Magnetic Resonance Spectroscopy of the Breast at 3T: Pre- and Post-Contrast Evaluation for Breast Lesion Characterization

Purpose. To determine whether in vivo proton magnetic resonance spectroscopy at 3T can provide accurate breast lesion characterization, and to determine the effect of gadolinium on the resonance of tCho. Methods. Twenty-four positive-mammogram patients were examined on a 3T MR scanner. 1H-MRS was performed before and after gadolinium administration. tCho peak was qualitatively evaluated before and after contrast injection. Results. Fourteen out of 27 lesions proved to be malignant after histopathological diagnosis. Using 1H-MRS, before contrast injection, 6/14 confirmed malignancies and 11/13 benign lesions were correctly classified; while, after contrast injection, 11/14 confirmed malignancies and 12/13 benign processes were correctly classified. Post gadolinium 1H-MRS proved useful in picking up tCho signal, improving the overall accuracy, sensitivity, and specificity by 35%, 83%, and 9%, respectively. Conclusion. 1H-MRS overall accuracy, sensitivity, and specificity in detecting breast lesion's malignancy were increased after gadolinium administration. It is prudent to perform 1H-MRS before contrast injection in large breast lesions to avoid choline underestimation. In cases of small or non-mass lesions, it is recommended to perform 1H-MRS after contrast injection for better voxel prescription to enable a reliable preoperative diagnosis

Sonographic detection of vesicoureteral reflux with fluid and air cystography. Comparison with VCUG

Purpose: Attempt to find out an effective and reliable alternative method for the diagnosis of vesicoureteral reflux (VUR), without irradiation, in children, and the comparison of its results with those of voiding cystourethrography (VCUG). Methods: In a prospective comparative study we examined 88 children (176 units) (average age = 2.8 years) sonographically and with VCUG, in order to detect VUR. First we examined sonographically the kidney's morphology on an empty bladder. Then we examined them sonographically after filling the urinary bladder with fluid (fluid-cystorenography, fluid-CRG), and after filling it with air (air cystorenography, air CRG). Within the following 2-5 days the standard VCUG was performed. We compared the results of these three methods. Results: Fluid CRG showed fluid reflux to the pelvicalyceal system in 25/176 kidneys (sensitivity = 94.4%, specificity = 94.9%, accuracy = 94.9%). Air CRG showed air reflux in 19/176 kidneys (sensitivity = 83.3%, specificity = 96.8%, accuracy = 95.4%). VCUG showed VUR in 18/176 pelvicalyceal systems and/or ureters. Conclusion: Fluid CRG and/or air CRG can be used as complementary methods to the VCUG, or during the follow up of patients with known VUR: VCUG cannot be replaced completely by fluid CRG or air CRG, especially the first and the last one, because of the false negative results of these methods and because none of them can show the renal collecting system, the urinary bladder and the urethra in the standard way

Hepatitis B virus and intrahepatic cholangiocarcinoma

Intrahepatic cholangiocarcinoma (ICC) is a rare type of primary liver cancer that arises from intrahepatic bile ducts. Its etiopathogenesis has been considered to be independent of the presence of chronic viral hepatitis infections or cirrhosis. These factors, particularly the hepatitis C virus, have been reported to play a role in the development of cholangiocarcinoma in a few studies, with inconclusive results. We report 2 cases of ICC that presented with a background of hepatitis B virus (HBV) infection and discuss the possible pathophysiological relationships between ICC and HBV infection, with an emphasis on the x gene of HBV. Copyright © Informa Healthcare

Magnetic colloidal superparticles of Co, Mn and Ni ferrite featured with comb-type and/or linear amphiphilic polyelectrolytes; NMR and MRI relaxometry

The ability to encapsulate hydrophobic ferrites in colloidal superparticle structures of an a-telechelic hexadecyl-functionalized poly(methacrylic acid) (C16H33-PMAA) polymer with a linear architecture was investigated and compared with that of two amphiphilic comb-type water-soluble copolymers, namely, P(ANa-co-DAAm) and P(MANa-co-DMA), which are comprised of a poly(sodium acrylate) or poly(sodium methacrylate) backbone and pendent dodecyl acrylamide or dodecyl methacrylate chains, respectively. In the case of C16H33-PMAA, the pH-sensitive self-assembly behavior, which was studied through Nile Red probing and TEM, was related to its encapsulation properties. Hydrophobic MFe2O4 nanoparticles coated with oleylamine (MFe2O4@OAm MNPs, where M = Co, Mn, Ni) with a similar shape and size (similar to 9 nm) and magnetization values of 87.4, 63.1 and 55.0 emu g(-1) for CoFe2O4@OAm, MnFe2O4@OAm and NiFe2O4@OAm, respectively, were successfully encapsulated into the hydrophobic cores of spherical micellar structures formed by the copolymers in an aqueous solution through a solvent mixing procedure. The synthesized magnetic colloidal superparticles fell in the static dephasing regime (SDR). NMR relaxivity measurements of MFe2O4@P(ANa-co-DAAm), MFe2O4@P(MANa-co-DMA) and MFe2O4@C16H33-PMAA at pH = 4.5 and pH = 7 (where M = Co, Mn, Ni) at 11.7 T were recorded and the transverse relaxivity (r(2)) (mM(-1) s(-1)) was determined. Among all, the CoFe2O4@polymers demonstrated the highest r(2) relaxivity values, ranging from 61.6 for CoFe2O4@C16H33-PMAA (pH = 7) to 316.0 mM(-1) s(-1) for CoFe2O4@P(ANa-co- DAAm). The relaxation efficiency (r(1) and r(2)) of CoFe2O4@P(ANa-co-DAAm) was investigated further by magnetic resonance imaging (MRI) at 1.5 T and 3 T and the r(2)/r(1) ratios were found to be 16.5 and 18.2, respectively, indicating its potential use as a T-2 contrast agent

Increased soluble E-selectin levels in type 2 diabetic patients with peripheral arterial disease

Aim. Abnormal endothelial function is well known in patients with type 2 diabetes mellitus; and thought to induce macroangiopathy. Increased levels of adhesion molecules have been found in type 2 diabetic patients and it has been suggested that they play an important role in the initiation of atherosclerosis. The aim of the present study was to clarify the relationship between objectively proven peripheral arterial disease (pAVD) and serum levels of soluble adhesion molecules in patients with type 2 diabetes mellitus. Methods. Levels of soluble E-selectin, ICAM-1 and VCAM-1 were evaluated in 18 type 2 diabetic patients with pAVD assessed by Doppler ultrasound, in 19 type 2 diabetic patients and 22 non-diabetic subjects without pAVD. Results. Soluble E-selectin levels were significantly increased in pAVD-diabetic patients compared to diabetics and non-diabetics without pAVD (78.7 +/- 29 vs 49.7 +/- 20.4 and 36 +/- 17 ng/ml respectively, p<0.001), while sICAM-1 and sVCAM-1 levels were comparable between the groups. No significant correlation was found between pAVD and adhesion molecule levels. Peripheral AVD was correlated with smoking (p=0.024), duration of diabetes (p=9.048) and microalbuminuria (p=0.041). Regression analysis revealed that only smoking (R=0.536, p=0.012) and glycosylated hemoglobin (R=0.435, p=0.036) were independent factors related to pAVD. Soluble ICAM-1 levels were significantly higher (p=0.041) in diabetic smokers with pAVD and sVCAM-1 (p=0.011) in patients with longer duration of diabetes. Conclusion. Type 2 diabetic patients with pAVD showed increased serum sE-selectin levels. No significant relationship was found between the presence or extent of pAVD and measured adhesion molecules. Our results suggest that sE-selectin reflects endothelial activation and is possibly involved in the atherogenesis process with the contribution of other factors that characterize the metabolic syndrome of diabetes

Paraplegia-related alterations of bone density in forearm and hip in Greek patients after spinal cord injury

Purpose: Paraplegia due to spinal cord injury is related with sublesional bone demineralization with an increased incidence of pathologic fractures in lower extremities. This study was carried out in order to evaluate bone density alterations in forearm and hip in Greek paraplegic patients after spinal cord injury and to correlate the findings with the level of injury, the neurological status. the time interval from injury and the performing of physiotherapy and therapeutic standing, Method: Fifty-se en paraplegic patients (33 men and 24 women. with injuries sustained from 6 months to 27 years) and 36 able-bodied age-matched controls (25 men, 16 women) participated in the study. Bone mineral density (BMD) was measured by dual X-ray absorptiometry (DXA) in the proximal an distal forearm, the femoral neck, the greater trochanter and Ward's triangle. Results: The measurements revealed a significant reduction of BNID of femoral neck (p<0.001 in male, p<0.001 in female paraplegics), greater trochanter (p<0.001 and p=0.001, respectively) and Ward's triangle (p=0.001 and p=0.005, respectively). Proximal forearm depicted non-significantly decreased BMD values and distal forearm depicted a slight increase in BMD values. The degree of demineralization was independent of factors such as complete or incomplete spinal cord injury. level of the lesion, physiotherapy and performing of standing. In addition to that. BMD values in both hip and forearm showed no statistically significant correlation with time after injury. Conclusions: BMD measurements in Greek paraplegic patients reveal bone loss, which most dramatically occurs in the region of hip with a consequent increase of fracture risk. Forearm measurements depict a non-homogeneous response with limited proximal bone loss and slight distal increase of BMD. the latter being possibly attributed to daily activities