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| 5. |
- Annertz, Mårten, et al.
(author)
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Ländryggsröntgen ger falsk säkerhet och ringa nytta för patienten : MRT och DT ger bättre och billigare resultat
- 2017
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In: Läkartidningen. - 0023-7205. ; 114:46, s. 1962-1962
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Journal article (other academic/artistic)abstract
- In 2016 140 000 lumbar spine radiographies were performed in Sweden (14 000 per million inhabitants) to a cost of about 85 million SEK (≈8.5 million Euro) and a negligible value for the patients with low back pain. In the work-up of low back pain, when imaging is indicated, lumbar spine radiography should be replaced by limited magnetic resonance imaging including a whole lower body coronal STIR sequence or computed tomography with radiation dose adapted to indication and patient age. Indication for imaging should be restricted to 1) low back pain with more than 3-4 weeks duration in combination with at least one »red flag«, 2) radicular pain without improvement on conservative treatment, or 3) low back pain with more than 8 weeks duration in combination with »yellow flags«.
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| 9. |
- Aspelin, Peter, 1944, et al.
(author)
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Samgåendet Hälsohögskolan och Karolinska Institutet
- 2010
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In: Kerstin Hagenfeldt (red.) Det medicinska universitetet: Utbildning vid Karolinska Institutet 1960-2010. - Stockholm : Karolinska Institutet University Press. - 9789185565375 ; , s. 9-26
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Book chapter (other academic/artistic)
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| 10. |
- Aspelin, Peter, et al.
(author)
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Ultrasound examination of soft tissue injury of the lower limb in athletes
- 1992
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In: The American journal of sports medicine. - : SAGE Publications. - 1552-3365 .- 0363-5465. ; 20:5, s. 601-603
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Journal article (peer-reviewed)abstract
- We performed ultrasonography on 32 athletes complaining of intense pain in a swollen and tender thigh or calf after a contusion or stretching trauma. The ultrasonogram was used to visualize the presence and size of a suspected hematoma. The findings included the following: 7 patients with a circumscribed, anechoic lesion compatible with a liquefied hematoma; 10 patients with a circumscribed lesion of mixed echogenicity compatible with areas of liquefied hematoma, coagulated blood, and edema; and 15 patients with a diffuse change in echogenicity of the whole muscle. The circumscribed liquefied, and mixed hematoma were more common after contusion trauma, while the diffuse type was more common after injury caused by stretching. Ultrasonography is useful in localizing the hematoma and in characterizing the different types. Differentiation is important in diagnosis and choice of treatment.
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| 11. |
- Barrefelt, Asa, et al.
(author)
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Fluorescence labeled microbubbles for multimodal imaging
- 2015
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In: Biochemical and Biophysical Research Communications - BBRC. - : Elsevier BV. - 0006-291X .- 1090-2104. ; 464:3, s. 737-742
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Journal article (peer-reviewed)abstract
- Air-filled polyvinyl alcohol microbubbles (PVA-MBs) were recently introduced as a contrast agent for ultrasound imaging. In the present study, we explore the possibility of extending their application in multimodal imaging by labeling them with a near infrared (NIR) fluorophore, VivoTag-680. PVA-MBs were injected intravenously into FVB/N female mice and their dynamic biodistribution over 24 h was determined by 3D-fluorescence imaging co-registered with 3D-mu CT imaging, to verify the anatomic location. To further confirm the biodistribution results from in vivo imaging, organs were removed and examined histologically using bright field and fluorescence microscopy. Fluorescence imaging detected PVA-MB accumulation in the lungs within the first 30 min post-injection. Redistribution to a low extent was observed in liver and kidneys at 4 h, and to a high extent mainly in the liver and spleen at 24 h. Histology confirmed PVA-MB localization in lung capillaries and macrophages. In the liver, they were associated with Kupffer cells; in the spleen, they were located mostly within the marginal-zone. Occasional MBs were observed in the kidney glomeruli and interstitium. The potential application of PVA-MBs as a contrast agent was also studied using ultrasound (US) imaging in subcutaneous and orthotopic pancreatic cancer mouse models, to visualize blood flow within the tumor mass. In conclusion, this study showed that PVA-MBs are useful as a contrast agent for multimodal imaging. (C) 2015 Elsevier Inc. All rights reserved.
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| 12. |
- Barrefelt, Åsa, et al.
(author)
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Biodistribution, kinetics, and biological fate of SPION microbubbles in the rat
- 2013
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In: International Journal of Nanomedicine. - 1176-9114 .- 1178-2013. ; 8, s. 3241-3254
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Journal article (peer-reviewed)abstract
- Background: In the present investigation, we studied the kinetics and biodistribution of a contrast agent consisting of poly(vinyl alcohol) (PVA) microbubbles containing superparamagnetic iron oxide (SPION) trapped between the PVA layers (SPION microbubbles). Methods: The biological fate of SPION microbubbles was determined in Sprague-Dawley rats after intravenous administration. Biodistribution and elimination of the microbubbles were studied in rats using magnetic resonance imaging for a period of 6 weeks. The rats were sacrificed and perfusion-fixated at different time points. The magnetic resonance imaging results obtained were compared with histopathologic findings in different organs. Results: SPION microbubbles could be detected in the liver using magnetic resonance imaging as early as 10 minutes post injection. The maximum signal was detected between 24 hours and one week post injection. Histopathology showed the presence of clustered SPION microbubbles predominantly in the lungs from the first time point investigated (10 minutes). The frequency of microbubbles declined in the pulmonary vasculature and increased in pulmonary, hepatic, and splenic macrophages over time, resulting in a relative shift from the lungs to the spleen and liver. Meanwhile, macrophages showed increasing signs of cytoplasmic iron accumulation, initially in the lungs, then followed by other organs. Conclusion: The present investigation highlights the biological behavior of SPION microbubbles, including organ distribution over time and indications for biodegradation. The present results are essential for developing SPION microbubbles as a potential contrast agent and/or a drug delivery vehicle for specific organs. Such a vehicle will facilitate the use of multimodality imaging techniques, including ultrasound, magnetic resonance imaging, and single positron emission computed tomography, and hence improve diagnostics, therapy, and the ability to monitor the efficacy of treatment.
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| 13. |
- Barrefelt, Åsa, et al.
(author)
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DYNAMIC MR IMAGING, BIODISTRIBUTION AND PHARMACOKINETICS OF POLYMER SHELLED MICROBUBBLES CONTAINING SPION
- 2014
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In: NANO. - 1793-2920. ; 9:6, s. 1450069-
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Journal article (peer-reviewed)abstract
- Magnetic Resonance Imaging (MRI) is a noninvasive diagnostic method that provides information on morphological and physiological changes of the internal organs over time. Imaging and measurements can be repeated on the same subject, thereby reducing inter-individual variability effects and hence the number of subjects required. A potential MRI contrast agent consisting of microbubbles embedded with superparamagnetic iron oxide nanoparticles (SPION) in the shell (SPION MBs) was injected intravenously into rats to determine their biodistribution and pharmacokinetics using MR imaging. Agarose phantoms containing SPION MBs were scanned using 3 T MRI to construct a standard curve. Rats were injected with SPION MBs, free SPION or plain MBs and scanned dynamically at 3 T using a clinical MR scanner. The relaxation rate (R2*) was studied over time as a measure of the iron oxide concentrations to enable calculation of the pharmacokinetic parameters. The kinetics of SPION MBs in the liver was fitted to a one-compartment model. Furthermore, the biological fate of SPION MBs was examined via a histological survey of tissue samples using Perls' Prussian blue staining and immunohistochemistry (IHC). 1.2 h after injection of SPION MBs, T2* of the liver had decreased to its minimum. The elimination half-life of SPION MBs was 598.2 +/- 97.3 h, while the half-life for SPION was 222.6 +/- 26.4 h. Moreover, our study showed that SPION MBs were taken up by the macrophages in the lungs, spleen and liver. MBs labeled with SPION can be used for MR imaging. Moreover, MRI is a reliable and noninvasive tool that can be utilized in pharmacokinetic investigations of future contrast agents using SPION MBs and SPION in the rat.
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| 14. |
- Berglund, Jan, et al.
(author)
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Rapid increase in volume of the remnant after hemithyroidectomy does not correlate with serum concentration of thyroid stimulating hormone
- 1998
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In: European Journal of Surgery. - : Oxford University Press (OUP). - 1102-4151 .- 1741-9271. ; 164:4, s. 257-262
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Journal article (peer-reviewed)abstract
- OBJECTIVE: To study the effect of postoperative thyroxine on the volume of the thyroid remnant after lobectomy for benign nontoxic goitre. DESIGN: Prospective, randomised study. SETTING: University hospital, Sweden. SUBJECTS: 50 consecutive patients who underwent lobectomy for benign non-toxic goitre. INTERVENTIONS: Patients were randomised postoperatively to take thyroxine 0.1 mg or placebo daily. MAIN OUTCOME MEASURES: The median volume of the remaining thyroid lobe measured by ultrasound. Serum concentrations of thyroxine, triiodothyronine (T3) and thyroid stimulating hormone (TSH) were measured preoperatively and 1, 3, 6, 12 months postoperatively. RESULTS: The median volume of the remaining lobe had increased significantly compared with preoperatively by 1 month postoperatively by 30% in the thyroxine group and 25% in the placebo group (p < 0.01). The difference between the groups was not significant. After the first month the volume did not change significantly. In the thyroxine group, the TSH concentration was unchanged and the thyroxine concentration increased significantly throughout the study. In the placebo group there was a significant increase in TSH concentration and a significant decrease in that of thyroxine at all follow-up examinations. CONCLUSIONS: There is a significant increase in the volume of the remaining thyroid 1 month after lobectomy that persisted throughout the first year. Thyroxine given in a dose that kept the serum TSH concentration at the same level as preoperatively did not seem to influence volume changes; consequently we consider that these are caused by factors other than TSH.
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| 15. |
- Bergquist, Magnus, 1960, et al.
(author)
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The effects of PACS on radiographer’s work practice
- 2007
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In: Radiography. - London : W.B. Saunders Co. Ltd.. ; 13:3, s. 235-240
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Journal article (peer-reviewed)abstract
- This paper identifies and analyses the effects of picture archiving and communica- tion systems (PACS) on radiographers’ work practice. It shows that the introduction of PACS did not simply entail the transfer of data and information from the analogue world to the digital world, but it also led to the introduction of new ways of communicating, and new activities and responsibilities on the part of radiography staff. Radiographers are called upon to work increasingly independently, and individual practitioners require higher levels of professional expertise. In all, this paper demonstrates that new technical solutions sometimes lead to sub- stantial changes in responsibilities in work. In this example, the radiographers’ work practice has become more highly scientific and they are enjoying a higher level of prestige.
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| 16. |
- Ekberg, Olle, et al.
(author)
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In memoriam Prof. Erik Boijsen
- 2018
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In: European Radiology. - : Springer Science and Business Media LLC. - 0938-7994 .- 1432-1084. ; 28:4, s. 1788-1789
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Journal article (peer-reviewed)
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| 17. |
- Högberg, Ulf, 1949-, et al.
(author)
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Infant abuse diagnosis associated with abusive head trauma criteria : incidence increase due to overdiagnosis?
- 2018
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In: European Journal of Public Health. - : OXFORD UNIV PRESS. - 1101-1262 .- 1464-360X. ; 28:4, s. 641-646
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Journal article (peer-reviewed)abstract
- Background: The hypothesis of this study is that the diagnosis of infant abuse is associated with criteria for shaken baby syndrome (SBS)/abusive head trauma (AHT), and that that changes in incidence of abuse diagnosis in infants may be due to increased awareness of SBS/AHT criteria.Methods: This was a population-based register study. Setting: Register study using the Swedish Patient Register, Medical Birth Register, and Cause of Death Register. The diagnosis of infant abuse was based on the International Classification of Diseases, 9th and 10th revision. Participants: All children born in Sweden during 1987-2014 with a follow-up until 1 year of age (N = 2 868 933). SBS/AHT criteria: subdural haemorrhage, cerebral contusion, skull fracture, convulsions, retinal haemorrhage, fractures rib and long bones. Outcomes: Incidence, rate ratios, aetiologic fractions and Probit regression analysis.Results: Diagnosis of infant abuse was strongly associated with SBS/AHT criteria, but not risk exposure as region, foreign-born mother, being born preterm, multiple birth and small for gestational age. The incidence of infant abuse has increased tenfold in Sweden since the 1990s and has doubled since 2008, from 12.0 per 100 000 infants during 1997-2007 to 26.5/100 000 during 2008-2014, with pronounced regional disparities.Conclusions: Diagnosis of infant abuse is related to SBS/AHT criteria. The increase in incidence coincides with increased medical preparedness to make a diagnosis of SBS/AHT. Hidden statistics and a real increase in abuse are less plausible. Whether the increase is due to overdiagnosis cannot be answered with certainty, but the possibility raises ethical and medico-legal concerns.
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| 18. |
- Jadidi, M, et al.
(author)
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Evaluation of a new system for chest tomosynthesis : aspects of image quality of different protocols determined using an anthropomorphic phantom.
- 2015
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In: British Journal of Radiology. - : British Institute of Radiology. - 0007-1285 .- 1748-880X. ; 88:1053, s. 20150057-
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Journal article (peer-reviewed)abstract
- OBJECTIVE: To compare the image quality obtained with the different protocols in a new chest digital tomosynthesis (DTS) system.METHODS: A chest phantom was imaged with chest X-ray equipment with DTS. 10 protocols were used, and for each protocol, nine acquisitions were performed. Four observers visually rated the quality of the reconstructed section images according to pre-defined quality criteria in four different classes. The data were analysed with visual grading characteristics (VGC) analysis, using the vendor-recommended protocol [12-s acquisition time, source-to-image distance (SID) 180 cm] as reference, and the area under the VGC curve (AUCVGC) was determined for each protocol and class of criteria.RESULTS: Protocols with a smaller swing angle resulted in a lower image quality for the classes of criteria "disturbance" and "homogeneity in nodule" but a higher image quality for the class "structure". The class "demarcation" showed little dependency on the swing angle. All protocols but one (6.3 s, SID 130 cm) obtained an AUCVGC significantly <0.5 (indicating lower quality than reference) for at least one class of criteria.CONCLUSION: The study indicates that the DTS protocol with 6.3 s yields image quality similar to that obtained with the vendor-recommended protocol (12 s) but with the clinically important advantage for patients with respiratory impairment of a shorter acquisition time.ADVANCES IN KNOWLEDGE: The study demonstrates that the image quality may be strongly affected by the choice of protocol and that the vendor-recommended protocol may not be optimal.
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| 19. |
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| 20. |
- Morcos, Sameh K., et al.
(author)
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Reducing the risk of iodine-based and MRI contrast media administration : recommendation for a questionnaire at the time of booking
- 2008
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In: European Journal of Radiology. - : Elsevier BV. - 0720-048X .- 1872-7727. ; 66:2, s. 225-229
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Journal article (peer-reviewed)abstract
- This paper presents a practical questionnaire to be used when a contrast medium examination is requested. The questionnaire is based on the guidelines from the European Society of Urogenital Radiology. Its aim is to identify patients at increased risk of clinically relevant renal and non-renal adverse reactions to iodine-based and MRI contrast agents. The questionnaire should be completed by the referring physician when the examination is requested.
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| 25. |
- Nyman, Ulf, et al.
(author)
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Obituary for Prof. Torsten Almén.
- 2016
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In: Acta radiologica (Stockholm, Sweden : 1987). - : SAGE Publications. - 1600-0455 .- 0284-1851. ; 57:4, s. 387-388
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Journal article (peer-reviewed)
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| 26. |
- Nyman, Ulf, et al.
(author)
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Preventing contrast medium-induced acute kidney injury: Side-by-side comparison of Swedish-ESUR guidelines
- 2018
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In: European Radiology. - : Springer Science and Business Media LLC. - 0938-7994 .- 1432-1084. ; 28:12, s. 5384-5395
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Journal article (peer-reviewed)abstract
- A side-by-side comparison of updated guidelines regarding contrast medium-induced acute kidney injury (CI-AKI) from the Swedish Society of Uroradiology (SSUR) and the European Society of Urogenital Radiology (ESUR) is presented. The major discrepancies include a higher glomerular filtration rate (GFR) threshold as a risk factor for CI-AKI and for discontinuation of metformin by SSUR, i.e., < 45 ml/min versus < 30 ml/min/1.73 m(2) by ESUR, when intravenous or intra-arterial contrast media (CM) with second-pass renal exposure is administered. SSUR also continues to recommend consideration of traditional non-renal risk factors such as diabetes and congestive heart failure, while ESUR considers these factors as non-specific for CI-AKI and does not recommend anyconsideration. Contrary to ESUR, SSUR also recommends discontinuation of NSAID and nephrotoxic medication if possible. Insufficient evidence at the present time motivates the more cautionary attitude taken by SSUR. Furthermore, SSUR expresses GFR thresholds in absolute values in ml/min as recommended by the National Kidney Foundation for drugs excreted by glomerular filtration, while ESUR uses the relative GFR normalised to body surface area in ml/min/1.73 m(2). CM dose/GFR ratio thresholds established for coronary angiography/interventions are also applied as recommendations for CM-enhanced CT by SSUR, since SSUR regards coronary procedures as a second-pass renal exposure of CM with no obvious difference in the incidence of AKI compared withIV CM administration. Finally, SSUR recommends reducing the gram-iodine dose/GFR ratio from < 1.0 in patients not at risk to < 0.5 in patients at risk of CI-AKI, while ESUR has no such recommendation.Key Points center dot The more cautionary attitude taken by SSUR compared with that of ESUR is motivated by insufficient evidence regarding risk for contrast medium-induced acute kidney injuries (CI-AKI).center dot SSUR recommends that absolute and not relative GFR should be used when dosing drugs eliminated by the kidneys such as contrast media.center dot According to SSUR the gram-iodine dose/GFR ratio should be < 0.5 in patients at risk of CI-AKI, while ESUR has no such recommendation.
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| 27. |
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| 28. |
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| 29. |
- Nyman, Ulf, et al.
(author)
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Torsten Almén (1931-2016) : The father of non-ionic iodine contrast media
- 2016
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In: Acta Radiologica. - : SAGE Publications. - 0284-1851 .- 1600-0455. ; 57:9, s. 1072-1078
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Journal article (peer-reviewed)abstract
- The Swedish radiologist Torsten Almén is the first clinical radiologist ever to have made a fundamental contribution to intravascular contrast medium design, the development of non-ionic contrast media. He became emotionally triggered by the patients' severe pain each time he injected the ionic "high-osmolar" contrast media when performing peripheral arteriographies in the early 1960s. One day he got a flash of genius that combined the observation of pain, a pathophysiological theory and how to eliminate it with suitable contrast media chemistry. After self-studies in chemistry he developed the concept of iodine contrast media not dissociating into ions in solution to reduce their osmolality and even reach plasma isotonicity. He offered several pharmaceutical companies his concept of mono- and polymeric non-ionic agents but without response, since it was considered against the chemical laws of that time. Contrast media constructed as salts and dissociating into ions in solution was regarded an absolute necessity to achieve high enough water solubility and concentration for diagnostic purposes. Finally a small Norwegian company, Nyegaard & Co., took up his idea 1968 and together they developed the essentially painless "low-osmolar" monomeric non-ionic metrizamide (Amipaque) released in 1974 and iohexol (Omipaque) in 1982 followed by the "iso-osmolar" dimeric non-ionic iodixanol (Visipaque) released in 1993. This has implied a profound paradigm shift with regard to reduction of both hypertonic and chemotoxic side effects, which have been a prerequisite for the today's widespread use of contrast medium-enhanced CT and advanced endovascular interventional techniques even in fragile patients.
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| 30. |
- Olivecrona, Henrik, et al.
(author)
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A new technique for diagnosis of acetabular cup loosening using computed tomography - Preliminary experience in 10 patients
- 2008
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In: Acta Orthopaedica. - New York, NY, USA : Informa Healthcare. - 1745-3674 .- 1745-3682. ; 79:3, s. 346-353
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Journal article (peer-reviewed)abstract
- Background and purpose: Considerable migration of the acetabular cup is required for diagnosis of loosening by conventional radiography. We have developed a new clinically applicable method for assessment of cup loosening using computed tomography (CT). Patients and methods 10 patients scheduled for revision hip replacement due to suspected wear or loosening were scanned twice with CT under torsion loading of the prosthesis. Two independent examiners assessed each patient with respect to motion of the acetabular cup relative to the pelvis using CT volume registration. The CT measurements were compared to findings at revision surgery. Results The method was applicable in 8 of the 10 patients. 1 patient had a severe tremor. In 1 patient, surgery revealed that the hip was ankylotic due to massive ectopic bone formation. This left 8 patients that could be evaluated. 4 cups were loose at surgery, and 3 of these cups could be seen to be mobile by CT. 4 cups that were stable on revision were accurately diagnosed as not being mobile by CT. Movements of less than 1 millimeter between bone and prosthesis could not be distinguished from errors in CT acquisition and volume registration. There was good agreement between the two observers. Interpretation Movement of loose acetabular cups during torsion loading could be detected using CT volume registration. It was sensitive to cup movement in 3 out of 4 cases of loose cups. The method was specific and yielded no false positive results.
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| 31. |
- Olivecrona, Lotta, et al.
(author)
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Assessing wear of the acetabular cup using computed tomography : an ex vivo study
- 2005
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In: Acta Radiologica. - London, UK : Informa Healthcare. - 0284-1851 .- 1600-0455. ; 46:8, s. 852-857
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Journal article (peer-reviewed)abstract
- Purpose: To validate a clinically useful method for measuring acetabular cup wear using computed tomography (CT). Material and Methods: Eight uncemented acetabular cups were scanned twice ex vivo using CT. The linear penetration depth of the femoral component head into the cup and the thickness of the remaining polyethylene liner were measured in the CT volumes using dedicated software. Two independent examiners twice assessed each volume. The CT measurements were compared to direct measurements using a coordinate measuring device and micrometer measurements. Results: Accuracy of wear measurements expressed as penetration depth was +/- 0.6 and +/- 1.0 mm for the two examiners, respectively, with no significant differences between examiners, trials, and CT scans. Accuracy of measurements of remaining polyethylene was +/- 1.3 and +/- 1.0 mm, respectively, for the two examiners. Systematic differences between examiners were found, but no significant differences between trials and CT scans. These differences were due to different interpretations of metal artifacts in the volumes. Conclusion: The proposed CT method for evaluating wear as head penetration depth allows for reliable wear detection at a clinically relevant level. Measurements of remaining polyethylene on CT volumes are not as reliable as wear measurements owing to metal artifacts.
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| 32. |
- Olivecrona, Lotta, et al.
(author)
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Standard orientation of the pelvis : Validation on a model and ten patients
- 2005
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In: Acta Radiologica. - London, UK : Informa Healthcare. - 0284-1851 .- 1600-0455. ; 46:1, s. 74-82
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Journal article (peer-reviewed)abstract
- Purpose: To validate an image post-processing method for re-orienting the pelvis in CT volumes to a standardized orientation in a model and in 10 patients. Material and Methods: Twenty-four CT volumes of a pelvic model and 10 pairs of postoperative total hip arthroplasty (THA) patient CT scans were rotated to a defined pelvic standard orientation and the rotation was recorded. For precision, a test-retest procedure was used. For accuracy, three exactly represented coordinate points were used. For clinical application, the standard orientation was used for calculating the direction of acetabular cup migration from a previous model study. Results: Precision of pelvic standard orientation, calculated as maximal directional error, was better than 1degrees in the model study and better than 1.5degrees in the patient study. Accuracy, expressed as angle between ideal and measured coordinate axes, was 0.1degrees for x, y, z axes. No measurable systematic errors were found. When applied to acetabular cup migration in the model, standardization of pelvic orientation had no significant effect on the measurements. Conclusion: Reorienting the pelvis during image post-processing was shown to be accurate. It enables measurements relative to the pelvis and minimizes the dependency of patient positioning.
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| 33. |
- Rohlin, Madeleine, et al.
(author)
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Evidensbaserad vård - vad är det och vad är det inte?
- 2005
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In: Tandläkartidningen. - 0039-6982. ; 97:6, s. 44-48
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Journal article (peer-reviewed)abstract
- Evidensbaserad vård är att på ett medvetet sätt använda bästa sammantagna vetenskapliga bevis – evidens – i kliniska beslut. Men evidensbaserad vård innebär inte att man mekaniskt kan följa en "kokbok". I stället måste man samtidigt ta hänsyn till varje patients unika förutsättningar och sin kliniska erfarenhet. Det kan vara svårt att vid sidan av patientarbetet hålla sig à jour med den ständigt växande vetenskapliga litteraturen, följa nya rön och värdera resultatens tillförlitlighet och tillämpbarhet. Tandläkarna måste hitta sätt att hantera den växande kunskapsmassan, sätt att sovra och sammanställa informationen så att den blir kliniskt användbar. Evidensbaserad vård innebär en sådan strävan efter vård på säkrare vetenskaplig grund och är en logisk följd av vårdens ledstjärnor – vetenskap och beprövad erfarenhet.
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| 34. |
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| 35. |
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| 36. |
- Strandberg, Soren, et al.
(author)
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Muscle morphometric effect of anterior cruciate ligament injury measured by computed tomography : aspects on using non-injured leg as control
- 2013
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In: BMC Musculoskeletal Disorders. - : Springer Science and Business Media LLC. - 1471-2474. ; 14, s. 150-
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Journal article (peer-reviewed)abstract
- Background: Anterior cruciate ligament (ACL) tears are common, functionally disabling, and predispose to subsequent injuries and early onset of osteoarthritis in the knee. Injuries result in muscular atrophy and impaired muscular activation. To optimize surgical methods and rehabilitation strategies, knowledge of the effects of ACL injuries on muscles size and function is needed. Asymmetry due to limb dominance implies that the effect of ACL-injury might be different in right-sided and left-sided injuries which, should be taken in account when evaluating the effect of an injury. Evaluation of the effects of injuries is usually made with the contralateral leg as control. The aim of this study is to describe the effect of ACL-injuries on thigh muscle size and also to analyze feasibility of using contralateral limb as control. Methods: Sixty-two patients scheduled to undergo ACL reconstruction were examined with computed tomography (CT). Muscle cross sectional area (CSA) was recorded for quadriceps, hamstrings, gracilis and sartorius 15 cm above the knee joint. Comparisons were made between the injured and non-injured side and between individuals separated by gender and side of injury. Comparisons were also made for patients with or without concomitant meniscal tear, for patients differing in time between injury and examinations and for patients with different level of physical activity after the injury. Results: Quadriceps CSA was 5% smaller on the injured side. There was an indication that the muscles of the right thigh were generally bigger than those of the left thigh. The difference between the injured and the non-injured side was larger for right-sided injuries than for left-sided. There was also a greater difference in semimembranosus for women than for men. There were no differences related to meniscal injury, time since injury or physical activity. Conclusion: The use of contralateral leg for evaluating the effect of ACL-injury is often the only available alternative but our study indicates that the difference in CSA between injured and non-injured side does not necessarily reflect the true degree of atrophy, as there are side differences both in muscle size in general and in the effect of an ACL-injury on muscle size.
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| 37. |
- Svensson, Anders, et al.
(author)
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Automatic individualized contrast medium dosage during hepatic computed tomography by using computed tomography dose index volume (CTDIvol)
- 2014
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In: European Radiology. - : Springer Science and Business Media LLC. - 0938-7994 .- 1432-1084. ; 24:8, s. 1959-1963
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Journal article (peer-reviewed)abstract
- To compare hepatic parenchymal contrast media (CM) enhancement during multi-detector row computed tomography (MDCT) and its correlation with volume pitch-corrected computed tomography dose index CTDIvol) and body weight (BW). One hundred patients referred for standard three-phase thoraco-abdominal MDCT examination were enrolled. BW was measured in the CT suite. Forty grams of iodine was administered intravenously (iodixanol 320 mg I/ml at 5 ml/s or iomeprol 400 mg I/ml at 4 ml/s) followed by a 50-ml saline flush. CTDIvol presented by the CT equipment during the parenchymal examination was recorded. The CM enhancement of the liver was defined as the attenuation HU of the liver parenchyma during the hepatic parenchymal phase minus the attenuation in the native phase. Liver parenchymal enhancement was negatively correlated to both CTDIvol (r = -0.60) and BW (r = -0.64), but the difference in correlation between those two was not significant. CTDIvol may replace BW when adjusting CM doses to body size. This makes it potentially feasible to automatically individualize CM dosage by CT. aEuro cent CTDI (vol) is related to liver CM enhancement in the parenchymal phase. aEuro cent CTDI (vol) provides comparable information to body weight (BW). aEuro cent CTDI (vol) may be used when automatically adjusting CM dose for patient size.
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| 38. |
- Svensson, Anders, et al.
(author)
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Hepatic contrast medium enhancement at computed tomography and its correlation with various body size measures
- 2012
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In: Acta Radiologica. - : SAGE Publications. - 1600-0455 .- 0284-1851. ; 53:6, s. 601-606
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Journal article (peer-reviewed)abstract
- Background: When the same dose of iodine is given to all patients when performing abdominal computed tomography (CT) there may be a wide inter-individual variation in contrast medium (CM) enhancement of the liver. Purpose: To evaluate if any of the measures body height (BH), body mass index (BMI), lean body mass (LBM), ideal body weight (IBW), and body surface area (BSA) correlated better than body weight (BW) with hepatic enhancement, and to compare the enhancement when using iodixanol and iomeprol. Material and Methods: One hundred patients referred for standard three-phase CT examination of abdomen were enrolled. Body weight and height were measured at the time of the CT examination. Forty grams of iodine (iodixanol 320 mg l/mL or iomeprol 400 mg l/mL) was injected at a rate of 1.6 g-l/s, followed by a 50 mL saline flush. The late arterial phase was determined by using a semi-automatic smart prep technique with a scan delay of 20 s. The hepatic parenchymal phase started automatically 25 s after the late arterial phase. CM concentration was estimated by placement of regions of interest in aorta (native and late arterial phase) and in liver (native and parenchymal phase). Results: BW (r = -0.51 and -0.64), LBM (r = -0.54 and -0.59), and BSA (r = -0.54 and -0.65) showed the best correlation coefficients with aortic and hepatic parenchymal enhancement, respectively, without any significant differences between the measures. Comparing iodixanol and iomeprol there was no significant difference in aortic enhancement. The liver enhancement was significantly higher (P < 0.05) using iodixanol than iomeprol. Conclusion: To achieve a consistent hepatic enhancement, CM dose may simply be adjusted to body weight instead of using more complicated calculated parameters based on both weight and height.
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| 40. |
- Zhang, Yi, et al.
(author)
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Acceleration of hippocampal atrophy in a non-demented elderly population : the SNAC-K study
- 2010
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In: International psychogeriatrics. - 1041-6102 .- 1741-203X. ; 22:1, s. 14-25
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Journal article (peer-reviewed)abstract
- BACKGROUND: Brain atrophy in Alzheimer's disease (AD) includes not only AD-specific brain atrophy but also the atrophy induced by normal aging. Atrophy of the hippocampus has been one diagnostic marker of AD, but it was also found to emerge in healthy adults, along with increasing age. It was reported that the important age when age-related shrinkage of the hippocampus starts was around the mid-40s. The aim is to study the aging atrophy speed and acceleration of brain atrophy in a cross-sectional database, to identify the age at which acceleration of hippocampal atrophy starts in non-demented elderly persons.METHODS: 544 subjects (aged 60-97 years; 318 female and 226 male) were recruited into the MRI study by using a subsample of an epidemiological sample of 3363 healthy non-demented elderly people (over 60 years of age). Hippocampus and ventricle sizes were measured.RESULTS: The normalized volumes (by intracranial volume, ICV) of the hippocampus in males were smaller than those in females. The right hippocampus was larger than the left. The expansion of the lateral ventricles (2.80% per year in males, 2.95% in females) and third ventricle (1.58% and 2.28%, respectively) was more marked than the hippocampal shrinkage (0.68% and 0.79%, respectively). The suggested age at which acceleration of hippocampal atrophy starts is 72 years.CONCLUSIONS: Males present smaller hippocampus volumes (normalized by ICV) than females; however, females are more vulnerable to hippocampal atrophy in a non-demented elderly population. An acceleration of hippocampal atrophy may emerge and start around 72 years of age in a non-demented elderly population.
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| 41. |
- Zhang, Yi, et al.
(author)
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Usefulness of computed tomography linear measurements in diagnosing Alzheimer's disease.
- 2008
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In: Acta Radiologica. - : SAGE Publications. - 1600-0455 .- 0284-1851. ; 49:1, s. 91-97
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Journal article (peer-reviewed)abstract
- Background: Medial temporal lobe atrophy (MTA) is an early sign of Alzheimer's disease (AD). The current method of choice for measuring MTA is volumetric measurement based on 3D magnetic resonance imaging (MRI), but this complicated method has not been implemented clinically. Purpose: To investigate whether simple computed tomography (CT) linear measurements of the brain could be of value in AD workup. Material and Methods: Fifty-nine healthy control subjects and 248 AD subjects were recruited. They were evaluated using a comprehensive clinical workup. A series of linear CT measurements were obtained from brain CT. Results: In discriminant analysis, the temporal horn ratio and the suprasellar cistern ratio were the atrophy factors that contributed most significantly to the diagnoses. Combined with other clinical factors (apolipoprotein E4 genotype), a correct AD classification of 90.2% was achieved. Conclusion: CT linear measurements could be of value in the workup of AD patients, considering the inexpensiveness and availability of CT as well as the simplicity of linear measurements.
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