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Biomedical subjects

M Rué

Publications and source records attributed to M Rué.

At least 19 recordsLinked to original sources
PubMed2006

The bronchodilator test in chronic obstructive pulmonary disease: interpretation methods.

The objective of the study was to evaluate the best method for interpreting the bronchodilator test (BDT). Five formulas for expressing the BDT results were analyzed and compared: changes experienced by maximum expiratory volume in 1s (FEV(1)) and forced vital capacity (FVC) measured in milliliters, in percentage with respect to the baseline, in percentage with respect to the predicted, in percentage with respect to the possible, and in standardized residuals. Ninety-eight chronic obstructive pulmonary disease (COPD) patients were submitted to a respiratory function test on two different days. On each occasion three spirometries were conducted: basal, post-placebo and post bronchodilator. As a gold standard, a normality interval was defined using the variability experienced with the placebo between the two days of the study. The best formulas according to their sensitivity, specivity and area under receiver operating characteristic (ROC) curve were the "standardized residuals", with a cut point of .3, and the "percentage with respect to the predicted" with a cut point of 6%.

Aged↗
PubMed2003

Long-term effects of almitrine bismesylate in COPD patients with chronic hypoxaemia.

BACKGROUND: Almitrine bismesylate (AB) is a peripheral chemoreceptor agonist which is believed to improve oxygenation of COPD patients with chronic hypoxaemia, probably by improving the ventilation perfusion mismatch. We studied the long-term effects of AB in COPD patients with chronic hypoxaemia. METHODS DESIGN: Prospective, randomised, double-blind, placebo-controlled trial. SETTING: Eight hundred bed teaching hospital with a catchment population of 350,000 inhabitants. PATIENT RECRUITMENT: COPD outpatients consulting between September 95 and September 99. INCLUSION CRITERIA: (1) COPD (FEV1 < 50%). (2) PaO2 < or = 65 mmHg. (3) Stable arterial blood gases (ABG), spirometry (S) and clinical state. EXCLUSION CRITERIA: Asthma, restrictive disease, sleep apnoea syndrome, advanced renal or hepatic disease, peripheral neuropathy, use of respiratory stimulants or psychotrophic drugs. TREATMENT: AB 1 mg/kg/day (weight < 75 kg = 50 mg/day; weight > or = 75 kg = 100 mg/day) in an intermittent schedule with resting periods of 1 month after the third, 6th and 9th months during 1 year. INSTRUMENTATION: Stabilisation period: S, ABG. Run-in period: S, ABG, 6-min walking test (WT), nocturnal pulse oximetry (NP) and quality of life evaluation (CRQ). Third, 6th and 9th months: S, ABG. End of the study: S, ABG, WT, NP, CRQ. STATISTICS: ANOVA for repeated measurements. RESULTS: Two hundred and eighty-nine patients were evaluated and 81 were included in the study. Sixty-six were followed for 6 months, 53 for 9 months and 42 for 1 year. Almitrine and placebo groups did not present significant differences in ABG and S in the 6th, 9th and 12th months. Evolution in WT, NP and CRQ were similar in the two groups. No relevant side-effects were detected: only two patients stopped treatment (one placebo and one AB). CONCLUSION: In an intermittent schedule, although well tolerated, at doses of 1 mg/kg/day, AB was not effective in long-term treatment of chronic hypoxemia in COPD patients.

Aged↗
PubMed2001

[Probabilistic models of mortality for patients hospitalized in conventional units].

BACKGROUND: We have developed a tool to measure disease severity of patients hospitalized in conventional units in order to evaluate and compare the effectiveness and quality of health care in our setting. PATIENTS AND METHOD: A total of 2,274 adult patients admitted consecutively to inpatient units from the Medicine, Surgery and Orthopaedic Surgery, and Trauma Departments of the Corporació Sanitària Parc Taulí of Sabadell, Spain, between November 1, 1997 and September 30, 1998 were included. The following variables were collected: demographic data, previous health state, substance abuse, comorbidity prior to admission, characteristics of the admission, clinical parameters within the first 24 hours of admission, laboratory results and data from the Basic Minimum Data Set of hospital discharges. Multiple logistic regression analysis was used to develop mortality probability models during the hospital stay. RESULTS: The mortality probability model at admission (MPMHOS-0) contained 7 variables associated with mortality during hospital stay: age, urgent admission, chronic cardiac insufficiency, chronic respiratory insufficiency, chronic liver disease, neoplasm, and dementia syndrome. The mortality probability model at 24-48 hours from admission (MPMHOS-24) contained 9 variables: those included in the MPMHOS-0 plus two statistically significant laboratory variables: hemoglobin and creatinine. CONCLUSIONS: Severity measures, in particular those presented in this study, can be helpful for the interpretation of hospital mortality rates and can guide mortality or quality committees at the time of investigating health care-related problems.

Female↗
PubMed2001

The bronchodilator test with increasing doses of terbutaline in chronic obstructive pulmonary disease patients.

There is no uniform consensus on the dose of bronchodilator to be used in the bronchodilator test (BDT). The objective of the study was to determine the dose of inhaled terbutaline that can safely achieve a greater number of positive BDT in patients with chronic obstructive pulmonary disease (COPD). The study was prospective and single blinded. One-hundred and fifty patients with stable COPD were included. Their mean (+/-SD) age was 67.4 (8.8) years. Their mean forced expiratory volume in the first second (FEV1) was 1.14 (0.48) l (41% of the predicted value). A baseline spirometry was performed and a second 20 min after the inhalation of placebo. Three consecutive doses of 500 microg of inhaled terbutaline were administered and a new spirometry was performed after each one. A multivariate analysis based on the comparison of the repeated means was performed in order to analyse the spirometric changes achieved after the different doses of bronchodilator. The increase of FEV1 and forced vital capacity (FVC) with the two first doses of terbutaline was statistically significant; the increase of the peak expiratory flow (PEF) was significant after the three doses administered. The number of positive BDT were 40, 47 and 60 after each dose of terbutaline (P=0.004). The higher dose of terbutaline was more useful in identifying patients with significant bronchoreversibility and, moreover, was well tolerated. We suggest that this dose (1500 microg) should be routinely used in performing the BDT.

Aged↗
PubMed2001

Daily assessment of severity of illness and mortality prediction for individual patients.

OBJECTIVE: To refine the prognosis of critically ill patients using a statistical model that incorporates the daily probabilities of hospital mortality during the first week of stay in the intensive care unit (ICU). DESIGN: Prospective inception cohort. SETTING: Fifteen adult medical and surgical ICUs in Spain. PATIENTS: A total of 1,441 patients aged > or =18 yrs who were consecutively admitted from April 1, 1995, through July 31, 1995. INTERVENTIONS: Prospective data collection during the stay of the patient in the ICU. Data collected included vital status at hospital discharge as well as all variables necessary for computing the Mortality Probability Models II system at admission and during the first 7 days of stay in the ICU. MEASUREMENTS AND MAIN RESULTS: Four logistic regression models were obtained. These models contained survival status at hospital discharge as a dependent variable and the following explanatory variables: (model 1) only the probability of dying at admission; (model 2) only the probability of dying during the current day; (model 3) the probability of dying at admission and during the current day; and (model 4) the probabilities of dying at admission and during the previous and current days. Models were evaluated using the Hosmer-Lemeshow statistic and the area under the receiver operating characteristic curve. For survivor and nonsurvivor patients, mortality probabilities obtained using the aforementioned models were compared using linear regression and the paired Student's t-test. Although severity at admission was a statistically significant variable, models 2 and 3 produced almost the same probabilities of hospital mortality, as shown with the linear regression and paired Student's t-test results. CONCLUSIONS: To have an accurate measurement of the prognosis, it is necessary to update the severity measure. The best estimate of hospital mortality was the probability of death on the current day. Severity at admission and at previous days did not improve the assessment of prognosis.

Adult↗
PubMed2000

Interobserver variability of the measurement of the mortality probability models (MPM II) in the assessment of severity of illness.

OBJECTIVE: To assess the interobserver variability of the measurement of the MPM II system. DESIGN: Random sample of an inception cohort. SETTING: Fifteen adult medical and surgical intensive care units (ICUs) in Spain. PATIENTS: A 5% random sample (n = 119) of 2332 patients consecutively admitted in the ICU, aged 18 years or older. INTERVENTIONS: Prospective data collection during the stay of the patient in the ICU. Repeated data collection, after the patient's hospital discharge. MEASUREMENTS AND MAIN RESULTS: Demographic information, length-of-stay and vital status at both ICU and hospital discharge, as well as all variables necessary for computing the MPM II system were measured. Interobserver variability for categorical variables was measured computing the kappa index. For interval variables the interobserver variability was assessed by the intraclass correlation coefficient, the paired t-test, and linear regression. In the MPM II0 index, the variables coma, heart rate, systolic blood pressure, chronic renal insufficiency, metastatic neoplasm, acute renal failure, cardiac dysrhythmia and cardiopulmonary resuscitation, showed moderate or low levels of agreement. In the MPM II24 index, the variables coma or deep stupor, PaO2 and prothrombin time showed low or moderate interobserver agreement. Agreement for the MPM II probability of death was high, although the external observer obtained a lower estimation than the hospital observer. CONCLUSIONS: The MPM II severity system showed a high level of stability when used in groups of patients. Nevertheless, the observed variability in some variables means that it should be used with caution for individual patients.

Adult↗
PubMed2000

Inequalities in mortality by social class in men in Barcelona, Spain.

Most of the studies of inequalities in mortality carried out in Spain have been ecological, due to the difficulty of obtaining good quality socioeconomic information at individual level. The objective of this study was to describe inequalities in mortality by social class, based on occupation, among men residents of Barcelona in 1993. A representative sample was obtained of men residents of Barcelona who died during the year 1993, aged between 15 and 65 years. It was a retrospective interview given to relatives of the deceased, or other closely related persons. The variables analysed were: age, education level, underlying cause of death, and social class based on occupation (manual and non-manual workers). Rates, relative risks (RRs) and their 95% confidence intervals (95% CIs) are presented by age groups and cause of death. The main results show that among young people, the excess of mortality due to infectious diseases is notable (RR: 1.9; 95% CI: 1.6-2.2), and also due to external causes (RR: 2.1; 95% CI: 1.8-2.4) among manual workers with respect to non-manual workers, mainly due to AIDS and drug overdose. No significant differences were found in mortality due to tumours. For respiratory and cardiovascular causes, there is an increase in mortality in the less favoured social classes, as also occurs for mortality due to diseases of the digestive system, particularly among young manual workers, with an RR: 2.6 (95% CI: 1.5-3.6) compared to non-manual workers. This study shows that it is necessary to continue exploring inequalities in health, but above all it is necessary to implement efficient preventive measures addressed mainly at young people in situations of disadvantage, in order to avoid the excess of avoidable mortality which is found.

Adolescent↗
PubMed2000

Performance of the Mortality Probability Models in assessing severity of illness during the first week in the intensive care unit.

OBJECTIVE: To extend the Mortality Probability Models (MPM) II severity system to time periods between 4 and 7 days after admission to the intensive care unit (ICU). DESIGN: Prospective inception cohort. SETTING: Fifteen adult medical and surgical ICUs in Spain. PATIENTS: A total of 1,441 patients aged > or =18 yrs consecutively admitted from April 1, 1995 through July 31, 1995. INTERVENTIONS: Prospective data collection during the stay of the patient in the ICU. Data collected included demographic information, length-of-stay and vital status at both ICU and hospital discharge, as well as all variables necessary for computing the MPM II system at admission and during the first 7 days of stay in the ICU MEASUREMENTS AND MAIN RESULTS: Calibration and discrimination of the four existing MPM II models (MPM0, MPM24, MPM48, and MPM72) were assessed in the study database. The MPM II system overestimated the mortality of patients with probabilities of death > or =0.4. The MPM24 model was customized. Models for time periods between 48 hrs and 7 days (MPM48 to MPMd7) were obtained using the same strategy that was used to develop the original MPM48 and the MPM72 models. The variable coefficients of the MPM24 model were kept fixed and the constant terms of the MPM48 to MPMd7 models were estimated by logistic regression. The constant term stabilized after the fourth day of admission and it was similar to the constant term of the MPM72 model. The customized MPM72 performed very well for days 4 to 7 after admission to the ICU. CONCLUSIONS: If the patient's condition stays the same day after day, the probability of dying in the hospital increases until 72 hrs, and then stabilizes. A severity measure that performs well at 72 hrs can be a useful tool for measuring severity at later time periods.

Critical Care↗
PubMed1999

[An assessment of the quality of life of patients with COPD and chronic hypoxemia by using the Spanish version of the Chronic Respiratory Disease Questionnaire].

INTRODUCTION: The Chronic Respiratory Disease Questionnaire (CRDQ) is a specific evaluation instrument that has been recently translated to Spanish and validated in patients with COPD without chronic respiratory insufficiency. OBJECTIVE: To study the relation of CRDQ scores to several lung function parameters in COPD patients with chronic hypoxemia (PaO2 < 65). MATERIAL AND METHODS: Forty-four middle aged [68 (7)] men with COPD (FEV1 post-PBD < 50%; PaO2 < 65 mmHg) were enrolled with established medical histories, including blood gas and spirometric data. We collected the patients' responses to the CRDQ and measured blood gas levels, spirometric and plethysmographic variables and DLCO. Performance on a six-minute walking test was recorded, with dyspnea assessed on a visual analogue scale (VAS) initially and at the end of the walk. Nighttime pulse oximetry was also monitored. Pearson's and Spearman's correlation coefficients were used to study the relation between CRDQ scores and the aforementioned parameters. Gas and spirometric data were compared to CRDQ scores between groups of patients treated with continuous domiciliary oxygen therapy (CDOT) and the untreated group, using Student t-test and a Mann-Whitney U-test. RESULTS: Results are expressed as means and standard deviations within parentheses. FVC was 2,609 (618) ml, 72 (15)%; FEV1 867 (297) ml, 34 (11)%; FEV1/FVC 33 (8)%; PaO2 55(8) mmHg; and PaCO2 49(6) mmHg. The overall CRDQ score was related to FEV1 (0.38; p < 0.01); FEV1/FVC (0.43, p < 0.005); walking test distance (0.49, p < 0.01); final VAS (-0.64, p < 0.0001) and DLCO (0.59, p < 0.01). No relation was observed between CRDQ score and blood gases, nighttime pulse oximetry or plethysmograph data. "Dyspnea", "fatigue", "emotional function" and "disease control" dimensions of the CRDQ were related to the same variables as was the overall score, with the exception of FEV1/FVC for the "fatigue" dimension and FEV1 and DLCO for the "disease control" dimension. The CRDQ scores were similar in the CDOT and non-CDOT groups in spite of differences in their spirometric and gasometric variables. CONCLUSIONS: 1) Score on the CRDQ is related to FEV1, the FEV1/FVC ratio, walking test distance, dyspnea and DLCO but not to blood gases, FVC, lung volume or nighttime pulse oximetry. 2) The VAS dyspnea score recorded at the end of the walking test is the variable that is most strongly related to CRDQ score. 3) We found that use of CDOT did not undermine the COPD patient's quality of life.

Aged↗
PubMed1999

[Prevalence of chronic bronchitis, asthma and airflow limitation in an urban-industrial area of Catalonia].

OBJECTIVES: To determine the prevalence of chronic bronchitis, asthma and airflow limitation in the general population of the urban-industrial area in and around the town of Sabadell (Catalonia, Spain), and to assess its degree of association with smoking and exposure to secondhand smoke. METHODS: Transversal study of 642 men and women between 20 and 70 years of age listed on census rolls. The standardized questionnaire of the American Thoracic Society was used to interview 576 subjects (90%). Tests of forced spirometry with bronchodilation were administered to 497 individuals (77%). RESULTS: The prevalence of chronic bronchitis was 11.6% (21% of men and 2.7% of women). Asthma had been diagnosed by a subject's doctor in 3.3% of the sample (2.1% of men and 4.4% of women). The prevalence of several asthma-related symptoms was higher. Dyspnea with wheezing was reported by 10.6% of the population (11.4% of men and 9.8% of women); wheezing within the past year was reported by 38.2% (45.4% of men and 31.4% of women). The prevalence of airflow limitation (defined as FEV1 < 80% with an FEV1/FVC index < 70%) in the population sample was 7.2% (10.4% of men and 4.1% of women); in men aged 60 to 70 years, however, the prevalence was 30.8%. Exposure to secondhand smoke was related to the presence of chronic coughing (OR = 4.6) and wheezing (OR = 1.8), but not to significant spirometric changes. CONCLUSIONS: The prevalence of respiratory symptoms and airflow limitation is high in our area, particularly among men and older patients (60 to 70 years old). Like active smokers and ex-smokers, subjects who have been exposed to secondhand smoke are at greater risk of developing respiratory symptoms.

Adult↗
PubMed1999

Gender, sequence of cases and day effects on clinical skills assessment with standardized patients.

OBJECTIVE: Clinical skills assessment using standardized patients (SPs) is an accepted method of professional testing, but some factors can threaten the validity of the scores obtained. OBJECTIVE: The main objective of this work was to test whether the gender of the patients, the sequence of cases and the day of the examination have any impact on the scores of the examinees. MATERIALS: Data from examinations conducted at three Medical Schools are used. Each student encountered 10 different SPs (5 men and 5 women). METHODS: Analysis of variance was used to test the existence of association between the variables. RESULTS: The results showed no significant differences or association between the scores and the three variables analysed. CONCLUSIONS: The results are coherent with the studies that show that performance based examination using SPs can be used without introducing biases into students score.

Analysis of Variance↗
PubMed1999

Identification of factors that influence tolerance of upper gastrointestinal endoscopy.

OBJECTIVE: Unsedated gastroscopy is unpleasant for some patients. The identification of factors related to tolerance would permit the selection of patients for sedation. The aim of the present study was to identify these factors. METHODS: Five hundred and nine patients underwent diagnostic gastroscopy after the administration of topical pharyngeal anaesthesia, without sedation. Patients were grouped as to whether they had undergone prior examinations or not. Tolerance was assessed with a visual analogue scale and a questionnaire. RESULTS: Two hundred and seventy-three (54%) patients underwent gastroscopy for the first time, and 236 (46%) patients had prior experience. Patient tolerance was poor in 84 of 273 (31%) patients undergoing gastroscopy for the first time, and in 61 of 236 (26%) patients with prior experience. Logistic regression analysis identified the following variables related to poor tolerance: (a) in patients undergoing gastroscopy for the first time: presence of gag reflex (odds ratio (OR) = 3.42, 95% confidence interval (CI) 1.90-6.17), apprehension (OR = 2.57, CI 1.33-4.95), young age (OR = 0.95, CI 0.93-0.98) and high level of anxiety (OR = 1.91, CI 0.96-3.89); (b) in patients with prior experience: apprehension (OR = 4.21, CI 1.93-9.20), poor tolerance of prior examinations (OR = 4.92, CI 1.93-12.5) and female (OR = 2.23, CI 1.09-4.57). CONCLUSIONS: The above-mentioned factors are predictive of poor tolerance, and may enable the identification of those patients who might benefit more from sedation for gastroscopy.

Adolescent↗
PubMed1999

Influence of proxy respondents in children's health interview surveys.

STUDY OBJECTIVES: To study the influence of the proxy respondent on health interview surveys in children. DESIGN: Cross sectional study. SETTING: Children under the age of 15 years drawn from the general population of Catalonia, Spain. PARTICIPANTS: The Catalan Health Interview Survey consisted of a multistage probability sample representative to the population of Catalonia. The sample size was 2433 children younger than 15 years of age. The interviews were answered by proxy respondents (the mother, father, or other carer), with the questionnaire adapted for the proxy respondent. Logistic regression models were used to analyse the relation between the proxy respondent's characteristics and health status and health care utilisation, controlling for the effect of sociodemographic factors. MAIN RESULTS: Proxy respondent's characteristics influenced the reports of chronic conditions and accidents within the last year. Proxy respondents over 55 years (OR = 0.47; 95% CI = 0.26, 0.82), men (OR = 0.69; 95% CI = 0.53, 0.89), the father (OR = 0.66; 95% CI = 0.50, 0.89), and the grandparents (OR = 0.49; 95% CI = 0.26, 0.89), reported a lower rate of chronic conditions. Age of the proxy 55 years or greater (OR = 0.41; 95% CI = 0.20, 0.82), men (OR = 0.70; 95% CI = 0.52, 0.94), fathers (OR = 0.68; 95% CI = 0.49, 0.92), and grandparents (OR = 0.40; 95% CI = 0.18, 0.85) showed a lower probability to report accidents. No variables related to the proxy were associated with physician visits or hospitalisation in the previous year. CONCLUSIONS: Selected characteristics of the proxy respondent can influence responses to health surveys involving children. A minimum set of basic data should be collected from the proxy respondent to evaluate different patterns of response.

Adolescent↗
PubMed1998

Mortality prediction in head trauma patients: performance of Glasgow Coma Score and general severity systems.

OBJECTIVE: To assess the performance of general severity systems (Acute Physiology and Chronic Health Evaluation [APACHE] II, Simplified Acute Physiology Score [SAPS] II, and Mortality Probability Models [MPM] II) for head trauma patients and to compare these systems with the Glasgow Coma Score, in order to obtain a good estimate of severity of illness and probability of hospital mortality. DESIGN: Inception cohort. SETTING: Adult medical and surgical intensive care units in 12 European and North American countries. PATIENTS: Patients (n = 401) who were diagnosed with head trauma (with/without multiple trauma), leading to intensive care unit admission, and who were not brain dead at the time of arrival. INTERVENTIONS: Statistical analysis to assess the performance of general severity systems. MEASUREMENTS AND MAIN RESULTS: Vital status at the time of hospital discharge was the outcome measure. Performance of the severity systems (SAPS II, MPM II0 [MPM at admission], MPM II24 [MPM at 24 hrs], and APACHE II) was assessed by evaluating calibration and discrimination. Logistic regression was used to convert the Glasgow Coma Score into a probability of death. The MPM II system (either MPM II0 or MPM 1124) provided an adequate estimation of the mortality experience in patients with head trauma. SAPS II and APACHE II systems did not calibrate well, although they showed high discrimination (area under the receiver operating characteristic curve 0.95 for SAPS II, 0.94 for APACHE II, and 0.90 for MPM II0 and MPM II24). The logistic regression model containing the Glasgow Coma Score as an independent variable and developed in this group of patients was not as well calibrated as MPM II. The discrimination of this model was very high, in the range observed for the APACHE II, SAPS II, and MPM II systems. CONCLUSIONS: The MPM II system performs better than APACHE II, SAPS II, and Glasgow Coma Score for head trauma patients. If our results are supported by other studies, MPM II would be an appropriate tool to assess severity of illness in head trauma patients, with applications to clinical practice and clinical research.

APACHE↗
PubMed1998

Mental health expectancy: an indicator to bridge the gap between clinical and public health perspectives of population mental health.

Mental health indicators generally used in public health are derived from mortality statistics, but they do not reflect the impact that disability due to mental disorders has on population health. The present study proposes a global indicator of population mental health which combines both mortality and morbidity data. The data used were the results of a Health Interview Survey, including the 12-item version of the General Health Questionnaire, mortality life-tables for the general population, and data from a two-step epidemiological study used to assign the probability of case status. The results are calculated for the Catalonia region in north-east Spain. Life expectancy and mental health expectancies at all ages were found to be higher for women than for men. Men were found to have a higher total life expectancy in good mental health. The feasibility and potential areas of application of this generic mental health index are discussed.

Adolescent↗
PubMed1998

Hyperechoic liver nodules: characterization with proton fat-water chemical shift MR imaging.

PURPOSE: To evaluate proton fat-water chemical shift fast low-angle shot magnetic resonance (MR) imaging for differentiation of fat-containing hyperechoic liver nodules from hyperechoic liver nodules without a fatty component. MATERIALS AND METHODS: T1-weighted fast low-angle shot fat-water chemical shift gradient-echo MR imaging was performed in 96 patients without cirrhosis with 138 hyperechoic liver nodules. In-phase and opposed-phase breath-hold images were acquired. The percentage of signal intensity variation between in-phase and opposed-phase images and the spleen-to-lesion contrast ratio were used to differentiate liver nodules. RESULTS: Chemical shift MR images showed fat in 15 (11%) hyperechoic nodules (two angiomyolipomas and 13 nodular fatty infiltrations of the liver). The mean percentage of signal intensity variation between in-phase and opposed-phase images was 156% (standard error, 43.5%) in nodules with fat and -0.16% (standard error, 0.96%) in nodules without fat (P = .003). Spleen-to-lesion contrast was similar on in- and opposed-phase images in lesions without fat (mean difference, -0.0107; standard error, 0.012), whereas the mean difference in fat-containing nodules was 0.805 (standard error, 0.225; P = .003). The area under the receiver operating characteristic curve was 0.97 for signal intensity variation. CONCLUSION: Hyperechogenicity in certain liver nodules is caused by fat. Chemical shift MR imaging allows accurate differentiation between these and other hyperechoic lesions with no fat component.

Adipose Tissue↗