Perfusion dynamics play a vital role in delivering essential nutrients and oxygen to tissues while removing metabolic waste products. Imaging techniques such as magnetic resonance imaging (MRI), computed tomography (CT), and positron emission tomography (PET) use contrast agents to visualize perfusion and clearance patterns; however, each technique has specific limitations. Hybrid PET/MRI combines the quantitative power and sensitivity of PET with the high functional and anatomical detail of MRI and holds great promise for precision in molecular imaging. However, the development of dual PET/MRI probes has been hampered by challenging synthesis and radiolabeling. Here, we present a novel PET/MRI probe, [18F][Gd(FL1)], which exhibits excellent stability comparable to macrocyclic MRI contrast agents used in clinical practice. The unique molecular design of [18F][Gd(FL1)] allows selective and expeditious radiolabeling of the gadolinium chelate in the final synthetic step. Leveraging the strengths of MRI and PET signals, the probe enables quantitative in vivo mapping of perfusion and excretion dynamics through an innovative voxel-based analysis. The diagnostic capabilities of [18F][Gd(FL1)] were demonstrated in a pilot study on healthy mice, successfully detecting early cases of unilateral renal dysfunction, a condition that is typically challenging to diagnose. This study introduces a new approach for PET/MRI and emphasizes a streamlined probe design for practical synthesis and improved diagnostic accuracy.

• Klíčová slova
• cancer, fluorine 18, gadolinium, hybrid PET/MRI, imaging agents,
• MeSH
• gadolinium chemie   MeSH
• kontrastní látky * chemie   chemická syntéza   MeSH
• magnetická rezonanční tomografie * metody   MeSH
• makrocyklické sloučeniny * chemie   chemická syntéza   MeSH
• myši MeSH
• perfuzní zobrazování metody   MeSH
• pozitronová emisní tomografie * MeSH
• radioizotopy fluoru chemie   MeSH
• zvířata MeSH
• Check Tag
• myši MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• gadolinium MeSH
• kontrastní látky * MeSH
• makrocyklické sloučeniny * MeSH
• radioizotopy fluoru MeSH

PURPOSE: The aim of the study was to compare the assessment of ischemic changes by expert reading and available automated software for non-contrast CT (NCCT) and CT perfusion on baseline multimodal imaging and demonstrate the accuracy for the final infarct prediction. METHODS: Early ischemic changes were measured by ASPECTS on the baseline neuroimaging of consecutive patients with anterior circulation ischemic stroke. The presence of early ischemic changes was assessed a) on NCCT by two experienced raters, b) on NCCT by e-ASPECTS, and c) visually on derived CT perfusion maps (CBF<30%, Tmax>10s). Accuracy was calculated by comparing presence of final ischemic changes on 24-hour follow-up for each ASPECTS region and expressed as sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). The subanalysis for patients with successful recanalization was conducted. RESULTS: Of 263 patients, 81 fulfilled inclusion criteria. Median baseline ASPECTS was 9 for all tested modalities. Accuracy was 0.76 for e-ASPECTS, 0.79 for consensus, 0.82 for CBF<30%, 0.80 for Tmax>10s. e-ASPECTS, consensus, CBF<30%, and Tmax>10s had sensitivity 0.41, 0.46, 0.49, 0.57, respectively; specificity 0.91, 0.93, 0.95, 0.91, respectively; PPV 0.66, 0.75, 0.82, 0.73, respectively; NPV 0.78, 0.80, 0.82, 0.83, respectively. Results did not differ in patients with and without successful recanalization. CONCLUSION: This study demonstrated high accuracy for the assessment of ischemic changes by different CT modalities with the best accuracy for CBF<30% and Tmax>10s. The use of automated software has a potential to improve the detection of ischemic changes.

• Klíčová slova
• ASPECTS, CT perfusion, Early ischemic changes, RAPID, Stroke imaging, e-ASPECTS,
• MeSH
• časná diagnóza MeSH
• časové faktory MeSH
• cévní mozková příhoda diagnostické zobrazování   patofyziologie   terapie   MeSH
• dospělí MeSH
• ischemie mozku diagnostické zobrazování   patofyziologie   terapie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mozkový krevní oběh * MeSH
• perfuzní zobrazování metody   MeSH
• počítačová rentgenová tomografie * MeSH
• prediktivní hodnota testů MeSH
• prognóza MeSH
• rentgenový obraz - interpretace počítačová * MeSH
• reprodukovatelnost výsledků MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• software * MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• pozorovací studie MeSH
• srovnávací studie MeSH

BACKGROUND: In randomized clinical trials, mechanical thrombectomy (MT) was proved to be a highly effective treatment of acute ischemic stroke which improved clinical outcomes. Some of the trials used automated computed tomography perfusion (CTP) analysis for selection of participants. We present a single-center experience with CTP selection and comparison with CTP trials. METHODS: Data of consecutive MT patients (from January 2016 to December 2017) were retrospectively reviewed. All patients with multiphase CT angiography confirmed the presence of anterior circulation large vessel occlusion/s in the intracranial internal carotid artery and/or middle cerebral artery (M1 or M2) and with admission brain CTP analyzed by RAPID software were included into the analysis. RESULTS: Sixty-two patients fulfilled the inclusion criteria (mean age was 70.1 ± 13.6 years, females 48.5%). At baseline, National Institutes of Health Stroke Scale score was 16 (IQR = 13-20), Alberta Stroke Program Early CT Score (ASPECTS) was 8 (IQR = 7-9), CTP core volume was 20 mL (IQR = 2-36), and CTP penumbra volume was 145.5 mL (IQR = 107-184). Time from stroke onset to imaging was 1 hour 32 minutes, time from stroke onset to reperfusion was 3 hours 50 minutes, and median time from CT to reperfusion was 1 hour 56 minutes. Modified thrombolysis in cerebral infarction 2b/3 was achieved in 42 patients (67.7%). Twenty-three patients (37%) had modified Rankin scale 0-2 at 90 days. CONCLUSIONS: Our analysis of CTP-selected patients for MT supports clinical applicability of automated CTP analysis into everyday clinical practice.

• Klíčová slova
• CT perfusion, Mechanical thrombectomy, RAPID, single-centre experience,
• MeSH
• cévní mozková příhoda diagnostické zobrazování   patofyziologie   chirurgie   MeSH
• CT angiografie metody   MeSH
• ischemie mozku diagnostické zobrazování   patofyziologie   chirurgie   MeSH
• klinické rozhodování * MeSH
• klinické zkoušky jako téma metody   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mozkový krevní oběh * MeSH
• perfuzní zobrazování metody   MeSH
• posuzování pracovní neschopnosti MeSH
• prediktivní hodnota testů MeSH
• retrospektivní studie MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• trombektomie metody   MeSH
• výběr pacientů * MeSH
• výsledek terapie MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• srovnávací studie MeSH

Perfusion scintigraphy with technetium-99-methoxy-isobutyl-isonitrile ((99m)Tc-MIBI) is often used for assessing myocardial function but the number of studies concerning lower limb perfusion is limited. The aim of our study was to assess whether (99m)Tc-MIBI was an eligible method for evaluation of the effect of cell therapy on critical limb ischemia (CLI) in diabetic patients. (99m)Tc-MIBI of calf muscles was performed before and 3 months after autologous cell therapy (ACT) in 24 diabetic patients with CLI. Scintigraphic parameters such as rest count and exercising count after a stress test were defined. These parameters and their ratios were compared between treated and untreated (control) limbs and with changes in transcutaneous oxygen pressure (TcPO(2)) that served as a reference method. The effect of ACT was confirmed by a significant increase in TcPO(2) values (p<0.001) at 3 months after ACT. We did not observe any significant changes of scintigraphic parameters both at rest and after stress 3 months after ACT, there were no differences between treated and control limbs and no association with TcPO(2) changes. Results of our study showed no significant contribution of (99m)Tc-MIBI of calf muscles to the assessment of ACT in diabetic patients with CLI over a 3-month follow-up period.

• MeSH
• autologní transplantace trendy   MeSH
• bérec diagnostické zobrazování   MeSH
• buněčná a tkáňová terapie trendy   MeSH
• diabetes mellitus 2. typu diagnostické zobrazování   terapie   MeSH
• diabetická noha diagnostické zobrazování   terapie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• perfuzní zobrazování metody   MeSH
• senioři MeSH
• technecium 99mTc sestamibi MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• technecium 99mTc sestamibi MeSH

BACKGROUND: Perfusion assessment of the pancreas is challenging and poorly evaluated. Pancreatic affection is a prevalent feature of cystic fibrosis (CF). Little is known about pancreatic perfusion in CF. We aimed to assess pancreatic perfusion by contrast-enhanced ultrasound (CEUS) analysed in the bolus-and-burst model and software. METHODS: We performed contrast enhanced ultrasound of the pancreas in 25 CF patients and 20 healthy controls. Perfusion data was analysed using a dedicated perfusion model providing the mean capillary transit-time (MTT), blood flow (BF) and blood-volume (BV). CF patients were divided according to exocrine function. RESULTS: The pancreas insufficient CF patients had longer MTT (p ≤ 0.002), lower BF (p < 0.001) and lower BV (p < 0.05) compared to the healthy controls and sufficient CF patients. Interrater analysis showed substantial agreement for the analysis of mean transit time. CONCLUSION: The bolus-and-burst method used on pancreatic CEUS-examinations demonstrates reduced perfusion in CF patients with pancreas affection. The perfusion model and software requires further optimization and standardization to be clinical applicable for the assessment of pancreatic perfusion.

• Klíčová slova
• Contrast enhanced ultrasound, Cystic fibrosis, Exocrine pancreatic function, Pancreas, Perfusion,
• MeSH
• cystická fibróza diagnostické zobrazování   MeSH
• dospělí MeSH
• kontrastní látky MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• pankreas diagnostické zobrazování   MeSH
• perfuzní zobrazování metody   MeSH
• prospektivní studie MeSH
• senioři MeSH
• software MeSH
• studie případů a kontrol MeSH
• ultrasonografie MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• pozorovací studie MeSH
• práce podpořená grantem MeSH
• Názvy látek
• kontrastní látky MeSH

UNLABELLED: The last eight survivors of 80 workers accidentally exposed to 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) during production of herbicides based on trichlorophenoxyacetic acid in 1965-1967 in a chemical factory were followed. All were men, mean age 72.4 ± 1.3 years. Their current median TCDD blood level was 112 (46-390) pg/g lipids. Neurological examination revealed central nervous system impairment in all individuals and signs of polyneuropathy in 87.5%, which was confirmed by a nerve conduction study (NCS) in 75%. A Lanthony test demonstrated acquired dyschromatopsia in 87.5% of the patients, with deterioration of mean colour confusion index (CCI) from 1.52 ± 0.39 in 2010 to 1.73 ± 0.41 in 2016. Single-photon emission computer tomography (SPECT) of the brain showed focal reduction of perfusion in various brain locations in all patients and worsening in six patients. Visual-evoked potentials (VEP) was abnormal in 62.6% of individuals. Most patients complained of psychological problems. The neuropsychological test battery showed most positive impairments in the Trail Making Test evaluating processing speed (average level in the range of mild neurocognitive impairment), which correlated with mean CCI (p < 0.05). CONCLUSION: Fifty years after exposure, blood levels of TCDD are still 10 times higher than the general population. NCS, VEP, Lanthony test and SPECT findings deteriorated from examination of these patients in 2004 and in 2010. The total of abnormal tests per patient in 2016 is very high. Minor differences among patients and their reduced count may explain why the number of impairments in 2016 does not correlate with TCDD blood level.

• MeSH
• časové faktory MeSH
• chemický průmysl * MeSH
• herbicidy škodlivé účinky   krev   chemická syntéza   MeSH
• hygiena práce * MeSH
• jednofotonová emisní výpočetní tomografie MeSH
• kognice účinky léků   MeSH
• lidé MeSH
• mozek diagnostické zobrazování   účinky léků   patofyziologie   MeSH
• mozkový krevní oběh účinky léků   MeSH
• nervové vedení účinky léků   MeSH
• neurologické vyšetření MeSH
• neuropsychologické testy MeSH
• neurotoxické syndromy diagnóza   etiologie   patofyziologie   psychologie   MeSH
• perfuzní zobrazování metody   MeSH
• polychlorované dibenzodioxiny škodlivé účinky   krev   chemická syntéza   MeSH
• polyneuropatie chemicky indukované   diagnóza   patofyziologie   MeSH
• pracovní expozice škodlivé účinky   MeSH
• pracovní nehody * MeSH
• senioři MeSH
• vidění barevné účinky léků   MeSH
• zrakové evokované potenciály účinky léků   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• herbicidy MeSH
• polychlorované dibenzodioxiny MeSH

BACKGROUND: Strokes secondary to acute internal carotid artery (ICA) occlusion are associated with an extremely poor prognosis. The best treatment approach in this setting is still unknown. The aim of our study was to evaluate the efficacy, safety, and outcomes of emergent surgical revascularization of acute extracranial ICA occlusion in patients with minor to severe ischemic stroke. METHODS: A retrospective analysis was performed using prospectively collected data of consecutive patients who underwent carotid thromboendarterectomy for symptomatic acute ICA occlusion during the period from January 2013 to December 2015. Primary outcomes were disability at 90 days assessed by the modified Rankin Scale (mRS) and neurological deficit at discharge assessed using the National Institute of Health Stroke Scale (NIHSS). Secondary outcomes were the recanalization rate, 30-day overall mortality, and any intracerebral bleeding. RESULTS: During the study period, a total of 6 patients (5 men and 1 woman) with a median age of 64 years (range: 58-84 years) underwent emergent reconstruction for acute symptomatic ICA occlusion within a median of 5.4 hours (range: 2.9-12.0 hours) after symptoms onset. The median presenting NIHSS score was 10.5 points (range: 4-21). Before surgery, 4 patients (66.7%) had been treated by systemic recombinant tissue plasminogen activator lysis. The median time interval between initiation of intravenous thrombolysis and carotid thromboendarterectomy was 117.5 minutes (range: 65-140 minutes). Patency of the ICA was achieved in all patients. On discharge, the median NIHSS score was 2 points (range: 0-11 points). There was no postoperative intracerebral hemorrhage and zero 30-day mortality rate. At 3 months, 5 patients (83.3%) had a good clinical outcome (mRS ≤ 2). CONCLUSION: Patients presenting with minor to severe ischemic stroke syndromes due to isolated extracranial ICA occlusion may benefit from emergent carotid revascularization. Thorough preoperative neuroimaging is essential to aid in selecting eligible candidates for acute surgical intervention.

• Klíčová slova
• acute ischemic stroke, carotid artery occlusion, carotid endarterectomy, internal carotid artery, outcome, penumbra,
• MeSH
• akutní nemoc MeSH
• arteria carotis interna diagnostické zobrazování   patofyziologie   chirurgie   MeSH
• čas zasáhnout při rozvinutí nemoci MeSH
• časové faktory MeSH
• cévní mozková příhoda diagnóza   etiologie   mortalita   patofyziologie   MeSH
• CT angiografie MeSH
• digitální subtrakční angiografie MeSH
• ischemie mozku diagnóza   etiologie   mortalita   patofyziologie   MeSH
• karotická endarterektomie * škodlivé účinky   mortalita   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mozková angiografie metody   MeSH
• mozkový krevní oběh MeSH
• náhlé příhody MeSH
• perfuzní zobrazování metody   MeSH
• posuzování pracovní neschopnosti MeSH
• průchodnost cév MeSH
• retrospektivní studie MeSH
• rizikové faktory MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• stenóza arteria carotis komplikace   diagnostické zobrazování   mortalita   chirurgie   MeSH
• stupeň závažnosti nemoci MeSH
• trombolytická terapie MeSH
• výběr pacientů MeSH
• výsledek terapie MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

BACKGROUND: An analysis of medical records of young females who were examined in our department during a five-year period (2005-2009) on suspicion of pulmonary embolism (PE) in relation to hormonal contraception (HC). MATERIAL AND METHODS: The patient sample included 86 young females aged 15-25 (mean 21) years who underwent a ventilation/ perfusion scintigraphy (V/P scan). Seventeen of them were examined repeatedly. Altogether, 114 scintigraphic examinations were performed. Lung perfusion scintigraphy was performed using a planar gamma camera (Mediso MB 9200) in 4 projections following 100 MBq 99mTc--MAA i.v. application with 81 mKr ventilation scintigraphy concurrently. RESULTS: 1. Among 57/86 (66%) patients on HC, 24 (42%) had scintigraphic signs of PE. 2. 11/57 (19%) of them had clinical signs of deep venous system thrombosis of the lower limbs that were confirmed by sonography. 3. Leiden mutation was found in 9/24 (37%) patients with PE. 4. Among 29/86 (34%) females not taking HC, PE was detected in only 3 patients (10%). 5. 10/17 (59%) repeatedly examined females had permanent post-embolic residual changes of lung perfusion. CONCLUSIONS: In our group of patients who underwent a P/V scan, 42% of those on HC were diagnosed with PE on scintigraphy, compared to 10% of those not taking HC. Among the patients with PE, there were 10/24 (42%) young females with persistent post-embolic changes. Our study indicates that the well-known risk of venous thromboembolism related to the use of HC needs to be considered as a cause of PE even among very young females. In our experience, prevention of these life-threatening conditions in patients with a family history of venous thromboembolism consists of timely examination of their thrombotic profile and selection of appropriate contraception.

• MeSH
• bérec diagnostické zobrazování   MeSH
• dospělí MeSH
• faktor V genetika   MeSH
• gama kamery MeSH
• kontraceptiva orální hormonální škodlivé účinky   MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mutace MeSH
• perfuzní zobrazování metody   MeSH
• plíce diagnostické zobrazování   MeSH
• plicní embolie chemicky indukované   diagnostické zobrazování   genetika   MeSH
• radiofarmaka MeSH
• retrospektivní studie MeSH
• technecium 99mTc-agregovaný albumin MeSH
• ultrasonografie MeSH
• žilní trombóza chemicky indukované   diagnostické zobrazování   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• factor V Leiden MeSH Prohlížeč
• faktor V MeSH
• kontraceptiva orální hormonální MeSH
• radiofarmaka MeSH
• technecium 99mTc-agregovaný albumin MeSH

AIM: The aim of the study is to present the feasibility of using dual-energy CT and the evaluation of iodine and air distribution in differentiation of pathological conditions. MATERIAL AND METHOD: We used the data of 50 CT examinations performed due to suspected pulmonary embolism with any pathological finding except consolidation of the parenchyma. The patients underwent CT angiography of the pulmonary arteries on a dual-source CT (DSCT), with the two tubes independently operated at 140 and 80 kV. By exploiting the dual-energy information, iodine distribution maps were obtained in addition to the conventional CT images which served as a marker of pulmonary perfusion. Minimum intensity projections (MinIP) were used as a marker of air content. RESULTS: By comparing the iodine distribution maps and MinIP images, it was possible to differentiate between the following templates of lung parenchyma: A--normal iodine and air distribution; B--iodine content deficit with minimal or with no redistribution of air; C--reduced iodine content and increased content of air; D--deficit of iodine content and increased content of air; E--increased iodine content and normal content of air; F--increased iodine content and reduced content of air; G--reduced perfusion and reduced content of air. The type A (five cases) was typical for the pulmonary embolism with preserved normal conditions of perfusion and ventilation. Type B (18 cases) occurred in pulmonary embolism; type C was found in case of inflammation of small respiratory airways (five cases); emphysema was typical for type D (nine cases); increased perfusion was observed in the parenchyma preserved from emphysema or preserved from embolism in cases of emphysema or pulmonary embolism; type F occurred in pulmonary interstitial edema (four cases) both with pulmonary infection; finally type G was found in interstitial lung diseases (five cases). CONCLUSION: Imaging of the pulmonary circulation by means of dual-energy CT opens the potential to study pathological changes of circulatory and pulmonary perfusion impairments, our presented work signs the important relations between iodine and air distribution which have to be thought in the interpretation of dual-energy perfusion imaging of the lungs.

• MeSH
• angiografie metody   MeSH
• dospělí MeSH
• jod farmakokinetika   MeSH
• kontrastní látky farmakokinetika   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• perfuzní zobrazování metody   MeSH
• plicní embolie metabolismus   MeSH
• počítačová rentgenová tomografie metody   MeSH
• rentgendiagnostika - dvourozměrná projekce metody   MeSH
• reprodukovatelnost výsledků MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• senzitivita a specificita MeSH
• vzduch analýza   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• jod MeSH
• kontrastní látky MeSH