European journal of radiology
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Image-guided radiofrequency (RF) ablation is a minimally invasive therapy option in the treatment of primary and secondary hepatic malignancies. Magnetic resonance (MR) imaging offers an accurate pre-interventional imaging having important impact on patient selection and planning of the ablation procedure. Peri-interventional imaging is used for targeting, monitoring, and controlling of the ablation procedure. ⋯ Post-interventional imaging is performed to assess treatment response after RF ablation and has prognostic impact, as an early detection of treatment failure, e.g. residual tumor tissue, enables immediate therapy. Nevertheless, differential diagnostic difficulties arise from benign periablational enhancement which may cover tumor tissue. Hence, further evaluation and improvement in the assessment of treatment response is essential.
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The aims of this study were to investigate absolute assessment of aortic valve area (AVA), before surgery for aortic stenosis, using cardiovascular magnetic resonance (CMR) in comparison with transesophageal echocardiography (TEE) and with effective AVA indirectly obtained by routine techniques i.e. transthoracic echocardiography (TTE) and cardiac catheterisation. ⋯ CMR planimetry of the AVA is a noninvasive and reproducible technique to evaluate stenotic aortic valves and can be used as an alternative to echocardiography or cardiac catheterisation.
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Our challenge was to design and implement a dedicated temperature imaging feedback control system to guide and assist in a thermal liver ablation procedure in a double-donut 0.5T open MR scanner. This system has near-real-time feedback capability based on a newly developed "self-referenced" temperature imaging method using "moving-slab" and complex-field-fitting techniques. Two phantom validation studies and one ex vivo experiment were performed to compare the newly developed self-referenced method with the conventional subtraction method and evaluate the ability of the feedback control system in the same MR scanner. ⋯ In the second part of the validation and ex vivo study, target visualization, treatment planning and monitoring, and temperature and thermal dose visualization with the graphical user interface of the thermal ablation software were demonstrated. Furthermore, MR imaging with the "self-referenced" temperature imaging method has the ability to localize the hot spot in the heated region and measure temperature elevation during the experiment. In conclusion, we have demonstrated an interactively controllable feedback control system that offers a new method for the guidance of liver thermal ablation procedures, as well as improving the ability to assist ablation procedures in an open MR scanner.
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The role imaging studies play in the choice of treatment in traumatic pancreas damage remains unclear. This study was performed to gain insight into the role of radiological studies in children 16 years of age or younger admitted to our hospital with pancreatic damage due to a blunt abdominal trauma. ⋯ Traumatic pancreas damage is a rare and difficult diagnosis. There is no straightforward answer for diagnostic imaging in blunt abdominal trauma in children. The diagnostic relevance of CT is limited. CT in combination with MRCP may be a better option for exclusion of pancreatic duct lesions.
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The superior vena cava (SVC) obstruction by malignant diseases is either by direct invasion and compression or by tumour thrombus of the SVC. Whatever is its cause, obstruction of the SVC causes elevated pressure in the veins draining into the SVC and increased or reversed blood flow through collateral vessels. Severity of the syndrome depends on the collateral vascular system development. Therefore, imaging of the collateral veins with variable location and connection is important in determining the extension and management of the disease. Our aims are to describe collateral vessels of the superior vena cava syndrome (SVCS) related with the malignant diseases and to assess the ability of multi-detector row CT with multiplanar and 3D volume rendering techniques in determining and describing collateral circulations. ⋯ Multi-detector row CT with multiplanar and 3D imaging is an effective tool in evaluation of the SVCS and has a greater advantage than the other imaging techniques. 3D volume rendering is a useful technique in determining and describing collateral circulations in addition to the primary disease process.