MR first pass perfusion of benign and malignant cardiac tumours-significant differences and diagnostic accuracy.

OBJECTIVES: To determine the diagnostic value of magnetic resonance (MR) first pass perfusion in the differentiation of benign and malignant cardiac tumours. METHODS: 24 patients with cardiac tumours (11 malignant, histopathological correlation present in all cases) were examined using MRI. In addition to morphological sequences a saturation-recovery T1w-GRE technique was implemented for tumour perfusion. The maximum relative signal enhancement (RSE[%]) and the slope of the RSE(t)-curve (slopeRSE[%/s]) of tumour tissue were assessed. A t-test was used to identify significant differences between benign and malignant tumours. Sensitivities and specificities were calculated for detection of malignant lesions and were compared with the sensitivity and specificity based on solely morphological image assessment. RESULTS: The RSE and slopeRSE of malignant cardiac tumours were significantly higher compared with benign lesions (p < 0.001 and p < 0.001). The calculated sensitivities and specificities of RSE and slopeRSE for identification of malignant lesions were 100% and 84.6% and 100% and 92.3%, respectively with cut-off values of 80% and 6%/s. The sensitivity and specificity for identification of malignant lesions on the basis of morphological imaging alone were 90.9% and 69.2%. CONCLUSIONS: With first pass perfusion, malignant cardiac masses can be identified with higher sensitivity and specificity compared with morphological image assessment alone.

[Cardiac functional analysis with MRI]. / Kardiale Funktionsanalyse mittels MRT.

Cardiovascular diseases (CVD) are among the leading causes of death worldwide. Even in the 21(st) century CVD will still be the most frequent cause of morbidity and mortality. Precise evaluation of cardiac function is therefore mandatory for therapy planning and monitoring. In this article the contribution of MRI-based analysis of cardiac function will be addressed. Nowadays cine-MRI is considered as the standard of reference (SOR) in cardiac functional analysis. ECG-triggered steady-state free precession (SSFP) sequences are mainly used as they stand out due to short acquisition times and excellent contrast between the myocardium and the ventricular cavity. An indispensible requirement for cardiac functional analysis is an exact planning of the examination and based on that the coverage of the whole ventricle in short axial slices. By means of dedicated post-processing software, manual or semi-automatic segmentation of the endocardial and epicardial contours is necessary for functional analysis. In this way end-diastolic volume (EDV), end-systolic volume (ESV) and the ejection fraction (EF) are defined and regional wall motion abnormalities (RWMA) can be detected.

[Late gadolinium enhancement in the diagnostics of ischemic heart disease: technical principles, contrast optimization and clinical application]. / Late-Gadolinium-Enhancement in der Diagnostik der koronaren Herzerkrankung : Technische Grundlagen, Kontrastoptimierung und klinische Anwendung.

BACKGROUND: The purpose of the study was to explore a "dark blood" technique and to compare it with a standard inversion recovery gradient echo (IR GRE) sequence in the visualization of myocardial infarction. PATIENTS AND METHODS: A total of 9 patients were examined with standard IR GRE and a "dark blood" sequence 15 mins after contrast medium application (0.2 mmol/kg body weight gadobenate dimeglumine). Contrast-to-noise ratios (CNR) were calculated for each sequence. RESULTS: The CNR(inf-lvc) was significantly higher in the "dark blood" technique compared to the IR GRE sequence, while the CNR(inf-myo) was significantly lower. CONCLUSIONS: Small subendocardial infarctions may be easier to detect with the "dark blood" technique. However, the standard IR GRE sequence is superior in the demarcation of infarctions in relation to the myocardium and cannot be replaced by the "dark blood" technique.

[Nicotine addiction and current therapy of smoking cessation]. / La dipendenza da nicotina e le attuali terapie antifumo.

Nicotine is defined as substance which provokes addiction because it creates both physiological and biochemical modifications in the nervous system stimulating the activity of dopaminergic neurons releasing dopamine in the areas of the brain that control pleasure. In this paper, after a short overview of neurobiological and cellular mechanisms involved in the pathway of nicotine addiction, the main therapies, used in order to provide support to smokers who decide to reduce their cigarette consumption or to quit smoking, are examined. These therapies can be enclosed in the following categories: nicotine replacement therapy (NRT), non-nicotine pharmacological therapy (NNPT), psychological-behavioural therapies (PBT), alternative therapies (AT). In this work the advantages and disadvantages of various therapies are analysed, assessing the criteria found in literature. Results from randomised and controlled clinical studies which examine some of these therapies, alone or in association, also related to relapse time are reported. In conclusion, results of this analysis confirm that, as well as therapies and their treatment time, psychological support and personal motivation are indispensable for successful smoking cessation.

Changes in copper, lead and zinc concentrations in plants from paper mill sludge-treated soils.

Effects of paper mill sludge addition on the availability of metals were studied on different soils both laboratory and naturally polluted; copper, lead and zinc concentrations were determined in Hordeum Distichum plants grown on the untreated and on sludge-treated soils. In some case a decrease of metal concentration is observed on sludge-treated soils; these results are consistent with the reduction of metal mobile forms in the soil, before plant growth. The decrease of metal availability in sludge-treated soils may be related with the pH value of the soil after sludge addition.