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  • 1.
    Aalto, Anne
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medical and Health Sciences, Radiology. Östergötlands Läns Landsting, Centre for Medical Imaging, Department of Radiology in Linköping. Linköping University, Center for Medical Image Science and Visualization (CMIV).
    Sjoewall, Johanna
    Linköping University, Department of Clinical and Experimental Medicine, Clinical Immunology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Medicine, Department of Infectious Diseases in Östergötland.
    Davidsson, Leif
    Linköping University, Department of Medicine and Care, Radiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Medical Imaging, Department of Radiology in Linköping.
    Forsberg, Pia
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Infectious Diseases. Östergötlands Läns Landsting, Centre for Medicine, Department of Infectious Diseases in Östergötland.
    Smedby, Örjan
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medical and Health Sciences, Radiology. Östergötlands Läns Landsting, Centre for Medical Imaging, Department of Radiology in Linköping. Linköping University, Center for Medical Image Science and Visualization (CMIV).
    Brain magnetic resonance imaging does not contribute to the diagnosis of chronic neuroborreliosis2007In: Acta Radiologica, ISSN 0284-1851, E-ISSN 1600-0455, Vol. 48, no 7, 755-762 p.Article in journal (Refereed)
    Abstract [en]

    Background: Borrelia infections, especially chronic neuroborreliosis ( NB), may cause considerable diagnostic problems. This diagnosis is based on symptoms and findings in the cerebrospinal fluid but is not always conclusive. Purpose: To evaluate brain magnetic resonance imaging ( MRI) in chronic NB, to compare the findings with healthy controls, and to correlate MRI findings with disease duration. Material and Methods: Sixteen well- characterized patients with chronic NB and 16 matched controls were examined in a 1.5T scanner with a standard head coil. T1- ( with and without gadolinium), T2-, and diffusion- weighted imaging plus fluid- attenuated inversion recovery ( FLAIR) imaging were used. Results: White matter lesions and lesions in the basal ganglia were seen in 12 patients and 10 controls ( no significant difference). Subependymal lesions were detected in patients down to the age of 25 and in the controls down to the age of 43. The number of lesions was correlated to age both in patients ( rho=0.83, P < 0.01) and in controls ( rho=0.61, P < 0.05), but not to the duration of disease. Most lesions were detected with FLAIR, but many also with T2- weighted imaging. Conclusion: A number of MRI findings were detected in patients with chronic NB, although the findings were unspecific when compared with matched controls and did not correlate with disease duration. However, subependymal lesions may constitute a potential finding in chronic NB.

  • 2.
    Arlander, E
    et al.
    Stockholm.
    Cederlund, T
    Stockholm.
    Måre, Klas
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Radiology. Östergötlands Läns Landsting, Centre for Medical Imaging, Department of Radiology UHL.
    No volume effect on retrograde colonic spread of rectally-administered ropivacaine gel2003In: Alimentary Pharmacology and Therapeutics, ISSN 0269-2813, E-ISSN 1365-2036, Vol. 18, no 6, 655-660 p.Article in journal (Refereed)
    Abstract [en]

    Background: Rectal administration of enemas, foams and suppositories is the most efficient way to deliver locally acting drugs to the distal colon. Ropivacaine, a long-acting local anaesthetic, was chosen as a candidate for a new rectal treatment of ulcerative colitis. Aim: To determine the colonic spread of a rectal ropivacaine formulation. Methods: In this randomized, incomplete cross-over study, 12 male volunteers were given 200 mg ropivacaine HCl rectally in 20, 40, 60 and 80 mL hydroxypropyl methylcellulose gel. The viscosity of the gel was 1.1 Pa s. The spread of the radiolabelled ( 99mTc-labelled diethylenetriaminepenta-acetic acid) formulations was assessed by gamma-scintigraphy. Plasma was collected and analysed for ropivacaine base. Results: The retrograde spread was limited to the descending colon and the difference between the studied volumes was not statistically significant. Only the 80-mL volume tended to have a larger distribution, although the 20-mL volume showed the same maximal distribution in two subjects. No distinct relationship between volume, retrograde colonic spread and plasma concentrations could be found. Ropivacaine was well tolerated. Conclusions: Rectal ropivacaine gel in all volumes between 20 and 80 mL can spread up to the descending colon. There was no relationship between either retrograde colonic spread or the administered volume and the ropivacaine plasma concentrations.

  • 3.
    Aspelin, P
    et al.
    Huddinge.
    Aspelin, P
    Huddinge.
    Aubry, P
    Frankrike.
    Aubry, P
    Frankrike.
    Fransson, Sven Göran
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Radiology. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Strasser, R
    Tyskland.
    Strasser, R
    Tyskland.
    Willenbrock, R
    Tyskland.
    Willenbrock, R
    Tyskland.
    Berg, KJ
    Norge.
    Berg, KJ
    Norge.
    Nephrotoxicity in High-Risk Patients. A double-blind, randomized multicenter study of Iso-Osmolar and low-osmolar nonionic contrast media2002In: Am J Cardiol; Fourteenth Annual Symposium TCT sept 2002,2002, 2002, 143-143 p.Conference paper (Refereed)
  • 4. Aspelin, P
    et al.
    Aubry, P
    Fransson, Sven Göran
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Radiology. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Strasser, R
    Willenbrock, R
    Nephrotoxicity in high risk patients: A double blind, randomised study of iso-osmolar and low-osmolar non-ionic contrast media. The NEPHRIC study. ECR Wien 20032003In: Eur Radiol,2003, 2003, 175-175 p.Conference paper (Refereed)
  • 5.
    Aspelin, P
    et al.
    Huddinge University Hospital.
    Aubry, P
    Centre Hospitalier Universitaire Bichat.
    Fransson, Sven Göran
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Radiology. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Strasser, R
    Technische Universität, Dresden.
    Willenbrock, R
    Helios Kliniken, Berlin.
    Berg, K
    Rikshospitalet, Oslo.
    Nephrotoxic effects in high-risk patients undergoing angiography2003In: New England Journal of Medicine, ISSN 0028-4793, E-ISSN 1533-4406, Vol. 348, no 6, 491-499 p.Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The use of iodinated contrast medium can result in nephropathy. Whether iso-osmolar contrast medium is less nephrotoxic than low-osmolar contrast medium in high-risk patients is uncertain. METHODS: We conducted a randomized, double-blind, prospective, multicenter study comparing the nephrotoxic effects of an iso-osmolar, dimeric, nonionic contrast medium, iodixanol, with those of a low-osmolar, nonionic, monomeric contrast medium, iohexol. The study involved 129 patients with diabetes with serum creatinine concentrations of 1.5 to 3.5 mg per deciliter who underwent coronary or aortofemoral angiography. The primary end point was the peak increase from base line in the creatinine concentration during the three days after angiography. Other end points were an increase in the creatinine concentration of 0.5 mg per deciliter or more, an increase of 1.0 mg per deciliter or more, and a change in the creatinine concentration from day 0 to day 7. RESULTS: The creatinine concentration increased significantly less in patients who received iodixanol. From day 0 to day 3, the mean peak increase in creatinine was 0.13 mg per deciliter in the iodixanol group and 0.55 mg per deciliter in the iohexol group (P=0.001, the increase with iodixanol minus the increase with iohexol, -0.42 mg per deciliter [95 percent confidence interval, -0.73 to -0.22]). Two of the 64 patients in the iodixanol group (3 percent) had an increase in the creatinine concentration of 0.5 mg per deciliter or more, as compared with 17 of the 65 patients in the iohexol group (26 percent) (P=0.002, odds ratio for such an increase in the iodixanol group, 0.09 [95 percent confidence interval, 0.02 to 0.41]). No patient receiving iodixanol had an increase of 1.0 mg per deciliter or more, but 10 patients in the iohexol group (15 percent) did. The mean change in the creatinine concentration from day 0 to day 7 was 0.07 mg per deciliter in the iodixanol group and 0.24 mg per deciliter in the iohexol group (P=0.003, value in the iodixanol group minus the value in the iohexol group, -0.17 mg per deciliter [95 percent confidence interval, -0.34 to -0.07]). CONCLUSIONS: Nephropathy induced by contrast medium may be less likely to develop in high-risk patients when iodixanol is used rather than a low-osmolar, nonionic contrast medium.

  • 6.
    Aspelin, P
    et al.
    Huddinge.
    Aubry, P
    Frankrike.
    Fransson, Sven Göran
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Radiology. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Strasser, R
    Tyskland.
    Willenbrock, R
    Tyskland.
    Berg, KJ
    Norge.
    Nephorotoxicity of an Iso-Osmolar and Low-Osmolar Non-Ionic Contrast Media: A Double-Blind, Randomized Multicenter Study in High-Risk Patients.2002In: Radiology,2002, 2002, 442-442 p.Conference paper (Refereed)
  • 7. Axelsson, B
    et al.
    Bodén, K
    Fransson, Sven Göran
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Radiology. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Hansson, I B
    Persliden, Jan
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Radio Physics.
    Witt, Hans
    A comparison of analogue and digital techniques in upper gastrointestinal examinations: absorbed dose and diagnostic quality of the images.2000In: European Radiology, ISSN 0938-7994, E-ISSN 1432-1084, Vol. 10, 1351-1354 p.Article in journal (Refereed)
  • 8.
    Berglund, Ulf
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Radiology. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Richter, Arina
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Cardiology. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Clopidogrel treatment before percutaneous coronary intervention reduces adverse cardiac events2002In: The Journal of invasive cardiology, ISSN 1042-3931, E-ISSN 1557-2501, Vol. 14, no 5, 243-246 p.Article in journal (Refereed)
    Abstract [en]

    Objective. Platelet inhibition during percutaneous coronary intervention (PCI) generally reduces adverse cardiac events. There are very few data on the combination of aspirin and the platelet adenosine diphosphate-receptor inhibitor clopidogrel given before the intervention. Design. In a non-randomized comparison, a total of 706 consecutive patients received clopidogrel 375 mg in addition to aspirin on the day before PCI. The control group consisted of 724 consecutive PCI patients receiving only aspirin pre-treatment. Results. The two groups were well balanced regarding baseline characteristics. Pre-treatment with clopidogrel reduced the in-hospital composite of death, myocardial infarction or urgent revascularization by 41% compared to the control (8.2% versus 4.8%, respectively, p = 0.010). This was due to a decreased incidence of myocardial infarction (7.2% versus 4.4%, p = 0.024) and percutaneous reintervention (1.2% versus 0.3%, p = 0.039). There was no difference in femoral complications between the groups. For every patient in the clopidogrel group, there was a cost reduction of SEK 447 ($40 United States currency). Conclusion. Clopidogrel treatment in addition to aspirin before PCI was associated with a reduction of inhospital adverse cardiac events. It was also safe and cost-saving.

  • 9. Bergman, I
    et al.
    Lundberg, Peter
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Radiology. Östergötlands Läns Landsting, Centre for Medical Imaging, Department of Radiology UHL.
    Nilsson, M
    Microbial carbon mineralisation in an acid surface peat: effects of environmental factors in laboratory incubations.1999In: Soil Biology and Biochemistry, ISSN 0038-0717, E-ISSN 1879-3428, Vol. 31, 1867-1877 p.Article in journal (Refereed)
  • 10. Bergqvist, D
    et al.
    Blomqvist, P
    Eliasson, M
    Eriksson, H
    Hellgren-Wångdahl, M
    Holmberg, Lars
    Janson, J
    Lindahl, T
    Lindholm, C
    Ljungström, KG
    Måre, Klas
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Radiology. Östergötlands Läns Landsting, Centre for Medical Imaging, Department of Radiology UHL.
    Nyman, U
    Rosfors, Stefan
    Schulman, S
    Blodpropp - förebyggande, diagnostik och behandling av venös tromboembolism. En systematisk kunskapssammanställning.2002In: Fetma - problem och åtgärder :: en systematisk litteraturöversikt / [ed] Nils-Georg Asp, Linköping: Linköpings universitet , 2002, -503 p.Chapter in book (Other academic)
    Abstract [sv]

    Att utvärdera det vetenskapliga underlaget för olika åtgärder mot fetma hos vuxna och barn. Underlaget för såväl förebyggande åtgärder som olika behandlingsformer granskats. Bland behandlingsmetoderna ingår kost/diet, motion, beteendeterapi, läkemedel, alternativmedicinska och kirurgiska metoder.

  • 11.
    Carlsson, Carl A.
    et al.
    Linköping University, Department of Medicine and Care, Radio Physics. Linköping University, Faculty of Health Sciences.
    Alm Carlsson, Gudrun Alm
    Linköping University, Department of Medicine and Care, Radiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Radiation Physics.
    Basic physics of X-ray imaging1973Report (Other academic)
    Abstract [en]

    In X-ray diagnostics, radiation that is partly transmitted through and partly absorbed in the irradiated object is utilised. An X-ray image shows the variations in transmission caused by structures in the object of varying thickness, density or atomic composition.

    After an introductory description of the nature of X-rays, the most important processes in the X-ray source, the object (patient) and radiation detector for the generation of an X-ray image will be described.

  • 12. Duffy, SW
    et al.
    Tabar, L
    Vitak, B
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Radiology. Östergötlands Läns Landsting, Centre for Medical Imaging, Department of Radiology UHL.
    Day, NE
    Smith, RA
    Chen, HHT
    Yen, MFA
    The relative contributions of screen-detected in situ and invasive breast carcinomas in reducing mortality from the disease2003In: European Journal of Cancer, ISSN 0959-8049, E-ISSN 1879-0852, Vol. 39, no 12, 1755-1760 p.Article in journal (Refereed)
    Abstract [en]

    We aimed to quantify the benefits of detecting ductal carcinoma in situ (DCIS) and of downwards stage-shifting within invasive tumours in mammographic screening. Using data from the Swedish Two-County Trial of breast cancer screening, we examined the 20-year death rates from invasive tumours of stage II or worse, invasive tumours of stage I and DCIS. We then used these rates and their respective incidences in invited (active study population, ASP) and control (passive study population, PSP) arms of the trial, to estimate the numbers of deaths avoided by downward stage-shifting the larger stage II or worse tumours to stage I and the stage I cancers to DCIS. We also studied the association between the mortality reduction achieved and the proportion of DCIS cases detected in the randomised trials of breast cancer screening. In the Swedish Two County Trial, 141 breast cancer deaths were avoided in the ASP compared with the PSP at approximately 20 years of follow-up. Of these, 65% (91/141) were avoided as a result of stage-shifting from invasive stage II or worse to invasive stage I, and 5% (7/141) as a result of stage-shifting from invasive stage I to DCIS. If we assumed that 10% of stage II or worse tumours avoided were shifted not to stage I, but to DCIS, the estimated number of deaths prevented by shifting from invasive disease to in situ was 17, which is 12% of all deaths prevented. When the results of all the randomised trials of breast cancer screening were reviewed, there was no clear association between the percentage of DCIS cases diagnosed and the observed mortality reduction. We conclude that compared with downward stage-shifting of invasive tumours, detection of DCIS plays a small part in saving lives from breast cancer. Treatment decisions in DCIS, as in invasive carcinoma, should take full account of histopathological, clinical and radiological attributes of the tumour. ⌐ 2003 Elsevier Ltd. All rights reserved.

  • 13.
    Edholm, Paul
    Linköping University, Department of Medicine and Care, Radiology. Linköping University, Faculty of Health Sciences.
    Linograms1988Report (Other academic)
    Abstract [en]

    The several successful solutions to the problem of image reconstruction from projections have caused a rapid growth of a number of new techniques for the reconstruction of distributions and images in several scientific fields. The importance of these techniques, especially in medicine, can hardly be overestimated.

    In a new algorithm for image reconstruction from projections [l, 2], a special form of the projection data is employed providing some certain advantages. This new form or map of the projection data are called linograms.

    This is intended as an overview of linograms and the algorithm based on them. Thorough discussions of conventional techniques are to be found in [3, 4 and 5]. In conventional techniques for image reconstruction, a two dimensional distribution of some property is reconstructed. The property might be the x-ray attenuation in a cross-section of the body, the distribution of a radioactive substance or something else. The distribution is not directly accessible but it is possible to measure line integrals (rays) through i t. The problem now is to reconstruct the distribution (the image) from i ts line integrals (its projections).

    Let the property we are interested in be described by the function f(x, y). projection data are estimates of line integrals of f of known location. Incon~entional techniques each line is specified by two parameters s and e, where s is the (signed) distance from the origin and e its angle with the y-axis.

  • 14. Edvardsson, Hannes
    et al.
    Smedby, Örjan
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Radiology. Östergötlands Läns Landsting, Centre for Medical Imaging, Department of Radiology UHL. Linköping University, Center for Medical Image Science and Visualization, CMIV.
    Compact and efficient 3D shape description through radial function approximation2003In: Computer Methods and Programs in Biomedicine, ISSN 0169-2607, E-ISSN 1872-7565, Vol. 72, no 2, 89-97 p.Article in journal (Refereed)
    Abstract [en]

    A fast and simple method for three-dimensional shape description is described. The method views a 3D object as a radial distance function on the unit sphere, and thus reduces the dimensionality of the description problem by one. The radial distance function is approximated by Fourier methods in the basis of the spherical harmonic polynomials. The necessary integration is carried out on the object boundary, rather than on the unit sphere. Consequently, there is no need of a parameterisation of the object surface. The description makes it possible to compare shapes in a computationally very simple way. Solutions on how to cope with translated and rotated objects are discussed. The method is developed for star-shaped objects, but is stable even if the input image is non-star-shaped. The method is tested in a data set from magnetic resonance imaging (MRI) of the brain. Potential medical applications are discussed. ⌐ 2002 Elsevier Science Ireland Ltd. All rights reserved.

  • 15.
    Eriksson, Ola
    et al.
    Linköping University, Department of Biomedical Engineering, Biomedical Instrumentation. Linköping University, The Institute of Technology.
    Backlund, Erik-Olof
    Linköping University, Department of Neuroscience and Locomotion, Neurosurgery. Linköping University, Faculty of Health Sciences.
    Lundberg, Peter
    Linköping University, Department of Medicine and Care, Radiation Physics. Linköping University, Faculty of Health Sciences.
    Lindstam, Håkan
    Linköping University, Department of Medicine and Care, Radiology. Linköping University, Faculty of Health Sciences.
    Lindström, Sivert
    Linköping University, Department of Biomedicine and Surgery, Cell biology. Linköping University, Faculty of Health Sciences.
    Wårdell, Karin
    Linköping University, Department of Biomedical Engineering, Biomedical Instrumentation. Linköping University, The Institute of Technology.
    Experimental radiofrequency brain lesions: a volumetric study2002In: Neurosurgery, ISSN 0148-396X, E-ISSN 1524-4040, Vol. 51, no 3, 781-788 p.Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE : This study describes the production, under strictly standardized and controlled conditions, of radiofrequency lesions with identical neurogenerator settings: in vitro in two different albumin solutions (nongelatinous and gelatinous) and in vivo in the thalamus of the pig.

    METHODS : The radiofrequency lesions were investigated in vitro by the use of a specially designed video system and in vivo by magnetic resonance imaging. Moreover, the size of the in vivo lesions was estimated with the use of histological sectioning. The statistical analysis included the calculation of a correlation coefficient for the length, width, and volume for each lesion estimation.

    RESULTS : A high correlation (R = 0.96, P < 0.005; n = 14) was found between clot sizes in the two albumin solutions. Albumin clots generated in gelatinous albumin showed systematically larger volumes. In the pig, two concentric zones were seen in all magnetic resonance images and all histological preparations. The width correlation of the completely coagulated brain tissue (inner zones) was R = 0.94, P < 0.005, and n = 7. The corresponding correlation between magnetic resonance images and gelatinous albumin was R = 0.93, P < 0.005, and n = 7. As a rule, the in vitro clots were smaller than the outer zone but larger than the inner zone of the magnetic resonance imaging-recorded lesions for all of the electrode and temperature combinations tested. In vivo lesions generated with the same electrode and parameter settings showed high reproducibility.

    CONCLUSION : The value of presurgical electrode tests to validate the electrode function and lesion size in vitro has become evident in this study, which shows a high correlation between the in vitro albumin clots and the in vivo lesions observed on magnetic resonance images.

  • 16.
    Fransson, Sven Göran
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Radiology. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    The Botallo mystery1999In: Clinical Cardiology, ISSN 0160-9289, E-ISSN 1932-8737, Vol. 22, 434-436 p.Article in journal (Refereed)
  • 17.
    Fransson, Sven Göran
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Radiology. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Persliden, Jan
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Radio Physics.
    Patient radiation exposure during coronary angiography and intervention2000In: Acta Radiologica, ISSN 0284-1851, E-ISSN 1600-0455, Vol. 41, no 2, 142-144 p.Article in journal (Refereed)
    Abstract [en]

    Purpose: To prospectively register fluoroscopic and cine times in a random fashion, and to measure patient radiation exposure from routine coronary angiography and coronary balloon angioplasty. We also evaluated an optional dose reduction system used during interventions. Material and Methods: The incident radiation to the patient was measured as kerma area product (KAP) in Gycm2, obtained from an ionisation chamber mounted on the undercouch tube during 65 coronary angiography procedures and another 53 percutaneous transluminal coronary angioplasties (including 29 stent procedures), mostly directly following complete coronary angiography. Results and Conclusion: The values from coronary angiography were comparable to other reports with a mean fluoroscopic time of 4.4 min and a mean KAP value of 62.6 Gycm2. The corresponding figures from coronary balloon angioplasty without stenting were lower than otherwise reported, with 8.2 min and 47.9 Gycm2, respectively. The use of coronary stents did prolong the mean fluoroscopic time (10.5 min) but did not significantly enhance the patient mean radiation dose (51.4 Gycm2). The dose reduction technique resulted in a significant KAP value reduction of 57%. In conclusion, with regard to radiation exposure, coronary angiography and balloon angioplasty are considered safe procedures.

  • 18.
    Fransson, Sven Göran
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Radiology. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Rubboli, A
    Italien.
    Antonio Maria Valsalva2003In: Clinical Cardiology, ISSN 0160-9289, E-ISSN 1932-8737, Vol. 26, 102-103 p.Article in journal (Refereed)
  • 19.
    Fransson, Sven Göran
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Radiology. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Rubbolo, Andrea
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Radiology. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Bologna-en stad med stark medicinhistorisk förankring2001In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 98, 2357-2358 p.Article in journal (Other (popular science, discussion, etc.))
  • 20.
    Fransson, Sven Göran
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Radiology. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Sandborg, Michael
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Radiation Physics. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Radiation Physics.
    Petterson, Håkan
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Radiation Physics. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Radiation Physics.
    Stråldoser till patienter och personal vid kranskärlsröntgen och intervention vua radialis resptektive femoralispunktion.2003In: Svensk förening för medicinsk radiologi förhandlingar 2003,2003, 2003, 25-26 p.Conference paper (Refereed)
  • 21.
    Fransson, Sven Göran
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Radiology. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Sandborg, Michael
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Radio Physics. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Radiation Physics.
    Pettersson, Håkan
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Radio Physics. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Radiation Physics.
    Evaluation of patient and staff absorbed doses during coronary angiography and intervention by femoral and radial artery access.2002In: European IRPA Congress, Florence, Italy, October 2002,2002, 2002, 107-107 p.Conference paper (Refereed)
  • 22.
    Fransson, Sven-Göran
    Linköping University, Department of Medicine and Care, Radiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Tuberkulos. Medicinhistoria2003Other (Other (popular science, discussion, etc.))
  • 23.
    Geijer, H
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Radiology.
    Radiation dose and image quality in diagnostic radiology2002In: Acta Radiologica, ISSN 0284-1851, E-ISSN 1600-0455, Vol. 427Article in journal (Refereed)
  • 24.
    Geijer, Håkan
    Linköping University, Department of Medicine and Care, Radiology. Linköping University, Faculty of Health Sciences.
    Radiation dose and image quality in diagnostic radiology: optimization of the dose - image quality relationship with clinical experience from scoliosis radiography, coronary intervention and a flat-panel digital detector2001Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    X-rays are known to cause malignancies, skin damage and other side effects and they are thus potentially dangerous. Therefore, it is essential and in fact mandatory to reduce the radiation dose in diagnostic radiology as far as possible. This is also known as the ALARA (As Low As Reasonably Achievable) principle. However, the dose is linked to image quality and the image quality may not be lowered so far that it jeopardizes the diagnostic outcome of a radiographic procedure. The process of reaching this balance between dose and image quality is called optimization. The aim of this thesis is to propose and evaluate methods for optimizing the radiation dose - image quality relationship in diagnostic radiography with a focus on clinical usefulness. The work was performed in three main parts.

    Optimization of scoliosis radiography: In the first part, two recently developed methods for digital scoliosis radiography (digital exposure and pulsed fluoroscopy) were evaluated and compared to the standard screen-film method. Radiation dose was measured as Kerma area-product (KAP), Entrance surface dose (ESD) and effective dose; image quality was assessed with a contrastdetail phantom and through Visual grading analysis. Accuracy in angle measurements was also evaluated. The radiation dose for digital exposure was nearly twice as high as the screen-film method at a comparable image quality while the dose for pulsed fluoroscopy was very low but with a considerably lower image quality. The variability in angle measurements was sufficiently low for all methods. Then, the digital exposure protocol was optimized to a considerably lower dose with a slightly lower image quality compared to the baseline.

    Flat-panel detector: In the second part, an amorphous-silicon direct digital flat-panel detector was evaluated using a contrast-detail phantom, measuring dose as entrance dose. The flat-panel detector yielded a superior image quality at a lower dose than both storage phosphor plates and screen-film. Equivalent image quality compared to storage phosphor plates was reached at about one third of the dose.

    Optimization of percutaneous coronary intervention (PCI): In the third part, influence of various settings on radiation dose and image quality in coronary catheterisation and PCI was investigated. Based on these findings, the dose rate for fluoroscopy was reduced to one-third. The dose reduction was evaluated in a clinical series of 154 PCI procedures before and 138 after the optimization. Through this optimization, the total KAP was significantly reduced to two-thirds of the original value.

    In summary, this thesis indicates the possibility of dose reduction in diagnostic radiology through optimization of the radiographic process.

    List of papers
    1. Digital Radiography of Scoliosis with a Scanning Method: Initial Evaluation
    Open this publication in new window or tab >>Digital Radiography of Scoliosis with a Scanning Method: Initial Evaluation
    Show others...
    2001 (English)In: Radiology, ISSN 0033-8419, E-ISSN 1527-1315, Vol. 218, 402-410 p.Article in journal (Refereed) Published
    Abstract [en]

    PURPOSE: To evaluate the radiation dose, image quality, and Cobb angle measurements obtained with a digital scanning method of scoliosis radiography.

    MATERIALS AND METHODS: Multiple images were reconstructed into one image at a workstation. A low-dose alternative was to use digital pulsed fluoroscopy. Dose measurements were performed with thermoluminescent dosimeters in an Alderson phantom. At the same time, kerma area-product values were recorded. A Monte Carlo dose calculation also was performed. Image quality was evaluated with a contrast-detail phantom and visual grading system. Angle measurements were evaluated with an angle phantom and measurements obtained on patient images.

    RESULTS: The effective radiation dose was 0.087 mSv for screen-film imaging, 0.16 mSv for digital exposure imaging, and 0.017 mSv for digital fluoroscopy; the corresponding kerma area-product values were 0.43, 0.87, and 0.097 Gy · cm2, respectively. The image quality of the digital exposure and screen-film images was about equal at visual grading, whereas fluoroscopy had lower image quality. The angle phantom had lower angle values with digital fluoroscopy, although the difference in measured angles was less than 0.5°. The patient images showed no difference in angles.

    CONCLUSION: The described digital scanning method has acceptable image quality and adequate accuracy in angle measurements. The radiation dose required for digital exposure imaging is higher than that required for screen-film imaging, but that required for digital fluoroscopy is much lower.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-27101 (URN)11748 (Local ID)11748 (Archive number)11748 (OAI)
    Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2017-12-13Bibliographically approved
    2. Digital Radiography of Scoliosis with a Scanning Method: Radiation Dose Optimization
    Open this publication in new window or tab >>Digital Radiography of Scoliosis with a Scanning Method: Radiation Dose Optimization
    Show others...
    2003 (English)In: European Radiology, ISSN 0938-7994, E-ISSN 1432-1084, Vol. 13, no 3, 543-551 p.Article in journal (Refereed) Published
    Abstract [en]

    The aim of this study was optimization of the radiation dose–image quality relationship for a digital scanning method of scoliosis radiography. The examination is performed as a digital multi-image translation scan that is reconstructed to a single image in a workstation. Entrance dose was recorded with thermoluminescent dosimeters placed dorsally on an Alderson phantom. At the same time, kerma area product (KAP) values were recorded. A Monte Carlo calculation of effective dose was also made. Image quality was evaluated with a contrast-detail phantom and Visual Grading. The radiation dose was reduced by lowering the image intensifier entrance dose request, adjusting pulse frequency and scan speed, and by raising tube voltage. The calculated effective dose was reduced from 0.15 to 0.05 mSv with reduction of KAP from 1.07 to 0.25 Gy cm2 and entrance dose from 0.90 to 0.21 mGy. The image quality was reduced with the Image Quality Figure going from 52 to 62 and a corresponding reduction in image quality as assessed with Visual Grading. The optimization resulted in a dose reduction to 31% of the original effective dose with an acceptable reduction in image quality considering the intended use of the images for angle measurements.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-26783 (URN)10.1007/s00330-002-1476-1 (DOI)11388 (Local ID)11388 (Archive number)11388 (OAI)
    Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2017-12-13Bibliographically approved
    3. Image quality vs radiation dose for a flat-panel amorphous silicon detector: a phantom study
    Open this publication in new window or tab >>Image quality vs radiation dose for a flat-panel amorphous silicon detector: a phantom study
    2001 (English)In: European Radiology, ISSN 0938-7994, E-ISSN 1432-1084, Vol. 11, no 9, 1704-1709 p.Article in journal (Refereed) Published
    Abstract [en]

    The aim of this study was to investigate the image quality for a flat-panel amorphous silicon detector at various radiation dose settings and to compare the results with storage phosphor plates and a screen-film system. A CDRAD 2.0 contrast-detail phantom was imaged with a flat-panel detector (Philips Medical Systems, Eindhoven, The Netherlands) at three different dose levels with settings for intravenous urography. The same phantom was imaged with storage phosphor plates at a simulated system speed of 200 and a screen-film system with a system speed of 160. Entrance surface doses were recorded for all images. At each setting, three images were read by four independent observers. The flat-panel detector had equal image quality at less than half the radiation dose compared with storage phosphor plates. The difference was even larger when compared with film with the flat-panel detector having equal image quality at approximately one-fifth the dose. The flat-panel detector has a very favourable combination of image quality vs radiation dose compared with storage phosphor plates and screen film.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-26902 (URN)10.1007/s003300100851 (DOI)11526 (Local ID)11526 (Archive number)11526 (OAI)
    Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2017-12-13Bibliographically approved
    4. Radiation dose optimization in coronary angiography and percutaneous coronary intervention (PCI): I. Experimental studies
    Open this publication in new window or tab >>Radiation dose optimization in coronary angiography and percutaneous coronary intervention (PCI): I. Experimental studies
    2002 (English)In: European Radiology, ISSN 0938-7994, E-ISSN 1432-1084, Vol. 12, no 10, 2571-2581 p.Article in journal (Refereed) Published
    Abstract [en]

    The objectives of this study were to evaluate the influence on image quality and dose to the patient and operator of various equipment settings for percutaneous coronary intervention (PCI), and to optimize the set-up. With an Alderson phantom, different settings, such as projection, protective screens, filtration, image intensifier size and collimation, were evaluated. Kerma-area product (KAP) was recorded as a measure of patient dose and scattered radiation was measured with an ionization chamber. Effective dose for a standardized PCI procedure was measured with thermoluminescent dosimeters inside the phantom. Image quality was evaluated with a contrast-detail phantom. Based on these findings, the equipment set-up was optimized to a low fluoroscopy dose rate with a sufficient image quality. Several operating parameters affected dose, particularly scattered radiation. The optimization reduced the fluoroscopy KAP rate from 44 to 16 mGy cm2/s using 15 cm of acrylic. The effective dose was reduced from 13 to 4.6 mSv for a standardized PCI procedure. Radiation dose to patient and operator in PCI is heavily dependent on both equipment set-up and operating parameters which can be influenced by the operator. With a careful optimization, a large reduction of radiation dose is possible.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-80126 (URN)10.1007/s00330-001-1237-6 (DOI)12271400 (PubMedID)
    Available from: 2012-08-21 Created: 2012-08-21 Last updated: 2017-12-07Bibliographically approved
    5. Radiation dose optimization in coronary angiography and percutaneous coronary intervention (PCI): II. Clinical evaluation
    Open this publication in new window or tab >>Radiation dose optimization in coronary angiography and percutaneous coronary intervention (PCI): II. Clinical evaluation
    2002 (English)In: European Radiology, ISSN 0938-7994, E-ISSN 1432-1084, Vol. 12, no 11, 2813-2819 p.Article in journal (Refereed) Published
    Abstract [en]

    In a previous part of this study, the fluoroscopy dose rate was reduced in a cardiac catheterization laboratory. The objectives of the present study were to evaluate the effects in a clinical population undergoing percutaneous coronary intervention (PCI) of the dose-reducing measures detailed previously. Kerma area-product (KAP) values were first recorded for 154 patients undergoing PCI. Then, the fluoroscopy KAP rate was reduced from 44 to 16 mGy cm2/s by increasing filtration and reducing the image intensifier dose request. After this optimization, KAP was recorded for another 138 PCI procedures. After adjustment for differing proportions of combined procedures (coronary angiography+PCI), the total KAP was reduced to 67% of the original value with a 95% confidence interval from 57 to 78%, statistically significant. The mean total KAP values were 93.6 Gy cm2 before and 69.1 Gy cm2 after optimization. The KAP for digital acquisition did not change significantly. It is possible to make a large dose reduction in PCI by reducing the fluoroscopy dose rate. This dose reduction is beneficial for both patients and staff.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-26776 (URN)10.1007/s00330-001-1238-5 (DOI)11381 (Local ID)11381 (Archive number)11381 (OAI)
    Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2017-12-13Bibliographically approved
  • 25.
    Geijer, Håkan
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Radiology.
    Beckman, KW
    Örebro.
    Andersson, T
    Örebro.
    Persliden, Jan
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Radio Physics. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Radiation Physics.
    Radiation dose and image quality with a flat-panel amorphous silicon digital detector.2001In: Eur Radiol,2001, 2001, 280-280 p.Conference paper (Refereed)
  • 26.
    Gustafsson, M C
    et al.
    Linköping University, Department of Neuroscience and Locomotion, Neurology. Linköping University, Faculty of Health Sciences.
    Dahlqvist Leinhard, Olof
    Linköping University, Center for Medical Image Science and Visualization (CMIV). Linköping University, Department of Medical and Health Sciences, Radiation Physics. Linköping University, Faculty of Health Sciences.
    Jaworski, J
    Linköping University, Department of Neuroscience and Locomotion, Neurology. Linköping University, Faculty of Health Sciences.
    Lundberg, Peter
    Linköping University, Department of Medicine and Care, Radiation Physics. Linköping University, Department of Medicine and Care, Radiology. Linköping University, Department of Medicine and Care, Center for Medical Image Science and Visualization. Linköping University, Faculty of Health Sciences.
    Landtblom, Anne-Marie
    Linköping University, Department of Neuroscience and Locomotion, Neurology. Linköping University, Faculty of Health Sciences.
    Low Choline Concentrations in Normal-Appearing White Matter of Patients with Multiple Sclerosis and Normal MR Imaging Brain Scans2007In: American Journal of Neuroradiology, ISSN 0195-6108, E-ISSN 1936-959X, Vol. 28, no 7, 1306-1312 p.Article in journal (Refereed)
    Abstract [en]

    BACKGROUND AND PURPOSE: Spectroscopic studies (1H-MR spectroscopy) of normal-appearing white matter (NAWM) in patients with multiple sclerosis (MS) with MR imaging brain lesions have already been performed, but our intention was to investigate NAWM in MS patients who lack brain lesions to elucidate whether the same pathologic changes could be identified.

    MATERIALS AND METHODS: We checked 350 medical files of patients with MS who are registered in our institution. Fourteen patients (11 women and 3 men; mean age, 48.6 years; handicap score, Expanded Disability Status Scale [EDSS] 2.9; range, 1–6.5) with clinically definite MS and a normal MR imaging of the brain were included. 1H-MR spectroscopy was performed in 4 voxels (size approximately 17 × 17 × 17 mm3) using absolute quantification of metabolite concentrations. Fourteen healthy control subjects (11 women and 3 men; mean age, 43.3 years) were analyzed in the same way.

    RESULTS: Significant differences in absolute metabolite concentrations were observed, with the patients with MS showing a lower total concentration of N-acetyl compounds (tNA), including N-acetylaspartate and N-acetyl aspartylglutamate (13.5 mmol/L versus 14.6 mmol/L; P = .002) compared with the healthy control subjects. Unexpectedly, patients with MS presented significantly lower choline-containing compounds (Cho) compared with healthy control subjects (2.2 mmol/L versus 2.4 mmol/L; P < .001). The EDSS showed a positive correlation to myo-inositol concentrations (0.14 mmol/L per EDSS; r2 = 0.06) and a negative correlation to tNA concentrations (−0.41 mmol/L per EDSS; r2 = 0.22).

    CONCLUSION: The unexpected finding of lower Cho concentrations has not been reported previously. We suggest that patients with MS who lack lesions in the brain constitute a separate entity and may have increased protective or healing abilities.

  • 27. Hol, P K
    et al.
    Kvarstein, G
    Viken, O
    Smedby, Örjan
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Radiology. Östergötlands Läns Landsting, Centre for Medical Imaging, Department of Radiology UHL.
    Toennessen, T I
    MRI-guided celiac plexus block2000In: Magnetic Resonance Imaging, ISSN 0730-725X, E-ISSN 1873-5894, Vol. 12, 562-564 p.Article in journal (Refereed)
  • 28. Hol, P
    et al.
    Smedby, Örjan
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Radiology. Östergötlands Läns Landsting, Centre for Medical Imaging, Department of Radiology UHL.
    Tillung, T
    Kvarstein, G
    Viken, O
    Tönnesen, T
    MRI guided coeliac plexus block. 3rd interventional MRI symposium2000In: European radiology,2000, 2000Conference paper (Refereed)
  • 29.
    Holst, Holger
    et al.
    Lund.
    Måre, Klas
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Radiology. Östergötlands Läns Landsting, Centre for Medical Imaging, Department of Radiology UHL.
    Järund, Andreas
    Lund.
    Åström, Karl
    Lund.
    Evanader, Eva
    Lund.
    Tägil, Kristina
    Lund.
    Ohlsson, Mattias
    Lund.
    Edenbrandt, Lars
    Lund.
    An independent evaluation of a new method for automated interpretaion of lung scintigrams using artificial neural networks.2001In: European Journal of Nuclear Medicine, ISSN 0340-6997, E-ISSN 1432-105X, Vol. 28, 33-38 p.Article in journal (Refereed)
  • 30. Hänni, M
    et al.
    Edvardsson, H
    Pettersson, K
    Smedby, Örjan
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Radiology. Östergötlands Läns Landsting, Centre for Medical Imaging, Department of Radiology UHL.
    Quantification of atherosclerosis with MRI and image processing in animal models2001In: European Radiology,2001, 2001, 152-153 p.Conference paper (Refereed)
  • 31. Hänni, M
    et al.
    Lekka-Banos, I
    Nilsson, S
    Häggroth, L
    Smedby, Örjan
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Radiology. Östergötlands Läns Landsting, Centre for Medical Imaging, Department of Radiology UHL.
    Quantitation of atherosclerosis with magnetic resonance imaging in 3-D morphology operators.1999In: Magnetic Resonance Imaging, ISSN 0730-725X, E-ISSN 1873-5894, Vol. 17, 585-591 p.Article in journal (Refereed)
  • 32.
    Håkansson, E
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Anaesthesiology. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
    Håkansson, E
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Anaesthesiology. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
    Konstantinov, I
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Thoracic Surgery. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
    Fransson, Sven Göran
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Radiology. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Svedjeholm, Rolf
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Thoracic Surgery. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
    Management of life-threatening haemoptysis2002In: British Journal of Anaesthesia, ISSN 0007-0912, E-ISSN 1471-6771, Vol. 88, 291-295 p.Article in journal (Refereed)
    Abstract [en]

    Massive haemoptysis represents a major medical emergency that is associated with a high mortality. Here we present two cases of life-threatening haemoptysis, the first caused by rupture of an aortic aneurysm into the lung in a 37-yr-old woman with polyarteritis nodosa and the second caused by massive bleeding from an angiectatic vascular malformation in the right main bronchus in a 21-yr-old woman. Fibreoptic bronchoscopy played an essential role in the diagnostic process and management of the respiratory tract. Diagnosis in the first case was obtained by CT scan and the aneurysm was treated surgically. In the second case, bronchial arteriography contributed to both definitive diagnosis and treatment. Initial cardiorespiratory management, diagnostic procedures and definitive therapy are described and reviewed. Adequate early management of the cardiorespiratory system is essential to the outcome. Aggressive measures to elucidate the cause of haemoptysis and prompt therapy are warranted because of the high risk of recurrence.

  • 33.
    Håkansson, Erik
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Anaesthesiology. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
    Konstatinov, I
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Thoracic Surgery. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
    Fransson, Sven Göran
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Radiology. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Svedjeholm, Rolf
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Thoracic Surgery. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
    Invited reply to dr Savage on management of life-thretening haemotysis2002In: British Journal of Anaesthesia, ISSN 0007-0912, E-ISSN 1471-6771, Vol. 89, 185-186 p.Article in journal (Other (popular science, discussion, etc.))
  • 34. Johansson, B
    et al.
    Allared, M
    Borgencrantz, B
    Brorson, L
    Geijer, H
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Radiology.
    Kellerth, T
    Olsson, H
    Ragnarsson, A
    Skoglund, H
    Wennerblom, B
    Standardized, Angiographically-Guided "Over-Dilatation" of Stents Using High-Pressure Technique Optimizes Results Without Increasing Risks: An Intravascular Ultrasound Study2002In: The Journal of invasive cardiology, ISSN 1042-3931, E-ISSN 1557-2501, Vol. 14, 221-226 p.Article in journal (Refereed)
  • 35.
    Järemo, P
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Cardiology. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Lindahl, Tomas
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Clinical Chemistry.
    Fransson, Sven Göran
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Radiology. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Richter, Arina
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Cardiology. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Substantial individual differences of platelet inhibition after clopedogrel loading doses.2001In: Proccedings of the 4th Int'l Congr on Coronary Artery Disease, Prague 2001,2001, 2001, 587-590 p.Conference paper (Refereed)
  • 36.
    Järemo, Petter
    et al.
    Linköping University, Department of Medicine and Care, Cardiology. Linköping University, Faculty of Health Sciences.
    Lindahl, Tomas
    Linköping University, Department of Biomedicine and Surgery, Clinical Chemistry. Linköping University, Faculty of Health Sciences.
    Fransson, Sven Göran
    Linköping University, Department of Medicine and Care, Radiology. Linköping University, Faculty of Health Sciences.
    Richter, Arina
    Linköping University, Department of Medicine and Care, Cardiology. Linköping University, Faculty of Health Sciences.
    Individual variations of platelet inhibition after loading doses of clopidogrel2002In: Journal of Internal Medicine, ISSN 0954-6820, E-ISSN 1365-2796, Vol. 252, no 3, 233-238 p.Article in journal (Refereed)
    Abstract [en]

    Objective.  To investigate individual variations of platelet inhibition after clopidogrel-loading doses.

    Setting.  Department of Cardiology, Linköping University Hospital, Linköping, Sweden.

    Subjects.  Individuals with stable angina pectoris (n = 18) subject to percutaneous coronary interventions (PCI) and subsequent stenting were investigated.

    Methods and experimental protocol.  A 300-mg clopidogrel loading dose was administrated immediately after stenting (day 1) followed by an additional 75 mg clopidogrel after 24 h (day 2). The ADP-evoked platelet fibrinogen binding was analysed to estimate platelet reactivity immediately before angiography and on day 2. A flow cytometry technique was used with two ADP solutions (final concentrations 0.6 and 1.7 μmol L−1) employed as platelet activating agents. Soluble P-selectin was used as a marker of platelet activity.

    Results.  When using 1.7 μmol L−1 ADP to activate platelets four individuals had a strong inhibition (i.e. platelet reactivity <10% of the day 1-value day 2). In contrast, five patients demonstrated a weak inhibition (i.e. platelet reactivity >60% of the day 1-value day 2). Similar results were obtained when using 0.6 μmol L−1 ADP as a platelet-activating agent. Clopidogrel, however, fails to suppress platelet activity as estimated from soluble P-selectin.

    Conclusions.  Clopidogrel evoked platelet inhibition exhibits a considerable individual heterogeneity. Some individuals only had weak responses whereas others displayed strong platelet inhibition. The present flow cytometry technique appears suitable for identifying patients with abnormal reactions after clopidogrel exposure.

  • 37.
    Klaastad, O
    et al.
    Oslo.
    VadeBoncouer, TR
    Chicago.
    Tillung, T
    Oslo.
    Smedby, Örjan
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Radiology. Östergötlands Läns Landsting, Centre for Medical Imaging, Department of Radiology UHL. Linköping University, Center for Medical Image Science and Visualization, CMIV.
    An evaluation of the supraclavicular plumb-bob technique for brachial plexus block by magnetic resonance imaging2003In: Anesthesia and Analgesia, ISSN 0003-2999, E-ISSN 1526-7598, Vol. 96, no 3, 862-867 p.Article in journal (Refereed)
    Abstract [en]

    Partly based on magnetic resonance imaging studies, the "plumb-bob" approach for brachial plexus block was designed to minimize the risk of pneumothorax. Nevertheless, the risk of pneumothorax has remained a concern. We analyzed magnetic resonance images from 10 volunteers to determine whether the risk of pneumothorax was decreased with this method. The recommended initial needle direction is anteroposterior through the junction between the lateral-most part of the sternocleidomastoid muscle and the superior edge of the clavicle. If the initial placement is not successful, the brachial plexus may be sought in sectors 20░-30░ cephalad or caudad to the anteroposterior line in a sagittal plane through the insertion point. We found that the anteroposterior line reached the pleura in 6 of 10 volunteers without prior contact with the subclavian artery or the brachial plexus, but always with contact with the subclavian vein. To reach the middle of the brachial plexus, a mean cephalad redirection of the simulated needle by 21░ was required (range from 41░ cephalad to 15░ caudad in one case). We conclude that the risk of contacting the pleura and the subclavian vessels may be reduced by initially directing the needle 45░ cephalad instead of anteroposterior. If the brachial plexus is not contacted, the angle should be gradually reduced.

  • 38.
    Klaastad, Ö
    et al.
    Oslo.
    Smedby, Örjan
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Radiology. Östergötlands Läns Landsting, Centre for Medical Imaging, Department of Radiology UHL.
    Thompson, G E
    Oslo.
    Tillung, T
    Oslo.
    Hol, P K
    Oslo.
    Rötnes, J S
    Oslo.
    Brodal, P K
    Oslo.
    Breivik, H
    Oslo.
    Hetland, K R
    Oslo.
    Fosse, E T
    Oslo.
    Distribution of local anesthetic in axillary brachial plexus block: A clinical and magnetic resonance imaging study2002In: Anesthesiology, ISSN 0003-3022, E-ISSN 1528-1175, Vol. 96, no 6, 1315-1324 p.Article in journal (Refereed)
    Abstract [en]

    Background: There is an unsettled discussion about whether the distribution of local anesthetic is free or inhibited when performing brachial plexus blocks. This is the first study to use magnetic resonance imaging (MRI) to help answer this question. Methods: Thirteen patients received axillary block by a catheter-nerve stimulator technique. After locating the median nerve, a total dose of 50 ml local anesthetic was injected via the catheter in four divided doses of 1, 4, 15, and 30 ml. Results of sensory and motor testing were compared with the spread of local anesthetic as seen by MRI scans taken after each dose. The distribution of local anesthetic was described with reference to a 20-mm diameter circle around the artery. Results: Thirty minutes after the last dose, only two patients demonstrated analgesia or anesthesia in the areas of the radial, median, and ulnar nerve. At that time, eight of the patients had incomplete spread of local anesthetic around the artery, as seen by MRI. Their blocks were significantly poorer than those of the five patients with complete filling of the circle, although incomplete blocks were also present in the latter group. Conclusion: This study demonstrated that MRI is useful in examining local anesthetic distribution in axillary blocks because it can show the correlation between MRI distribution pattern and clinical effect. The cross-sectional spread of fluid around the brachial-axillary artery was often incomplete-inhibited, and the clinical effect often inadequate.

  • 39.
    Klaastad, Öivind
    et al.
    Olso.
    Smedby, Örjan
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Radiology. Östergötlands Läns Landsting, Centre for Medical Imaging, Department of Radiology UHL.
    The supraclavicular lateral paravascular approach for brachial plexus regional anesthesia: A simulation study using magnetic resonance imaging2001In: Anesthesia and Analgesia, ISSN 0003-2999, E-ISSN 1526-7598, Vol. 93, no 2, 442-446 p.Article in journal (Refereed)
    Abstract [en]

    In the supraclavicular lateral paravascular approach for brachial plexus regional anesthesia by Moorthy et al. (Moorthy's block), the patient is supine with the ipsilateral shoulder displaced anteriorly 5-8 cm. The needle direction is precisely defined in the coronal plane (using a Doppler flowprobe) but not in the sagittal plane. We sought to determine whether the block could be simplified by keeping the shoulder in a neutral position, if the needle direction in the sagittal plane could be more precisely described, and if the risk of pneumothorax appeared acceptably small. These questions were studied by magnetic resonance imaging in 10 volunteers. Volume datasets of the periclavicular region allowed precise positioning of simulated needles. In all volunteers, Moorthy's block could be performed with the shoulder in a neutral position. The optimal needle trajectory passed 5 mm posterior to the clavicle and was 25░ posterior to the coronal plane, never approaching the pleura closer than 18 mm. We conclude that Moorthy's block can be performed with the shoulder in a neutral position, that more precise instructions for the needle direction can be given, and that the risk of pneumothorax seems minimal. This should be confirmed by a clinical study.

  • 40.
    Kovacsovics, Bea
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Radiology. Östergötlands Läns Landsting, Centre for Medical Imaging, Department of Radiology UHL.
    Davidsson, L
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Radiology. Östergötlands Läns Landsting, Centre for Medical Imaging, Department of Radiology UHL.
    Harder, H
    Östergötlands Läns Landsting, RC - Rekonstruktionscentrum, ÖNH - Öron- Näsa- Halskliniken.
    Magnusson, Bengt
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Oto-Rhiono-Laryngology and Head & Neck Surgery. Östergötlands Läns Landsting, RC - Rekonstruktionscentrum, ÖNH - Öron- Näsa- Halskliniken.
    Ledin, Torbjörn
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Oto-Rhiono-Laryngology and Head & Neck Surgery. Östergötlands Läns Landsting, RC - Rekonstruktionscentrum, ÖNH - Öron- Näsa- Halskliniken.
    Three-dimensional fast spin echo T2 weighted MR imagaes of the cerebellopontine angle and inner ear.2002In: Neurootol Newslett, ISSN 1023-6422, Vol. 6, 33-36 p.Article in journal (Refereed)
  • 41.
    Kovacsovics, Bea
    et al.
    Linköping University, Department of Medicine and Health Sciences. Linköping University, Faculty of Health Sciences.
    Davidsson, L
    Linköping University, Department of Medicine and Care, Radiology. Linköping University, Faculty of Health Sciences.
    Harder, Henrik
    Linköping University, Department of Clinical and Experimental Medicine, Oto-Rhiono-Laryngology and Head & Neck Surgery . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Reconstruction Centre, Department of ENT - Head and Neck Surgery UHL.
    Magnuson, Bengt
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Ledin, Torbjörn
    Linköping University, Department of Clinical and Experimental Medicine, Oto-Rhiono-Laryngology and Head & Neck Surgery . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Reconstruction Centre, Department of ENT - Head and Neck Surgery UHL.
    MRI screening of the cerebellopontine angle and inner ear with fast spin-echo T2 technique2000In: Archives Italiennes de Biologie, ISSN 0003-9829, Vol. 138, no 1, 87-92 p.Article in journal (Refereed)
    Abstract [en]

    In patients with unilateral hearing loss and dizziness it is important to rule out a cerebellopontine angle process. This is often done by audiological and otoneurological investigations. However, in many cases we must rely on the imaging of the temporal bone and the cerebello-brainstem area. The paper has presented the three dimensional (3D) Fast Spin-Echo (FSE) T2 weighted, 0.7 mm thick MR images, which in addition to being quick, does not require the use of expensive contrast material. Between September 1996 and November 1997, 152 patients with unilateral hearing loss and/or balance disorders were investigated. In normal cases the 7th and 8th nerves could be followed accurately from the brainstem to the internal auditory meatus. The found tumors were hypointense compared to the cerebrospinal fluid and could be outlined with reasonable accuracy even without gadolinium contrast. The inner ear had high signal, like cerebrospinal fluid. The patency of the cochlea could be estimated accurately. Thus, 3D FSE T2 weighted images can reliably differentiate between patients with and without pathologies of the cerebellopontine angle. The use of gadolinium contrast could be avoided in most of the cases, but contrast is necessary for differential diagnostic purposes in patients with alterations in the cerebellopontine angle or in doubtful cases.

  • 42.
    Kovacsovics, Bea
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Radiology. Östergötlands Läns Landsting, Centre for Medical Imaging, Department of Radiology UHL.
    Davidsson, L
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Radiology. Östergötlands Läns Landsting, Centre for Medical Imaging, Department of Radiology UHL.
    Harder, Lena
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Oto-Rhiono-Laryngology and Head & Neck Surgery. Östergötlands Läns Landsting, RC - Rekonstruktionscentrum, ÖNH - Öron- Näsa- Halskliniken.
    Magnusson, Bengt
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Oto-Rhiono-Laryngology and Head & Neck Surgery. Östergötlands Läns Landsting, RC - Rekonstruktionscentrum, ÖNH - Öron- Näsa- Halskliniken.
    Ledin, Torbjörn
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Oto-Rhiono-Laryngology and Head & Neck Surgery. Östergötlands Läns Landsting, RC - Rekonstruktionscentrum, ÖNH - Öron- Näsa- Halskliniken.
    MRI screening of the cerebellopontine angel and inner ear with fast spin echo T" technique.2000In: Archives Italiennes de Biologie, ISSN 0003-9829, Vol. 138, 87-92 p.Article in journal (Refereed)
  • 43.
    Kovacsovics, Bea
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Radiology. Östergötlands Läns Landsting, Centre for Medical Imaging, Department of Radiology UHL.
    Schulin, M
    Östergötlands Läns Landsting, RC - Rekonstruktionscentrum, ÖNH - Öron- Näsa- Halskliniken.
    Rask-Andersen, H
    Ledin, Torbjörn
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Oto-Rhiono-Laryngology and Head & Neck Surgery. Östergötlands Läns Landsting, RC - Rekonstruktionscentrum, ÖNH - Öron- Näsa- Halskliniken.
    Large vestibular aqueduct syndrome2001In: Neuroradiology,2001, 2001, 81-81 p.Conference paper (Refereed)
  • 44.
    Kovasovics, Bea
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Radiology. Östergötlands Läns Landsting, Centre for Medical Imaging, Department of Radiology UHL.
    CT eller MR för att kartlägga maligna bihåletumörer?1999In: Svensk ÖNH tidskrift, ISSN 1400-0121, Vol. 1Article in journal (Other (popular science, discussion, etc.))
  • 45.
    Kovasovics, Bea
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Radiology. Östergötlands Läns Landsting, Centre for Medical Imaging, Department of Radiology UHL.
    Davidsson, L
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Radiology. Östergötlands Läns Landsting, Centre for Medical Imaging, Department of Radiology UHL.
    Harder, Henrik
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Oto-Rhiono-Laryngology and Head & Neck Surgery.
    Magnusson, B
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Oto-Rhiono-Laryngology and Head & Neck Surgery.
    Ledin, Torbjörn
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Oto-Rhiono-Laryngology and Head & Neck Surgery.
    Three-dimensional fast spin echo T2 weighted MR images of the cerebellopontine angle and inner ear.2003In: Neurootology Newsletter,2003, 2003, 33-36 p.Conference paper (Refereed)
  • 46.
    Kovasovics, Bea
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Radiology. Östergötlands Läns Landsting, Centre for Medical Imaging, Department of Radiology UHL.
    Harder, Henrik
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Oto-Rhiono-Laryngology and Head & Neck Surgery. Östergötlands Läns Landsting, RC - Rekonstruktionscentrum, ÖNH - Öron- Näsa- Halskliniken.
    Magnusson, B
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Oto-Rhiono-Laryngology and Head & Neck Surgery. Östergötlands Läns Landsting, RC - Rekonstruktionscentrum, ÖNH - Öron- Näsa- Halskliniken.
    Ledin, Torbjörn
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Oto-Rhiono-Laryngology and Head & Neck Surgery. Östergötlands Läns Landsting, RC - Rekonstruktionscentrum, ÖNH - Öron- Näsa- Halskliniken.
    Tillväxtmått hos akustikusneurinom2000In: Svensk ÖNH tidskrift, ISSN 1400-0121, Vol. 1, 17-18 p.Article in journal (Other (popular science, discussion, etc.))
  • 47.
    Kähäri, Anders
    Linköping University, Department of Medicine and Care, Radiology. Linköping University, Faculty of Health Sciences.
    Usefulness of coronary angiography for assessing left ventricular function2003Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    This thesis focus on the physiological information, on left ventricular (LV) motion in the long axis, evaluated in routine coronaty angiography sequences and based on previous knowledge from echocardiographic studies. As coronary angiography has become a very frequent examination, a method for assessment of LV function from routine coronary angiograms would probably have a significant impact on clinical work. Therefore, the motion of the left coronary artery is analysed in the studies described below.

    In a pilot study of 84 patients, refetTed for coronaty and LV angiography, the systolic descent of the left coronary ostium (LCO) towards apex was measured. This simple manual measure from routine coronary angiograms showed a mean amplitude of 9.6 mm (range 3.0-15.0) and significant linear correlation to ejection fraction (EF) (r = 0.72, SEE = 10.1, p < 0.001).

    In the second study, including 28 patients, coronary angiography and echoeardiography was used for measurement of circumflex artery motion (CAM) and mitral annulus motion (MAM) respectively. CAM amplitude tended to be higher than MAM in the higher range of amplitudes while the opposite was found in the lower range of amplitudes.

    In a eehocardiographic study of another 26 patients; it was found in 13 patients with normal EF that the motion amplitude of a site epicardially at the most basal lateral patt of the LV wall was significantly (p < 0.001) higher than endoeardially, but in 13 patients with decreased EF (< 50%) there was no significant difference between the two sites. The motion amplitude epicardially corresponds to the motion amplitude of the circumflex artery.

    In the 13 patients with normal EF the motion amplitude of the closed mitral valves was significantly lower than the motion amplitude epi- and endocardially during systole, with a rather conic shape of the atrioventricular plane (AVP) at the onset of systole. In end-systole the different parts of the left AVP, the epicardial part (circumflex artery), the endocardial part (mitral annulus) and the valves were almost on the same level.

    In the third study, including 73 patients referred for coronary and LV angiography, the systolic descent of LCO and of the circumflex artery towards apex was measured manually. The mean motion amplitude of LCO (9.1 mm, range 1.7-19.7) was significantly (p < 0.001) lower than the mean motion amplitude of CAM measured from the proximal part of the artery (14.3mm, range 3.0-25.0) or from the distal part of the artery (14.4 mm, range 1.2-26.6). There was no significant difference between the amplitudes at these two sites of the circumflex artery.

    It was found that the ratio between CAM and the end-diastolic length of the ventricle, which can be denominated fractional shortening in the long axis (FSL), was a better index of LV systolic function than CAM amplitude per se. There was a significant linear correlation between EF obtained by LV angiography and FSL (r = 0.81, SEE = 8.2, p < 0.001).

    A power regression model had the best correlation between EF and FSL. In this model the correlation between EF and FSL can be described by the equation EF(%) = 19.2 x FSL(%)0.45 (R = 0.86, SEE = 0.14, p < 0.001). When values of FSL ≥ 10% were selected to define a normal EF (≥ 50%) there was a sensitivity of 95% and a specificity of 93%.

    Visual estimation of EF from assessment of CAM was not as good as the use of calculated FSL but may be useful as fast screening method when classifying normal or impaired LV function.

    In the fourth study, including 72 patients from the previous third study, who were referred for coronary and LV angiography, the systolic and diastolic parameters of CAM were measured by M-mode from coronary angiography. There were no significant difference between M-mode measures of CAM amplitude and calculated FSL compared to the manually measured CAM amplitude and calculated FSL.

    The mean maximal systolic velocity of CAM was 70.1 mm/s (SD 21.8, range 17.6-139.0). When values ≥ 54 mm/s, a limit previously reported from an echocardiographic study (tissue Doppler of MAM), were selected to define a normal EF (≥ 50%) the sensitivity was 84.6% and specificity 94.6%.

    A subgroup of 23 patients (17 had EF ≥ 50%) were examined by echocardiographic M-mode of MAM, within 24 h before the angiographic examination, for comparison of amplitudes and velocities measured by angiographic M-mode of CAM.

    The total amplitude of CAM was significantly higher (p < 0.001) higher than the amplitude of MAM and so was the amplitude due to atrial contraction (p < 0.001).

    The maximal systolic velocity of CAM was significantly (p < 0.001) higher than the corresponding velocity of MAM. The early maximal diastolic velocity of CAM was also significantly higher (p < 0.05) than the corresponding velocity of MAM. There was no significant difference between the late maximal diastolic velocity of CAM and the late diastolic velocity of MAM.

    In summary, the systolic and diastolic phases of CAM, and thereby also the systolic and diastolic LV function, are well monitored by the angiographic M-mode method. The systolic indices arc CAM amplitude, FSL and maximal systolic velocity of CAM. The diastolic indices are maximal early diastolic velocity of CAM and the amplitude due to atrial contraction.

    The amplitudes and velocities of CAM are higher than the corresponding values for MAM in patients with normal EF. Therefore it is obvious that reference values of MAM and CAM amplitudes and velocities cannot be used interchangeably.

    List of papers
    1. Usefulness of coronary angiography for assessing left ventricular function
    Open this publication in new window or tab >>Usefulness of coronary angiography for assessing left ventricular function
    Show others...
    1998 (English)In: Journal of the American College of Cardiology, ISSN 0735-1097, E-ISSN 1558-3597, Vol. 82, no 3, 384-386 p.Article in journal (Refereed) Published
    Abstract [en]

    No abstract available.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-84319 (URN)10.1016/S0002-9149(98)00326-9 (DOI)
    Available from: 2012-10-04 Created: 2012-10-04 Last updated: 2017-12-07Bibliographically approved
    2. Comparison between circumflex artery motion and mitral annulus motion
    Open this publication in new window or tab >>Comparison between circumflex artery motion and mitral annulus motion
    2001 (English)In: Scandinavian Cardiovascular Journal, ISSN 1401-7431, E-ISSN 1651-2006, Vol. 35, no 5, 318-325 p.Article in journal (Refereed) Published
    Abstract [en]

    OBJECTIVE:

    To compare mitral annulus motion (MAM) with circumflex artery motion (CXM) and the motion amplitude at an endocardial site (representing MAM) with an epicardial site (representing CXM) at the most basal lateral part of the atrioventricular plane (AVP).

    DESIGN:

    MAM and CXM were obtained in 28 patients examined by echocardiography and coronary angiography. The motion amplitude epicardially and endocardially was recorded by echocardiography in 13 patients with normal ejection fraction (EF) (> or = 0.50) and in 13 patients with decreased EF (<0.50).

    RESULTS:

    CXM was higher than MAM in most patients with normal EF but lower than MAM in most patients with decreased EF. The motion amplitude epicardially was significantly higher (p < 0.001) than endocardially in patients with normal EF. while there was no significant difference in patients with decreased EF.

    CONCLUSION:

    CXM represents the motion of the epicardial part of the AVP and differs from MAM, which represents the endocardial part of the wall. This must be considered when CXM is used for assessment of left ventricular systolic function.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-26983 (URN)10.1080/140174301317116299 (DOI)11618 (Local ID)11618 (Archive number)11618 (OAI)
    Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2017-12-13Bibliographically approved
    3. Circumflex artery motion: a new angiographic method for assessment of left ventricular function
    Open this publication in new window or tab >>Circumflex artery motion: a new angiographic method for assessment of left ventricular function
    Show others...
    2003 (English)In: Scandinavian Cardiovascular Journal, ISSN 1401-7431, E-ISSN 1651-2006, Vol. 37, no 2, 80-86 p.Article in journal (Refereed) Published
    Abstract [en]

    OBJECTIVE: To evaluate the usefulness of circumflex artery motion (CAM) for assessment of left ventricular (LV) function.

    DESIGN: Seventy-three consecutive patients referred for coronary angiography and LV angiography were included. Ejection fraction (EF) was calculated from LV angiography and CAM was measured from coronary angiography.

    RESULTS: The ratio between CAM and the end-diastolic length of the ventricle, which can be denominated long-axis fractional shortening (FS(L)), was found to be a better index of LV function than CAM per se. There was a significant linear correlation between EF and FS(L) (r = 0.81, SEE = 8.2, p < 0.001). When values of FS(L) > or =10% were selected to define a normal EF (> or =50%) there was a sensitivity of 95% and a specificity of 93%. Visual estimation of EF from CAM was not as good as the use of calculated FS(L) but may me useful as a fast screening method.

    CONCLUSION: LV systolic function can be assessed by studying CAM recorded by coronary angiography.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-26781 (URN)12775306 (PubMedID)11386 (Local ID)11386 (Archive number)11386 (OAI)
    Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2017-12-13Bibliographically approved
    4. Assessment of left ventricular function from M‐mode measurement of circumflex artery motion recorded by coronary angiography
    Open this publication in new window or tab >>Assessment of left ventricular function from M‐mode measurement of circumflex artery motion recorded by coronary angiography
    Show others...
    2003 (English)In: Scandinavian Cardiovascular Journal, ISSN 1401-7431, E-ISSN 1651-2006, Vol. 37, no 5, 259-265 p.Article in journal (Refereed) Published
    Abstract [en]

    Objective—To evaluate the usefulness of M‐mode measurement of circumflex artery motion (CAM) for assessment of left ventricular (LV) function.

    Design—Seventy‐two patients referred for coronary angiography and LV angiography were included. Ejection fraction (EF) was calculated from LV angiography and systolic and diastolic parameters of CAM were measured by M‐mode from coronary angiography. Twenty‐three patients, examined by echocardiography of mitral annulus motion (MAM) within 24 h before the angiographic examination, formed a subgroup for comparison between angiographic M‐mode of CAM and echocardiographic M‐mode of MAM.

    Results—In addition to previous reported CAM amplitude and longitudinal fractional shortening (FS L ) the maximal systolic velocity of CAM can be reliably recorded by M‐mode. The diastolic indices, atrial contribution to the total amplitude and maximal early and late diastolic velocities, are also well monitored by M‐mode of CAM in comparison with echocardiographic MAM.

    Conclusion—LV systolic and diastolic function can be assessed by M‐mode of CAM.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-26782 (URN)10.1080/14017430310001708 (DOI)11387 (Local ID)11387 (Archive number)11387 (OAI)
    Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2017-12-13Bibliographically approved
  • 48.
    Kähäri, Anders
    et al.
    Linköping University, Department of Medicine and Care, Radiology. Linköping University, Faculty of Health Sciences.
    Andersson, Torbjörn
    Linköping University, Department of Medicine and Care, Radiology. Linköping University, Faculty of Health Sciences.
    Danielewicz, Mikael
    Örebro.
    Emilsson, Kent
    Örebro.
    Wandt, Birger
    Göteborg.
    Circumflexrörelsen: en ny angiografisk metod för bedömning av vänsterkammarfunktionen2002In: Svenska Läkaresällskapets Handlingar,2002, 2002, 228-228 p.Conference paper (Refereed)
  • 49.
    Landtblom, Anne-Marie
    et al.
    Linköping University, Department of Neuroscience and Locomotion, Neurology. Linköping University, Faculty of Health Sciences.
    Boivie, Jörgen
    Linköping University, Department of Neuroscience and Locomotion, Neurology. Linköping University, Faculty of Health Sciences.
    Fridriksson, Steen
    Linköping University, Department of Neuroscience and Locomotion, Neurosurgery. Linköping University, Faculty of Health Sciences.
    Hillman, Jan
    Linköping University, Department of Neuroscience and Locomotion, Neurosurgery. Linköping University, Faculty of Health Sciences.
    Johansson, Gunn
    Linköping University, Department of Neuroscience and Locomotion, Neurology. Linköping University, Faculty of Health Sciences.
    Johansson, Ingegerd
    Linköping University, Department of Medicine and Care, Radiology. Linköping University, Faculty of Health Sciences.
    Åskknallshuvudvärk: oftast ett godartat tillstånd2006In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 103, no 37, 2632-2637 p.Article in journal (Refereed)
    Abstract [en]

    We have performed a study of 137 consecutive patients with thunderclap headache (TCH), showing that a large majority of the patients do not have a subarachnoidal haemorrhage (SAH). It is concluded that 11% of all TCH is caused by SAH and that history and findings in the clinical neurological examination cannot discriminate safely between an SAH and a more benign cause. All patients should be investigated with a CT scan and an analyses of the cerebrospinal fluid to exclude a SAH if the CT scan did not show an SAH. The 10-year follow-up showed that none of the patients with TH without SAH had a cerebral haemorrhage of any kind. Pathological results on CT and CSF examinations were found in 14 of the patients with non-SAH TCH, including five with cerebral infarction, three with intracerebral haemorrhage, four with aseptic meningitis and one with venous sinus thrombosis.

  • 50.
    Landtblom, Anne-Marie
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Neurology.
    Dige, N
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Neurology.
    Schwerdt, K
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Neurology.
    Säfström, Kåge
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Radiology. Östergötlands Läns Landsting, Centre for Medical Imaging, Department of Radiology UHL.
    Granerus, Göran
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Clinical Physiology. Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology.
    A case of Kleine-Levin syndrome examined with SPECT and neuropsychological testing2002In: Acta Neurologica Scandinavica, ISSN 0001-6314, E-ISSN 1600-0404, Vol. 105, no 4, 318-321 p.Article in journal (Refereed)
    Abstract [en]

    A case of Kleine-Levin syndrome with typical periodic hypersomnia and bulemia was diagnosed. On examination with single photo emission tomography (SPECT) (CERETEC«) during a relapse period and 2 weeks later there was marked cortical hypoperfusion of the frontal and temporal lobes, especially on the left side as well as in the right parietal lobe. Neuropsychological testing performed 1 week after a relapse showed a reduction in encoding to memory function of verbal learning indicating neocortical damage of the left fronto-temporal region. A follow-up 2 months later after the patient had spontaneously recovered showed only a slight left fronto-temporal disturbance. CT and MRI of the brain were normal although the MRI showed a large and asymmetric mamillary body. Neuropsychological testing 6 years after recovery showed pronounced reduction in short-time verbal and visual memory. Seven years after recovery SPECT demonstrated a normalized frontal perfusion but still a slight hypoperfusion in the left temporal lobe. Our results correlate to autopsy findings in two cases described previously.

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