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Biomedical subjects

L Baath

Publications and source records attributed to L Baath.

5 recordsLinked to original sources

Multicenter study for the evaluation of a dedicated biopsy device for MR-guided vacuum biopsy of the breast.

The purpose of this multicenter study was to determine the accuracy and clinical value of a dedicated breast biopsy system which allows for MR-guided vacuum biopsy (VB) of contrast-enhancing lesions. In five European centers, MR-guided 11-gauge VB was performed on 341 lesions. In 7 cases VB was unsuccessful. This was immediately realized on postinterventional images or direct follow-up combined with histopathology-imaging correlation; thus, a false-negative diagnosis was avoided. Histology of 334 successful biopsies yielded 84 (25%) malignancies, 17 (5%) atypical ductal hyperplasias, and 233 (70%) benign entities. Verification of malignant or borderline lesions included reexcision of the biopsy cavity. Benign histologic biopsy results were verified by retrospective correlation with the pre- and postinterventional MRI and by subsequent follow-up. Our results indicate that MR-guided VB, in combination with the dedicated biopsy coil, offers the possibility to accurately diagnose even very small lesions that can only be visualized or localized by MRI.

Biopsy↗

European quadricentric evaluation of a breast MR biopsy and localization device: technical improvements based on phase-I evaluation.

Our purpose was to report about technical success, problems and solutions, as experienced in a first multicentre study on MR-guided localisation or vacuum biopsy of breast lesions. The study was carried out at four European sites using a dedicated prototype breast biopsy device. Experiences with 49 scheduled localisation procedures and 188 vacuum biopsies are reported. Apart from 35 dropped indications, one localisation procedure and 9 vacuum biopsies were not possible (3 times space problems due to obesity, 2 times too strong compression, 3 times impaired access from medially, 2 times impaired access due to a metal bar). Problems due to too strong compression were recognised by repeat MR without compression. During the procedure problems leading to an uncertain result occurred in eight vacuum biopsies, two related to the procedure: one limited access, and one strong post-biopsy enhancement. Improvements after phase-I study concerned removal of the metal bar, development of an improved medial access, of a profile imitating the biopsy gun, optimisation of compression plates and improved software support. The partners agreed that the improvements answered all important technical problems.

Biopsy, Needle↗

Reducing arrhythmogenic effects in the isolated heart enriching roentgen contrast media with electrolytes. Survey and present state.

A review of the literature on the effects of adding electrolytes to ionic as well as nonionic contrast media (CM) in the isolated heart model reveals that both ionic and nonionic CM favor from such addtion, if the added electrolytes are balanced with respect to each other. By enriching nonionic monomeric as well as dimeric CM with such a balanced electrolyte solution, the risk of ventricular fibrillation is reduced and myocardial contractibility is improved compared to nonionic CM without such enrichment. The new nonionic dimer iodixanol is slightly hypotonic to plasma in concentrations suitable for coronary arteriography. The water solution of iodixanol therefore contains an osmotic space in which electrolytes can be added, therby making it isotonic with plasma.

Animals↗

Vasodilatative and vasoconstrictive effects of angiography contrast media.

During angiography contrast media (CM) induces changes in vessel tone. The pathophysiological reasons for this are poorly understood. In this short review the anatomical structures and physiological factors involved in vessel tone are described, and previous and recent findings in vitro and in vivo concerning the effect of CM on vessel tone are discussed. Although multifactorial, the main effect seems to result from a direct action of the CM on the vessel wall. For a particular CM formulation, the effect is due to a combination of its osmolality, molecular properties as well as electrolyte content. In vitro experiments performed in iso-osmolar solutions of pure CM suggest the CM interfere with the cellular mechanisms controlling intracellular calcium. When injected intravascularly, CM may cause either vasodilatation and vasoconstriction. Vasodilatation is the most frequent effect when CM is injected into a vessel while vasoconstriction is relatively uncommon. Both vasodilatation and vasoconstriction can be caused by all types of CM.

Angiography↗

Adverse reactions in myelography.

An attempt was made to assess the usefulness of using animal models to predict the neural tolerability in man of iodinated contrast media (CM) in general, and of the new nonionic dimer iodixanol in particular. For this purpose, the results from 6 animal experiments evaluating excitative and depressive effects of subarachnoidally injected CM in nonanesthetized rabbits were compared with the results from 22 randomized double-blind clinical trials dealing with post-myelographic adverse reactions. Comparisons were made as regards the nonionic monomers metrizamide, iohexol, and iopamidol, and the dimer iotrolan. The results seem to justify the conclusion that the convulsive effects of CM can be reliably predicted from animal experiments. The animal model cannot be used to predict specific types of nonconclusive adverse reactions in man, but reflects well the differences in frequencies of minor reactions following clinical myelography with different nonionic CM. In general, the neural tolerability of iodixanol may be expected to be better than that of the nonionic monomers and approximately equal to that of iotrolan.

Animals↗