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Gastroenterology Research and Practice
Ritt [ 8 ] has abandoned the use of wrist arthrography altogether in his unit, and argues that arthroscopy is the way forward for diagnosis and treatment. His reasons for this include a low sensitivity of arthrogram and its inability to assess the quality of surrounding tissue.
Magnetic resonance imaging gained popularity because of better soft-tissue contrast and multiplanar capability. However, without intra-articular contrast, it is unreliable in diagnosing tears of the intrinsic ligaments. Hoby et al.
They concluded that MRI was unreliable without intra-articular contrast medium. Combining arthrography with MRI not only increases visualisation of the intrinsic ligaments but also makes lesions more detectable and increases the accuracy [ 10 , 11 ].
Dijke et al. Since the first description of wrist arthroscopy by Chen in [ 14 ], it has become a vital tool for surgeons. It allows direct visualisation of the wrist joint, obviating the need for open arthrotomy and thus decreases morbidity.
The exceptional view of the wrist joints interior has made it the gold standard for comparing other diagnostic techniques. However, as with all other techniques it has its limitations. It is more invasive and expensive than other techniques, it is unable to visualise all areas of the wrist and lastly, not all pathology is related to clinical findings [ 8 ].
In their study of 47 wrist arthroscopies, Westkaemper et al. They further showed a high rate of patient satisfaction, with a low rate of complications and quick recovery.
Edward et al. Tenderness was not necessarily associated with exact ligament injury. However, arthroscopy provides a precise delineation of the extent of injury can help plan surgical reconstruction as well as providing evaluation for future treatments [ 16 ].
Arthroscopy results should be interpreted with caution. Therefore, we are concerned that this work reflects a head-to-head comparison of well selected, modern MR-sites to rather ordinary SPECT labs.
This is underscored by the fact that only of SPECT investigations were gated, which, from our point of view, is an uncceptable low rate.
For example, 5 segments with fixed defects result in a summed grading of 5, whereas 5 segments with reversible defects result in a summed grading of This implies that 5 segments with reversible defects are rated 3 times more severe than 5 segments with fixed defects, which is hardly comprehensible.
A positive TID is graded 3, but keeping in mind that a positive TID is a clear index for a severe multi-vessel-disease, the arbitrary value of 3 is absolutely underscored. From our point of view a simple linear grading e. SSS 3 - like published hundred times before - would have been much more accurate and adequate.
The statistics suffer from the fact, that multiple testings were done, but the necessary correction for multiple comparisons e. Bonferroni correction was ignored.
References, 1.Any remaining distortions in structural images are affne. On the basis of our findings and similar results [ 22 ], we believe that, as an adjunct to dynamic MR imaging, hepatobiliary phase MR images can improve the characterization of most of these undetermined, diminutive lesions. Moreover, for RF ablation to be complete, the entire tumor as well as a peripheral safety margin of 0.
The macroscopic appearances of each resected tumor were analyzed, including the shape, size, number, edge, and capsule wall.
Nonlinear Registration of Longitudinal Images and Measurement of Change in Regions of Interest
Vauthey, and P. All rights reserved.
Figure 5: year-old man with an ablated HCC at segment 5—8. When acquired: a Fatty infiltration of the right ventricle, and b Occurrence of fibrosis by LGE should be provided.
Elazzazi, L. Despite the different cyst contents and distinct MRI characteristics between the cyst and solid groups, there were no significant differences in clinical features.
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