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Topic: Functional imaging methods of lung cancer MUDr. Táňa Baráková, Klinika zobrazovacích metod FN Plzeň Introduction: The aim of my work was to assess the use of direct quantification of dual-energy CT (DE-CT) radiation in the diagnosis and monitoring of non-small cell lung cancer (NSCLC) therapy. The work consists of three studies that were performed on Department of imaging methods. The main objectives were to assess the contribution of iodine quantification from DE-CT examinations, to verify the setting and to incorporate the DE-CT examination of the chest into a routine investigation. Furthermore, to investigate the possible benefit of dual- phase DE-CT in evaluating both primary non-small cell lung cancer itself and lymph nodes in terms of iodine and size relationship in chemotherapy or targeted therapy, and finally to investigate the possible benefit of staging FDG-PET / CT to evaluate the effect of therapy on lymph nodes. Methodics: In all presented studies, the same DE-CT protocol was used in the early (arterial) and late (venous) stages. Using a dedicated software prototype, iodine content analysis was performed as the equivalent of blood circulation in lymph nodes and tumors. The main evaluated parameters were iodine content (mg), iodine uptake (mg / ml) and ratio of arterial enhancement...

Phenotypic assessment of patients with severe chronic obstructive pulmonary disease with using HRCT of the lung Aim Chronic obstructive pulmonary disease (COPD) is very important societal and economic problem worldwide. The main risk factor form COPD is tabacco smoke. CODP patients are very heterogenic group with different clinical symptoms. Due to different dominant clinic symptoms it is important to sort out patients to different groups - phenotypes. However differentiation into phenotype groups is not unified. Also using computed tomography (CT) in COPD diagnosis is not routine. The aim of this study is to assess if CT should be one of the basal paraclinic method used in diagnosis of all COPD patient. Materials and methos Patients from Czech multicentre research database of severe COPD which is registered on www.clinicaltrials.gov with number NCT01923051were analysed. The analysis of CT scans with clinical symptoms and lung functional tests was performed. Results From May 2013 were 784 patients included to the database. Completelly 359 patients had CT examination and lung functional tests. More than two thirds of patients (69,4 %) were dyspnoeic even during walk on level ground. Most of the patients were i GOLD group C and D. We have found bronchiectasis on CT in 120 (37,4 %), lung emphysema in...

Background Bronchopulmonary malformations (BPMs) consists of a broad spectrum of developmental abnormalities, ranging from abnormal lung with normal vasculature to abnormal vasculature with normal lungs and lesions with both parenchymal and vascular abnormalities. Terminology remains a problem, the use of descriptive approach is strongly supported in practice. The aim of our study was to assess the accuracy of computed tomography (CT) and magnetic resonance imaging (MRI) in classifying the different types of BPMs and to correlate this imaging with pathologic finding. Materials and methods We identified 24 patients reffered to our institution between years 2010 and 2015 with prenatal ultrasound (US) diagnosis of BPM, who had undergone surgical resection. Postnatal chest CT scans and fetal MRI of these patients formed the basis of our retrospective study. Two radiologists blinded to the histopathological results rewieved all CT and fetal MRI scans. Detected lesions were classified by predetermined criteria. These data were correlated with histopathological results. Results The significant diagnosis overlap of 71% (17 cases out of 24) between the CT and histology was observed. The significant diagnosis overlap between MRI and histology was observed of 80 % (8 cases out of 10). The diagnosis overlap of...

Non invasive assessment of pulmonary hypertension on chest radiograph and non contrast CT Objective: To evaluate relationship between selected qualitative and quantitative parameters and mean pulmonary artery pressure (mPAP) in patients with chronic pulmonary disease. To assess, whether a radiologist with use of a set of measurements in combination with positivity of qualitative findings is able reliably predict presence of pulmonary hypertension (PH) on chest radiographs (CXR) and High-resolution CT (HRCT) of lungs. To examine reproducibility of the used method by assessment of interobserver agreement between radiologists in diagnosing pulmonary hypertsension. Materials and Methods:53 individuals with chronic lung disease underwent right heart cathetrisation, CXR and HRCT. 30 patients had PH confirmed. CXRs and HRCTs were reviewed independetly by three radiologist who besides evaluation of findings stated whether PH is present. Relation between relevant parameters and mPAP, agreement between radiologists and real presence of PH were assessed. Results: The strongest correlation on CXR was found between mPAP and ratio of right descending pulmonary artery width and the left main bronchus (r = 0,256650, p = 0,023362) and right descending pulmonary artery width (r = 0,188897, p = 0,002048). The...

Use of the prenatal MRI in the orofacial cleft diagnostics Aim: To evaluate the accuracy and credibility of MRI in the assessment of the fetal facial cleft lip defects severity using interobserver agreement between several specialists. Material and method: Our study consists of 23 MRI examinations of fetuses in gestation age before 24 week with differently severe lip clefts, which was detected by ultrasound as well as other 17 examinations without face anomaly (40 cases in total). Datasets were anonymized and analyzed by 3 radiologists and statistical analysis was performed. According to standardised protocol presence of cleft and degree of severity was evaluated - alveolar ridge involvement, continuation or noncontinuation to the pallate. The examinations were perfomed by Siemens Magnetom Symfony Masestro Class 1,5T with use of array coils. Results: Result of MRI was in 20 cases (87 %) in agreement with clinical findings. We found 3 discrepancies (13 %), mainly due to graphically limited examination caused by fetal movements. The best degree of interpretative agreement was in the evaluation of alveolar ridge involvement - 94 % (generalized kappa 0,894, SE 0,106), for isolated cleft lip it was 90 % (generalized kappa 0,848, SE 0,083) and for defect of palatte 86 % (generalized kappa 0,711, SE...

Traditional two-dimensional (2D) ultrasound has been and remains the mainstay of prenatal screening and diagnosis of congenital structural abnormalities. However, real clinical impact of the newer innovative methods (3D/4D ultrasound and MRI) remains to be unclear. The aim of this study is to evaluate the impact of combined examination by ultrasound and fetal magnetic resonance on prenatal diagnosis of congenital defects and optimization of perinatal management. Both imaging methods were in our department performed on the same day by a single operator specialized in fetal medicine. Therefore, another aim of this study was to compare the importance of 2D and 3D/4D ultrasound and magnetic resonance for exactness of the prenatal diagnosis of congenital defects. 212 pregnancies were examined. 89% of patients were referred for abnormal or suspicious finding at local ultrasound examination and 11% for an increased risk of congenital defects due to an abnormal family history or an abnormal result of previous laboratory testing. Detailed postnatal diagnosis was successfully retrieved in 113 (53%) of referred pregnancies. Only this group of pregnancies with known detailed postnatal diagnosis was used for the evaluation of the impact of combined imaging by ultrasound and magnetic resonance on prenatal diagnosis of...

Aim. In our study we focused on the ultrasound diagnostics of intracranial hypertension in neonates with diagnosis of posthemorrhagic hydrocephalus (PHH). We wanted to try and verify the method of "pressure provocation test". When performing this test, the great fonticulus is compressed by ultrasound probe and simultaneously systolic and diastolic velocities are being measured in the internal genu of the anterior cerebral artery with resisistive index calculation. Pressure on fonticulus during examination shows us the reserve capacity of liquor spaces and the response in cerebral arteries blood flow. The primary objective was to verify, if the basic and compressive resistive index correlates with the presence and eventually with the severity of intracranial hypertension. The secondary objective was to find relationship between the degree of intracranial hypertension and the diameter of cerebral ventricles, to asses the rapidity of PHH developement and to find out, in which period is PHH the most common. Method. In years 1999 - 2008, 52 children with diagnosis of posthemorrhagic hydrocephalus were examined in our department. The average birth weight in children with PHH was 1436 g (550 - 4090 g, median 1150 g). The average age was 29,6 weeks (24 - 41 weeks, median 28 weeks). Totally, 73 % of children...

5 3. Summary Purpose: To evaluate the clinical utility of contrast enhanced ultrasonography (CEUS) for the characterisation of focal liver lesions with the emphasis on the benign entities. Our aim was to find out the accuracy of CEUS to differentiate between the malignant and benign lesions and to extend the knowledge about the typical signs of solid benignomas on CEUS. Material and methods: our material consists of 163 liver masses observed in 144 patients. The final dianosis has been stated by means of the computed tomography in 26.4 %, magnetic resonance imaging (60.4 %) and histology (25.8 %). There was a majority of women (n=90) against men (n=54); the average age was 47.6 years. The number of benign lesions (n=137) markedly exceeded the number of malignant ones (n=6). The dominant lesions were hemangiomas (n=66), the second most common was focal nodular hyperplasia (FNH, n=42). The other lesions comprised of limited numbers of entities(focal steatotic or nonsteatis regions: n=21, metastatic lesions: n=15, hepatocelullar carcinoma, n=7, regenerative nodular hyperplasia, n=5, peripheral cholangiogenic carcinoma, n=4, and others - inflemmatory pseudotumour, adenoma, epithelial angiomyolipoma). Results: The accuracy of CEUS for the differentiation of malign or benign lesion was 95, 7 %. Regarding the...