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  • 1
    ISSN: 1619-7089
    Keywords: Technetium-99m sestamibi ; Tracer washout ; Tracer redistribution ; Exercise studies
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The aim of this study was to assess whether a clinically relevant change in myocardial sestamibi activity could be documented within the first 120 min following injection (p.i.). In 17 patients planar anterior imaging of the heart was performed 5 min and 120 min p.i. During this time interval, mean decay-corrected myocardial activity declined to 77.9%±9.7% after stress and to 85.7%±7.9% after injection at rest (P〈0.05). In 19 patients with angiographically documented coronary artery disease, single-photon emission tomography was performed 5 min and 120 min after injection at maximum stress. For analysis, sestamibi activity was scored semiquantitatively in six left ventricular segments. Furthermore, sestamibi uptake was assessed quantitatively using a circumferential profile method. In 35 of 114 segments the score improved within 120 min p.i. (early fillin); in these segments relative sestamibi activity rose from 69.9%±22.5% to 74.5%±20.8% (P〈0.01). In five patients this early fill-in was the only sign of exercise-induced hypoperfusion. In 7 of 114 segments the score deteriorated 120 min p.i. (early tracer washout); in these segments relative sestamibi activity declined from 85.6%±9.9% to 80.1%±10.7% (P〈0.02). In three of four patients with early tracer washout the corresponding coronary artery was significantly narrowed. In conclusion, a global myocardial sestamibi washout was registered within the first 120 min after injection. A fill-in of initial defects as well as an early tracer loss could be detected in a relevant number of patients with chronic coronary artery disease during the first 2 h p.i. In these patients the extent of detected reversible perfusion abnormality depends on the chosen time interval between injection and imaging. The results of this study suggest that exercise imaging should be started immediately after injection.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1615-3146
    Keywords: Kerspintomographie ; Kollateralbandruptur ; Knorpelläsion ; Hochauflösende Oberflächenspule ; Magnetic resonance imaging ; Collateral ligament rupture ; Cartilage lesion ; High-resolution coil
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Aim of this study was the evaluation of a prototype of a new high-resolution MRI coil for the detection of finger trauma. The practicability of this new coil for the assessment of traumatic lesions of the finger joints and the diagnostic value of this new method in clinical practice was assessed. Twenty patients between 13 and 50 years of age (mean 28 years) were examined with a 1.5-T whole-body-imager Magnetom SP 63 scanner (Siemens, Erlangen, Germany). A prototype of a high-resolution MRI coil with a diameter of 2.5 cm was used. T1- and T2-weighted images with an in plane resolution of 0.I95 x 0.098 mm were acquired. Bone structures, joint cartilage and capsule, ligaments, tendons and soft tissue alterations were assessed. All 19 patients with pathological changes at the finger joints had a joint effusion. With MR imaging, fractures were detected in almost all patients, compared with the X-ray examinations. Cartilage contusion showed high signal intensity. The collateral ligaments could best be assessed in the transversal, and ligament ruptures in the coronal plane. Hemorrhage in the tendon showed an increased signal intensity in T1- and T2-weighted, edema only in T2-weighted images. Especially traumatic lesions of cartilage and of ligaments can be sufficiently assessed by the high-resolution MRI due to its high anatomic resolution compared to common methods like X-ray. High-resolution MRI is practicable in clinical routine.
    Notes: Zusammenfassung Ziel der vorliegenden prospektiven Untersuchung war es, die Wertigkeit der hochauflösenden Kernspintomographie mittels einer speziellen Oberflächenspule in der Beurteilung von traumatischen Veränderungen der Fingergelenke zu evaluieren. Ferner sollte die Praktikabilität der Methode in der klinischen Routine überprüft werden. Es wurden 20 Patienten im Alter zwischen 13 und 50 Jahren (im Mittel 28 Jahre) an einem 1,5-T-Ganzkörpertomographen (Magnetom SP 63, Firma Siemens, Erlangen) untersucht. Als Spule wurde ein Prototyp einer hochauflösenden Oberflächenspule mit einem Durchmesser von 2,5 cm benutzt. T1- und T2-gewichtete Sequenzen mit einer maximalen Auflbsung in der Bildebene von 0,195 x 0,098 mm wurden zur Beurteilung von Knochen, Gelenkknorpel und -kapsel, der Sehnen und des Weichteilgewebes akquiriert. Kernspintomographisch fand sich bei 19 Patienten ein pathologischer Befund. Bei all diesen Patienten konnte ein Gelenkerguß nachgewiesen werden. Knöcherne Absprengungen, die anhand konventioneller Röntgenaufnahmen diagnostiziert wurden, zeigten sich kernspintomographisch als dislozierte signalreiche Strukturen. Gelenkknorpelkontusionen stellten sich hyperintens dar. Zur Beurteilung der Kollateralbānder eignete sich vor allem die koronare Schichtebene, da in dieser die Kollateralbdnder per continuitatem darstellbar sind. Sehneneinblutungen wiesen eine Signalerhöhung in T1- und T2-Wichtung auf. Ödeme der Weichteile und Bandstrukturen imponierten in T2-gewichteten Aufnahmen als signalreiche Strukturveränderungen. Aufgrund der hohen anatomischen Detailerkennbarkeit eignet sich die hochauflbsende Kernspintomographie als ergänzendes diagnostisches Verfahren zur nichtinvasiven Diagnostik von traumatischen Knorpel- und Bandläsionen. Unter Berücksichtigung des Zeitaufwandes handelt es sich dabei um eine im klinischen Alltag praktikable Methode.
    Type of Medium: Electronic Resource
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