, discretization methods of time-delay systems, and periodic motions to chaos in nonlinear time-delay systems. The book helps readers find analytical solutions of MDS, change traditional perturbation analysis in time-delay systems, detect motion complexity and singularity in MDS; and determine stability, bifurcation, and chaos in any time-delay system.

  11. Permutation entropy with vector embedding delays

    Science.gov (United States)

    Little, Douglas J.; Kane, Deb M.

    2017-12-01

    Permutation entropy (PE) is a statistic used widely for the detection of structure within a time series. Embedding delay times at which the PE is reduced are characteristic timescales for which such structure exists. Here, a generalized scheme is investigated where embedding delays are represented by vectors rather than scalars, permitting PE to be calculated over a (D -1 ) -dimensional space, where D is the embedding dimension. This scheme is applied to numerically generated noise, sine wave and logistic map series, and experimental data sets taken from a vertical-cavity surface emitting laser exhibiting temporally localized pulse structures within the round-trip time of the laser cavity. Results are visualized as PE maps as a function of embedding delay, with low PE values indicating combinations of embedding delays where correlation structure is present. It is demonstrated that vector embedding delays enable identification of structure that is ambiguous or masked, when the embedding delay is constrained to scalar form.

  12. Singlet Oxygen Imaging in Polymeric Nanofibers by Delayed Fluorescence

    Czech Academy of Sciences Publication Activity Database

    Mosinger, J.; Lang, Kamil; Hostomský, Jiří; Franc, Jiří; Sýkora, Jan; Hof, Martin; Kubát, Pavel

    2010-01-01

    Roč. 114, č. 48 (2010), s. 15773-15779 ISSN 1520-6106 R&D Projects: GA ČR GA203/08/0831; GA ČR GAP208/10/1678 Institutional research plan: CEZ:AV0Z40320502; CEZ:AV0Z40400503 Keywords : molecular-oxygen * meso-tetralylporphyrins * photodynamic therapy Subject RIV: CA - Inorganic Chemistry Impact factor: 3.603, year: 2010

  13. A Polynomial Estimate of Railway Line Delay

    DEFF Research Database (Denmark)

    Cerreto, Fabrizio; Harrod, Steven; Nielsen, Otto Anker

    2017-01-01

    by numerical analysis with simulation. This paper proposes an analytical estimate of aggregate delay with a polynomial form. The function returns the aggregate delay of a railway line resulting from an initial, primary, delay. Analysis of the function demonstrates that there should be a balance between the two...... remedial measures, supplement and buffer. Numerical analysis of a Copenhagen Sbane line shows that the polynomial function is valid even when theoretical assumptions are violated....

  14. Stability investigation of quadratic systems with delay

    Directory of Open Access Journals (Sweden)

    Vladimir Davydov

    2000-01-01

    Full Text Available Systems of differential equations with quadratic right-hand sides with delay are considered in the paper. Compact matrix notation form is proposed for the systems of such type. Stability investigations are performed by Lyapunov's second method with functions of quadratic form. Stability conditions of quadratic systems with delay, uniformly by argument deviation, and with delay depending on the system's parameters are derived. A guaranteed radius of the ball of asymptotic stability region for zero solution is obtained.

  15. Delayed enhanced MRI in intraparenchymal tumors

    International Nuclear Information System (INIS)

    Eguchi, Takahiko; Morimoto, Tetsuya; Takeshima, Toshikazu

    1991-01-01

    Delayed enhanced MRI was performed on 20 intraparenchymal tumors, and these findings were compared with those of early enhanced MRI. Using the spin-echo technique (SE: 400-500/20 msec), early scans were obtained 5 minutes, and delayed scans were obtained 60 minutes, after the intravenous injection of 0.1 nmol of gadolinium-DTPA/Kg. We discussed the changes in the delayed scan with regard to the change in the pattern of enhancement and the boundary of enhancement. In these twenty intraparenchymal tumors, there were three low-grade astrocytomas, two anaplastic astrocytomas, seven glioblastomas, and eight metastatic tumors. The changes in the enhanced pattern showed three types as follows: Type I: heterogeneous enhancement in both early and delayed scans; Type II: heterogeneous enhancement in early scan and homogeneous enhancement in delayed scan; Type III: homogeneous enhancement in both early and delayed scans. Most malignant tumors, such as glioblastomas (6/8), anaplastic astrocytomas (2/2), and metastatic tumors (7/8), revealed Type I, although low-grade astrocytomas showed Type II (3/2) and Type III (1/3). The heterogeneous enhancement in delayed scan was found in malignant tumors and in low-grade astrocytoma; even if the early scan revealed heterogeneous enhancement, the delayed scan showed homogeneous enhancement. In the delayed scan, most enhanced boundaries spread out of the boundaries in the early scan. Glioblastomas spread markedly in the delayed scan, although none of the low-grade astrocytomas, anaplastic astrocytomas, or metastases revealed marked spreading. We called these marked increases in the delayed scan a 'spreading sign' and thought that this sign was specific to glioblastomas. Recently some authors have emphasized the usefulness of serial scans. Delayed enhanced MRI 60 minutes after the administration of a contrast medium was here found also to be useful for the accurate diagnosis for brain tumors. (author)

  16. Faktor - Faktor Yang Mempengaruhi Audit Delay

    OpenAIRE

    Christine Tamba

    2010-01-01

    The aim for this study to investigate the influence of right issue, financial leverage, audit committee education, firm performance and audit opinion on audit delay. The samples consist of listed manufactured firms from 2005 to 2009. The results show that tight issue, audit committee education, and firm leverage significantly influence on audit delay. But, audit opinion and financial leverage do not significantly influence on audit delay. Keywords : Right isisue, Leverage, Education, Perfo...

  17. Neutron stochastic transport theory with delayed neutrons

    International Nuclear Information System (INIS)

    Munoz-Cobo, J.L.; Verdu, G.

    1987-01-01

    From the stochastic transport theory with delayed neutrons, the Boltzmann transport equation with delayed neutrons for the average flux emerges in a natural way without recourse to any approximation. From this theory a general expression is obtained for the Feynman Y-function when delayed neutrons are included. The single mode approximation for the particular case of a subcritical assembly is developed, and it is shown that Y-function reduces to the familiar expression quoted in many books, when delayed neutrons are not considered, and spatial and source effects are not included. (author)

  18. Erupted complex odontoma delayed eruption of permanent molar.

    Science.gov (United States)

    Ohtawa, Yumi; Ichinohe, Saori; Kimura, Eri; Hashimoto, Sadamitsu

    2013-01-01

    Odontomas, benign tumors that develop in the jaw, rarely erupt into the oral cavity. We report an erupted odontoma which delayed eruption of the first molar. The patient was a 10-year-old Japanese girl who came to our hospital due to delayed eruption of the right maxillary first molar. All the deciduous teeth had been shed. The second premolar on the right side had erupted, but not the first molar. Slight inflammation of the alveolar mucosa around the first molar had exposed a tooth-like, hard tissue. Panoramic radiography revealed a radiopaque mass indicating a lesion approximately 1 cm in diameter. The border of the image was clear, and part of the mass was situated close to the occlusal surface of the first molar. The root of the maxillary right first molar was only half-developed. A clinical diagnosis of odontoma was made. The odontoma was subsequently extracted, allowing the crown of the first molar to erupt almost 5 months later. The dental germ of the permanent tooth had been displaced by the odontoma. However, after the odontoma had been extracted, the permanent tooth was still able to erupt spontaneously, as eruptive force still remained. When the eruption of a tooth is significantly delayed, we believe that it is necessary to examine the area radiographically. If there is any radiographic evidence of a physical obstruction that might delay eruption, that obstruction should be removed before any problems can arise. Regular dental checkups at schools might improve our ability to detect evidence of delayed eruption earlier.

  19. New perspectives in nuclear imaging

    International Nuclear Information System (INIS)

    Wagner, H.N. Jr.

    1981-01-01

    In nuclear medicine, biodistribution is studied by quantitative nuclear imaging; chemistry is translated into radio-pharmacology; physics into instrumentation; and biology into physiology. Nuclear medicine can be thought of as applied physiology and physiological chemistry. The modern nuclear chemist is concerned with molecules, with relating chemical structure to biological distributions, as for iminodiacetate compounds. Using mixed ligand analysis, the hepatobiliary agent, HIDA, developed by Loberg, proved an anionic bis-complex with a charge of minus one. Further studies elsewhere showed that the co-ordination number of technetium was 5 and that an oxo-oxygen was in the apical position. From a series of analogues the amount of the complexes excreted in the bile was found to be directly proportional to the natural log of the molecular weight to charge ratio. The trend is towards the synthesis of labelled compounds whose biodistribution depends on their chemical interaction with structurally specific binding sites, i.e. receptors, enzymes or binding sites of active transport systems. Other examples include amino acids for pancreatic imaging; deoxyglucose for studies of regional brain and heart metabolism; fatty acids for studies of the heart; steroid hormones for breast tumours; and muscarinic compounds for study of the cholinergic system of the heart. Most of these compounds are labelled with 11 C, 18 F or 13 N, available only from cyclotrons, but the extension to the more widely available 123 I and sup(99m)Tc is also proceeding rapidly, stimulated chiefly by the success with the positron-emitting compounds. Advances in nuclear imaging include the development of both positron and single photon emission tomography. Biodistribution studies in man permit measurement of regional as well as global function. Improved perception is being augmented by improved quantification and automation

  20. Sources and reasons for delays in the care of acute stroke patients.

    Science.gov (United States)

    Yu, Rosalind F; San Jose, Maria Cristina Z; Manzanilla, Brenda M; Oris, Michael Y; Gan, Robert

    2002-07-15

    This study aimed to identify sources and reasons for delays in the care of our acute stroke patients. Data on time interval from symptom onset or awareness to initial presentation, to neurology assessment, to performance of cranial CT scan, and demographic and medical factors associated with delays among stroke patients admitted at St. Luke's Medical Center from May to October 2000 were obtained by interview and record review. Of 259 patients (mean age 61.5+/-13.6 years, 43% females), 63% had infarction (INF), 32% intracerebral hemorrhage (ICH) and 5% subarachnoid hemorrhage (SAH). Fifty-nine percent presented within 3 h of symptom onset or awareness, 73% within 6 h (median=2 h). Patients with ICH presented earlier than those with infarction. Reasons for delayed consultation included failure to recognize symptoms as serious and stroke-related. A non-neurologist was initially consulted in 97% of cases. Median delay from presentation to neurology evaluation was 7.5 h. Median time from presentation to brain imaging was significantly shorter for patients brought to CT-equipped facilities (2 h) than for those needing transfer to other hospitals (11.5 h). Patient delay in presentation is only one cause of delay in acute stroke care. Longer delays arise from healthcare-related factors such as delays in neurologist referral and neuroradiologic diagnosis. Professional and public education on the necessity of early neurologic evaluation and patient transport to CT-equipped "Stroke Centers" is recommended.

  1. Distinct clinicopathological phenotype of hepatocellular carcinoma with ethoxybenzyl-magnetic resonance imaging hyperintensity: association with gene expression signature.

    Science.gov (United States)

    Miura, Tomoya; Ban, Daisuke; Tanaka, Shinji; Mogushi, Kaoru; Kudo, Atsushi; Matsumura, Satoshi; Mitsunori, Yusuke; Ochiai, Takanori; Tanaka, Hiroshi; Tanabe, Minoru

    2015-09-01

    Although hepatocellular carcinoma (HCC) is mostly a lower intensity lesion in the hepatobiliary phase on gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging, some HCCs were shown as a higher intensity lesion (high HCC). This study aimed to reveal the clinicopathological and biological properties of high HCC. Patients who underwent curative hepatectomy as the first treatment for HCC were included. HCC was defined as high HCC if the ratio between the signal intensity of the HCC and the background liver was greater than or equal to 1.0. We retrospectively performed clinicopathological and global gene expression analyses. Of the 77 patients, 14 had high HCC. Serum protein induced by vitamin K absence or antagonist II levels in high HCC were lower, and the high HCCs were well differentiated. The 3-year disease-free survival rates in high HCC and low HCC patients were 90% and 54%, respectively (P = .035). Overall survival did not differ significantly. Global gene expression analysis revealed that SLCO1B3 was upregulated in high HCC. Clinicopathological analysis revealed low-grade malignancy in high HCCs compared with low HCCs. The expression of SLCO1B3 was key to the hyperintensity in the hepatobiliary phase of ethoxybenzyl-diethylenetriamine pentaacetic acid magnetic resonance imaging. Copyright © 2015 Elsevier Inc. All rights reserved.

  2. [Delayed posthypoxic leukoencephalopathy: case reports].

    Science.gov (United States)

    Okuda, Shiho; Ueno, Masao; Hayakawa, Michiko; Araki, Manabu; Kanda, Fumio; Takano, Shin

    2012-01-01

    Delayed posthypoxic leukoencephalopathy (DPL) is a rare and less well known complication of hypoxic brain injury. Although it is well known that anoxic or hypoxic injury produces acute neurologic deficits, DPL typically manifests days to weeks after apparent recovery from an obtunded state, and patients with DPL demonstrate cognitive impairment, high brain dysfunction, parkinsonism, or psychosis. MRI findings of the brain demonstrate deep white matter abnormalities. We report 2 cases of DPL after hypoxia due to benzodiazepine overdose. Both of our patients had normal arylsulfatase A activity. Although DPL is seen in carbon monoxide poisoning, pseudodeficiency of arylsulfatase A activity, or drug overdose with heroin or morphine, there are only some previous studies of DPL caused by an overdose with benzodiazepine. It is unclear whether neurotoxicity from the drug in addition to hypoxia alone is involved, however, it is important to note that overdose of common drugs as sleeping medicine can cause DPL. Since DPL may often be misdiagnosed and be subjected to unnecessary treatments, it is also important to understand its unique clinical course and MRI findings. With prompt recognition of DPL, we expect that more cases of DPL caused by overdose with benzodiazepine will be diagnosed, because benzodiazepine overdoses are common.

  3. Broadband hyperchaotic oscillator with delay line

    DEFF Research Database (Denmark)

    Cenys, Antanas; Lindberg, Erik; Anagnostopoulos, A. N.

    2002-01-01

    Dynamical systems with time delay can be employed as high dimensional hyperchaotic oscillators with multiple positive Lyapunov exponents. We describe an electronic circuit composed of a 3-stage amplifier and a delay line in the feedback loop. The 1st stage of the amplifier is a nonlinear one while...

  4. Programmable delay circuit for sparker signal analysis

    Digital Repository Service at National Institute of Oceanography (India)

    Pathak, D.

    on it to classify the seafloor sediment properties. A specific purpose oriented programmable delay circuit was developed to generate the necessary delay so that the A/D conversion could start just before the arrival of the echo from the water bottom interface...

  5. Discounting of Delayed Rewards Is Not Hyperbolic

    Science.gov (United States)

    Luhmann, Christian C.

    2013-01-01

    Delay discounting refers to decision-makers' tendency to value immediately available goods more than identical goods available only after some delay. In violation of standard economic theory, decision-makers frequently exhibit dynamic inconsistency; their preferences change simply due to the passage of time. The standard explanation for this…

  6. Action for delayed neutron data evaluation

    International Nuclear Information System (INIS)

    Okajima, Shigeaki

    1999-01-01

    Status of NEA/NSC/WPEC/SG6 activities on delayed neutron data evaluation is shortly reviewed. From this review the actions in evaluating the delayed neutron data are proposed to contribute the revise work for the JENDL-3.3 library. (author)

  7. [Delayed asthma bronchiale due to epoxy resin].

    Science.gov (United States)

    Authried, Georg; Al-Asadi, Haifaa; Møller, Ulla; Sherson, David Lee

    2013-10-28

    Epoxy resin is a low molecular weight agent, which can cause both acute and delayed allergic reactions. However, it is known causing skin reactions with direct or airborne contact. Rarely it can cause airway reactions like asthma bronchiale. We describe a case of a windmill worker who developed delayed asthma bronchiale due to airborne contact with epoxy resin.

  8. Analyzing delay causes in Egyptian construction projects.

    Science.gov (United States)

    Marzouk, Mohamed M; El-Rasas, Tarek I

    2014-01-01

    Construction delays are common problems in civil engineering projects in Egypt. These problems occur frequently during project life-time leading to disputes and litigation. Therefore, it is essential to study and analyze causes of construction delays. This research presents a list of construction delay causes retrieved from literature. The feedback of construction experts was obtained through interviews. Subsequently, a questionnaire survey was prepared. The questionnaire survey was distributed to thirty-three construction experts who represent owners, consultants, and contractor's organizations. Frequency Index, Severity Index, and Importance Index are calculated and according to the highest values of them the top ten delay causes of construction projects in Egypt are determined. A case study is analyzed and compared to the most important delay causes in the research. Statistical analysis is carried out using analysis of variance ANOVA method to test delay causes, obtained from the survey. The test results reveal good correlation between groups while there is significant difference between them for some delay causes and finally roadmap for prioritizing delay causes groups is presented.

  9. Congenital rubella syndrome and delayed manifestations

    DEFF Research Database (Denmark)

    Dammeyer, Jesper Herup

    2010-01-01

    Objective: Several hypotheses of different medical and psychological delayed manifestations among people who have congenital rubella syndrome (CRS) have been discussed. This study tests some of these hypotheses of delayed manifestations. Methods: Gathering information about 35 individuals who have...

  10. Beta delayed particle emission in light nuclei

    International Nuclear Information System (INIS)

    Riisager, K.; Gabelmann, H.

    1991-01-01

    A short discussion of theoretical treatments of beta delayed particle emission is followed by a presentation of data on the newly found beta delayed deuteron decay of 6 He. This decay cannot be described properly with existing theories. (author) 8 refs.; 3 figs

  11. On Delay and Security in Network Coding

    Science.gov (United States)

    Dikaliotis, Theodoros K.

    2013-01-01

    In this thesis, delay and security issues in network coding are considered. First, we study the delay incurred in the transmission of a fixed number of packets through acyclic networks comprised of erasure links. The two transmission schemes studied are routing with hop-by-hop retransmissions, where every node in the network simply stores and…

  12. Algebraic entropy for differential-delay equations

    OpenAIRE

    Viallet, Claude M.

    2014-01-01

    We extend the definition of algebraic entropy to a class of differential-delay equations. The vanishing of the entropy, as a structural property of an equation, signals its integrability. We suggest a simple way to produce differential-delay equations with vanishing entropy from known integrable differential-difference equations.

  13. Performance characteristics of positive and negative delayed ...

    Indian Academy of Sciences (India)

    The chaotic dynamics of directly modulated semiconductor lasers with delayed optoelectronic feedback is studied numerically. The effects of positive and negative delayed optoelectronic feedback in producing chaotic outputs from such lasers with nonlinear gain reduction in its optimum value range is investigated using ...

  14. Delaying Developmental Mathematics: The Characteristics and Costs

    Science.gov (United States)

    Johnson, Marianne; Kuennen, Eric

    2004-01-01

    This paper investigates which students delay taking a required developmental mathematics course and the impact of delay on student performance in introductory microeconomics. Analysis of a sample of 1462 students at a large Midwestern university revealed that, although developmental-level mathematics students did not reach the same level of…

  15. Delaying gratification depends on social trust

    Directory of Open Access Journals (Sweden)

    Laura eMichaelson

    2013-06-01

    Full Text Available Delaying gratification is hard, yet predictive of important life outcomes, such as academic achievement and physical health. Prominent theories focus on the role of self-control, hypersensitivity to immediate rewards, and the cost of time spent waiting. However, delaying gratification may also require trust in people delivering future rewards as promised. To test the role of social trust, participants were presented with character vignettes and faces that varied in trustworthiness, and then chose between hypothetical smaller immediate or larger delayed rewards from those characters. Across two experiments, participants were less willing to wait for delayed rewards from less trustworthy characters, and perceived trustworthiness predicted willingness to delay gratification. These findings provide the first demonstration of a causal role for social trust in willingness to delay gratification, independent of other relevant factors, such as self-control or reward history. Thus, delaying gratification requires choosing not only a later reward, but a reward that is potentially less likely to be delivered, when there is doubt about the person promising it. Implications of this work include the need to revise prominent theories of delay of gratification, and new directions for interventions with populations characterized by impulsivity.

  16. Congenital rubella syndrome and delayed manifestations

    DEFF Research Database (Denmark)

    Dammeyer, Jesper Herup

    2010-01-01

    Objective: Several hypotheses of different medical and psychological delayed manifestations among people who have congenital rubella syndrome (CRS) have been discussed. This study tests some of these hypotheses of delayed manifestations. Methods: Gathering information about 35 individuals who hav...... which people with CRS face must primarily be understood in relation to congenital deafblindness and dual sensory and communicative deprivation....

  17. Fuzzy delay model based fault simulator for crosstalk delay fault test ...

    Indian Academy of Sciences (India)

    generation is that the test patterns must guarantee not only that the deterministic fault effect is captured correctly ... In digital circuits, the delays associated with each element are different and may not be known with precision for a ... In this paper, the fuzzy delay model is employed for test generation of crosstalk delay faults in.

  18. Delay-dependent exponential stability of cellular neural networks with time-varying delays

    International Nuclear Information System (INIS)

    Zhang Qiang; Wei Xiaopeng; Xu Jin

    2005-01-01

    The global exponential stability of cellular neural networks (CNNs) with time-varying delays is analyzed. Two new sufficient conditions ensuring global exponential stability for delayed CNNs are obtained. The conditions presented here are related to the size of delay. The stability results improve the earlier publications. Two examples are given to demonstrate the effectiveness of the obtained results

  19. DELAYED EFFECTS OF RADIATION ON THE HUMAN CENTRAL NERVOUS SYSTEM. EARLY AND LATE DELAYED REACTIONS,

    Science.gov (United States)

    Two cases of delayed effects of radiation on the central nervous system of man are reported. One demonstrates the rare early delayed reaction which...involvement. This patient is an extreme example of the well-documented late delayed effects of radiation and is presented for contrast with the patient in

  20. Controllability of nonlinear delay oscillating systems

    Directory of Open Access Journals (Sweden)

    Chengbin Liang

    2017-05-01

    Full Text Available In this paper, we study the controllability of a system governed by second order delay differential equations. We introduce a delay Gramian matrix involving the delayed matrix sine, which is used to establish sufficient and necessary conditions of controllability for the linear problem. In addition, we also construct a specific control function for controllability. For the nonlinear problem, we construct a control function and transfer the controllability problem to a fixed point problem for a suitable operator. We give a sufficient condition to guarantee the nonlinear delay system is controllable. Two examples are given to illustrate our theoretical results by calculating a specific control function and inverse of a delay Gramian matrix.