BACKGROUND: The presence of myocardial fibrosis is associated with adverse outcome in dilated cardiomyopathy (DCM). Delayed contrast-enhanced cardiac magnetic resonance (DE-CMR) currently represents the gold standard in noninvasive evaluation of myocardial scarring. However, a significant number of patients are unable to undergo DE-CMR study for various reasons. We sought to determine the diagnostic accuracy of cardiac CT (CCT) compared with CMR in the investigation of the presence of delayed contrast enhancement (DCE) in subjects with DCM. METHODS: We prospectively enrolled 17 consecutive patients with DCM, who were initially referred to our institution because of recently manifested heart failure due to unexplained left ventricular systolic dysfunction. In all subjects, CCT and DE-CMR were performed within 1 week. RESULTS: CCT and DE-CMR showed satisfactory agreement in detecting DCE (agreement in 82% cases, κ = 0.56) with 50% sensitivity, 100% specificity, and a positive predictive value of 100%. CONCLUSION: CCT may be a valuable method for detecting DCE in patients with DCM. CCT thus might be considered as an alternative method to DE-CMR in the assessment of the presence and extent of myocardial fibrosis in subjects who are not suitable for DE-CMR examination.
- MeSH
- dilatační kardiomyopatie diagnostické zobrazování MeSH
- dospělí MeSH
- dysfunkce levé srdeční komory diagnostické zobrazování MeSH
- endomyokardiální fibróza diagnostické zobrazování MeSH
- kohortové studie MeSH
- kontrastní látky farmakokinetika MeSH
- lidé středního věku MeSH
- lidé MeSH
- magnetická rezonanční tomografie metody MeSH
- počítačová rentgenová tomografie metody MeSH
- prospektivní studie MeSH
- senzitivita a specificita MeSH
- vylepšení obrazu * MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- srovnávací studie MeSH
OBJECTIVE: To compare image quality of different reconstruction techniques in submillisievert ultralow-dose CT colonography (CTC) and to correlate colonic findings with subsequent optical colonoscopy. METHODS: 58 patients underwent ultralow-dose CTC. The images were reconstructed with filtered back projection (FBP), hybrid iterative reconstruction (HIR) or model-based iterative reconstruction (MBIR) techniques. In each segment, endoluminal noise (expressed as standard deviation of endoluminal density) was measured and image quality was rated on a five-point Likert scale by two independent readers. Colonic lesions were evaluated in consensus and correlated with subsequent optical colonoscopy where possible. RESULTS: The estimated radiation dose was 0.41 ± 0.05 mSv for the supine and 0.42 ± 0.04 mSv for the prone acquisitions. In the endoluminal view, the image quality was rated better in HIR, whereas better scores were obtained in MBIR in the cross-sectional view, where the endoluminal noise was the lowest (p < 0.0001). Five (26%) polyps were not identified using both computer-aided detection and endoluminal inspection in FBP images vs only one (5%) in MBIR and none in HIR images. CONCLUSION: This study showed that in submillisievert ultralow-dose CTC, the image quality for the endoluminal view is better when HIR is used, whereas MBIR yields superior images for the cross-sectional view. The inferior quality of images reconstructed with FBP may result in decreased detection of colonic lesions. ADVANCES IN KNOWLEDGE: Radiation dose from CTC can be safely reduced <1 mSv for both positions when iterative reconstruction is used. MBIR provides better image quality in the cross-sectional view and HIR in the endoluminal view.
- MeSH
- dávka záření MeSH
- kolonografie počítačovou tomografií metody MeSH
- lidé středního věku MeSH
- lidé MeSH
- rentgenový obraz - interpretace počítačová metody MeSH
- senioři MeSH
- teoretické modely MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- srovnávací studie MeSH
BACKGROUND: The aim of this study was to evaluate the frequency of gastrointestinal complications (GICs) and associated risk factors in patients after cardiac surgery, and to stratify them according to the risk of developing GICs in order to improve our diagnostic protocols. METHODS: A total of 5959 patients who underwent cardiac surgery within a period of 97 months were retrospectively evaluated. Surgical procedures included coronary artery bypass grafting, heart valve surgery, aortic surgery, surgical correction of adult congenital heart defects, or combined procedures. RESULTS: The frequency of GICs was 1.3% (75 patients). Intestinal ischemia and upper or lower gastrointestinal bleeding were the most common GICs. From 27 patients affected by intestinal ischemia, 21 patients were previously treated with intra-aortic balloon pump (p < 0.001). Low cardiac output, renal failure or dysfunction, renal risk, peripheral arterial disease, history of myocardial infarction, male gender, intra-aortic balloon pump, cardiopulmonary bypass time, aortic cross-clamp time, duration of intubation, SIRS, and MODS were associated with significantly increased risk of GICs. CONCLUSIONS: To decrease the occurrence of intestinal ischemia, we suggest that placement of intra-aortic balloon pump should be preceded by examination of the descending aorta to rule out severe atherosclerotic changes, in which case -alternative cardiac support should be attempted.
- MeSH
- časové faktory MeSH
- dospělí MeSH
- gastrointestinální nemoci epidemiologie etiologie MeSH
- incidence MeSH
- kardiochirurgické výkony škodlivé účinky MeSH
- lidé středního věku MeSH
- lidé MeSH
- míra přežití trendy MeSH
- mladý dospělý MeSH
- následné studie MeSH
- nemoci srdce chirurgie MeSH
- pooperační komplikace epidemiologie etiologie MeSH
- prognóza MeSH
- retrospektivní studie MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika epidemiologie MeSH
Benign breast lesions are usually divided with regard to the proliferative activity into three categories. These lesions, depending on their histopathological characteristics and correlation with epidemiological studies differ as to the risk of breast cancer. 1. The concentration of hormonal receptors in the breast tissue in our group correlated with the proliferative activity of the lesion. 2. A major proliferative lesion and atypical hyperplasia of the ductal epithelium are a typical precancerous condition. 3. The hormonal receptor concentration defines, in addition to the histological classification, the biological activity more accurately. The prevalence of the oestrogen receptor or its trend to predominate over the progesterone receptor is a serious marker of imminent cancerogenesis. 4. Based on the prevalence of hormonal receptors it is possible to select suitable hormonal treatment to suppress the proliferative potential of the breast lesion. 5. A high level of the oestrogen receptor in non-malignant formations of the breast can be considered a manifestation of increased sensitivity of this target tissue to circulating oestrogens. It is a question whether it is the manifestation of mutation of the oestrogen receptor or the consequence of long-term exposure to uncovered levels of bioavailable oestrogens.
- MeSH
- lidé MeSH
- nemoci prsů diagnóza terapie MeSH
- Check Tag
- lidé MeSH
- ženské pohlaví MeSH
- MeSH
- dospělí MeSH
- karcinom farmakoterapie chirurgie radioterapie MeSH
- lidé středního věku MeSH
- lidé MeSH
- mastektomie MeSH
- nádory prsu farmakoterapie chirurgie radioterapie MeSH
- pooperační komplikace MeSH
- senioři MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- senioři MeSH
- ženské pohlaví MeSH
