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S Dymarkowski

Publications and source records attributed to S Dymarkowski.

24 records · Page 2Linked to original sources

Noninvasive measurements of infarct size after thrombolysis with a necrosis-avid MRI contrast agent.

BACKGROUND: Gadophrin-2 is a new MRI contrast agent with high affinity for necrotic myocardium. The aim of the study was to evaluate whether noninvasive measurements of infarct size after thrombolysis are possible with gadophrin-2-enhanced MRI. METHODS AND RESULTS: Coronary artery thrombosis was induced in 3 groups of dogs by the copper-coil technique. Thrombolytic therapy together with aspirin and heparin was initiated after 90 minutes of occlusion. One day (group A), 2 days (group B), or 6 days (group C) after infarction, gadophrin-2 was injected intravenously (50 micromol. kg-1). In vivo T1-weighted segmented turbo-FLASH, in vivo T2-weighted segmented half-Fourier turbo spin echo (HASTE), and T1- and T2-weighted spin-echo MRI of the excised heart were performed 24 hours after gadophrin-2 injection. Regions of strong enhancement were observed on T1-weighted images. Planimetry of short-axis MR images and of corresponding triphenyltetrazolium chloride (TTC)-stained left ventricular (LV) slices showed a close correlation between the enhanced areas and TTC-negative areas for both in vivo (r2=0.98, P<0.0001; mean difference, 0.9+/-2.0% [SD] of the LV volume [LVV]) and postmortem (r2=0.99, P<0.0001; mean difference, 0.9+/-1.4% of LVV) measurements. T2-weighted images overestimated the infarct size by 8.1+/-5.4% of LVV. The mean infarct size was 10.8+/-11.6% of LVV (group A), 22.4+/-11.7% (group B), and 5.1+/-9.3% (group C). CONCLUSIONS: In this animal model, in vivo gadophrin-2-enhanced MRI could precisely determine infarct size after thrombolytic therapy. This technique may be very useful for the noninvasive evaluation of infarct size after reperfusion for AMI.

Animals↗

Three-dimensional MR angiography in the evaluation of thoracic outlet syndrome.

OBJECTIVE: The objective is to present our initial experience with the combination of three-dimensional time-resolved contrast-enhanced MR angiography and T1-weighted spin-echo imaging for investigation of vascular compression related to thoracic outlet syndrome. CONCLUSION: In patients with clinical signs of thoracic outlet syndrome suggesting vascular elongation or compression, this technique proves to be robust, and its results are comparable to those of conventional catheter angiography. Our results allow precise identification of the anatomic structure(s) responsible for the clinical symptoms and show the effect of arm hyperabduction on the patency of the subclavian vessels.

Adult↗

Functional MRI of the brain: localisation of eloquent cortex in focal brain lesion therapy.

The aim of this study was to assess the feasibility of functional MRI (fMRI) in a clinical environment on a large patient group, and to evaluate the pretherapeutic value of localisation of eloquent cortex. Forty patients with focal brain lesions of different origin were studied using fMRI. Functional information was obtained using motor, somatosensory, auditory and phonological stimuli depending on the localisation of the lesions. To obtain information about the spatial accuracy of fMRI, the results were compared with postoperative electrocortical stimulation. Two patients with secondary trigeminal neuralgia were scanned using a motor protocol and were implanted with an extradural plate electrode. Imaging was successful in 40 of 42 patients (including the 2 with trigeminal neuralgia). These patients were analysed for strength of activation, the relation of the lesion to activation sites and the presence of mass effect. The correlation between these data and surgical findings provided significant additional clinical information. Functional MRI can be accurately performed in patients with focal brain lesions using a dedicated approach. Functional MRI offers important clinical information as a contribution to a decrease in posttherapeutic morbidity. The accuracy of the technique can be confirmed by other modalities, including invasive cortical electrostimulation.

Adolescent↗

Functional magnetic resonance imaging (fMRI) visualises the brain at work.

Functional Magnetic Resonance Imaging (fMRI) is a recent MRI technique capable of visualising neuronal activity in humans in a non-invase way. The technique visualises the physiological changes in oxy- and deoxyhemoglobin concentration changes in small cortical blood vessels upon neuronal activation without the need for radiation or the administration of contrast media or radioactive tracers. The spatial accuracy of the technique is of the order of millimeters and the temporal resolution of the order of one second. The concept has captured the interest of neuroradiologists as well as neuroscientists, who now have a means to visualise their theories in human volunteers. In the clinical environment the non-invasive studies should aid neurosurgeons in adopting a safe course into the brain and assist neurologists in unraveling neurological hypotheses. This report describes the technical principals of fMRI and presents some of our clinical results on the mapping of several cortical functions, such as motor, auditory and language functions, in a large group of patients.

Brain↗

Role of magnetic resonance imaging in coronary heart disease.

Coronary heart disease (CHD) is the number one cause of morbidity and mortality in the developed countries. CHD involves a very broad clinical spectrum, ranging from stable angina pectoris to sudden cardiac death. Despite a huge improvement in treatment in the last 3 decades, significantly reducing the death rate, the prevalence of CHD will increase in the coming years due to an improved survival after a first acute myocardial infarction and due to an overall increased longevity, fueled by an epidemic of type-2 diabetes and obesity. This increased prevalence of cardiovascular disease will greatly impact the cost of health care. Moreover, new but often expensive imaging technologies are appealing for more accurate clinical and preclinical detection of CHD. Among these techniques, magnetic resonance imaging (MRI) is certainly one of the most promising. In this review we would like to highlight its potential in diagnosing CHD, against the background of a steadily increasing cost in health care and the need to choose the most cost-effective technique.

Belgium↗

Magnetic resonance imaging in the evaluation of the pericardium. A pictorial essay.

Magnetic resonance (MR) is an ideal technique for the evaluation of the pericardium since it enables the combination of high resolution anatomical images of the pericardial layers with functional information concerning the impact of pathology on diastolic heart function and cardiac filling in particular. In comparison with echocardiography, which remains the first choice technique for the study of the pericardium, MR provides larger fields of view allowing the visualisation of the entire chest, higher spatial and contrast resolution and greater reproducibility. The technique becomes particularly useful when ultrasound imaging does not provide adequate diagnostic information or requires further characterisation; ''non-echoic'' patients, loculated pericardial effusions, focal thickening of the layers and pericardial masses are usually better assessed with MR. The method also provides valuable diagnostic information for establishing the diagnosis of constrictive pericarditis and to differentiate this condition from restrictive cardiomyopathy. The aim of this paper is to present the role of MR imaging in the assessment of a patient with suspected pericardial disease, and discuss the MR technique, anatomy and the main pathological conditions.

Cardiomyopathies↗