Thomas Trieb

Language Lateralization in Temporal Lobe Epilepsy: A Comparison between fMRI and the Wada Test

Summary:  Purpose: Recent studies have claimed that language functional magnetic resonance imaging (fMRI) can identify language lateralization in patients with temporal lobe epilepsy (TLE) and that fMRI‐based findings are highly concordant with the conventional assessment procedure of speech dominance, the intracarotid amobarbital test (IAT).

Voxel based morphometry reveals specific gray matter changes in primary dystonia.

The present study assessed patterns of brain tissue alterations in different types of primary dystonia using voxel‐based morphometry (VBM). Nine patients with primary generalized dystonia (GD), 11 patients with primary cervical dystonia (CD), and 11 patients with primary focal hand dystonia (FHD) as well as 31 age and gender‐matched controls were included. When compared with healthy controls, patients with primary dystonia (n = 31) showed gray matter volume increase bilaterally in the globus pallidus internus, nucleus accumbens, prefrontal cortex, as well as unilaterally in the left inferior parietal lobe. This is the first study using VBM in patients with different types of primary dystonia, showing a common pattern of gray matter changes.

Kidney fusion anomalies revisited: clinical and radiological analysis of 209 cases of crossed fused ectopia and horseshoe kidney

To analyse the morphological appearance of horseshoe kidneys (HKs) and crossed fused ectopia (CFE) and to assess the frequency and clinical significance of associated anomalies and diseases.

Dynamic T1 mapping predicts outcome of chemoradiation therapy in primary rectal carcinoma: Sequence implementation and data analysis

To describe details about the implementation of a dynamic T1‐mapping technique and a simple data analysis strategy that can be used to predict therapy outcome in primary rectal carcinoma and to investigate the physiologic meaning of the obtained parameter.

Late microvascular obstruction after acute myocardial infarction: Relation with cardiac and inflammatory markers

OBJECTIVES We sought to assess the relation of late microvascular obstruction (l-MVO) size as quantified by cardiac magnetic resonance (CMR) imaging with cardiac and inflammatory marker concentrations after acute myocardial infarction (AMI). METHODS CMR was performed in 118 consecutive patients within 8 days after successful interventional reperfused first acute ST-elevation AMI. Infarct volumes and l-MVO sizes were calculated from late enhancement (LE) sequences and functional parameters were determined from short-axis cine MR sequences. Creatine kinase (CK) and cardiac troponin T (cTnT), high-sensitivity C-reactive protein (hs-CRP) as well as lactate dehydrogenase (LD) concentrations were determined serially from day 1 to day 4 after symptom onset. RESULTS L-MVO was detected in 66/118 patients (55.9%) and comprised 18.2 ± 10% of infarct size and 4.7 ± 3% of left ventricle myocardial mass. Each single-point, peak and cumulative release concentration of cTnT (r=0.44 to 0.73, p<0.0001), CK (r=0.21 to 0.76, p<0.0001), LD (r=0.36 to 0.82, all p<0.0001) as well as hs-CRP single-point values as assessed from day 1 to day 4 and its peak and cumulative release concentrations (r=0.24 to 0.49, p<0.003) significantly correlated with l-MVO size. Receiver operating curve (ROC) analysis indicated a cut-off value of 4.7 μg/l cTnT to best identify the presence of l-MVO (area under the curve (AUC) 0.904; 95% CI: 0.85-0.95; p<0.0001). CONCLUSION L-MVO sizes significantly correlate with cardiac and inflammatory marker concentrations as determined early after AMI. cTnT concentration of >4.7 μg/l could help to identify patients in whom l-MVO is present.

A method for calcium quantification by means of CT coronary angiography using 64-multidetector CT: very high correlation with agatston and volume scores

To find out whether calcium scoring of the coronary arteries (CAC scoring) could be carried out with a CT angiography of the coronary arteries (CTCA) in a single CT data acquisition. The Agatston and V130 scores for 113 patients were assessed. A calcium volume score (V600 score) was compiled from the CTCA data sets. Intra- and interobserver correlations were excellent (ρ > 0.97). The intra- and interobserver repeatability coefficients were extremely low, increasing in magnitude from the V600 score to the V130 and Agatston scores. The V600 score underestimates the coronary calcium burden. However, it has a linear relation to the Agatston and V130 scores. Thus, they are predictable from the values of the V600 score. The V600 score shows a linear relation to the classic CAC scores. Due to its extremely high reliability, the score may be a feasible alternative for classic CAC scoring methods in order to reduce radiation dosages.

Single-Beat Noninvasive Imaging of Ventricular Endocardial and Epicardial Activation in Patients Undergoing CRT

Background Little is known about the effect of cardiac resynchronization therapy (CRT) on endo- and epicardial ventricular activation. Noninvasive imaging of cardiac electrophysiology (NICE) is a novel imaging tool for visualization of both epi- and endocardial ventricular electrical activation. Methodology/Principal Findings NICE was performed in ten patients with congestive heart failure (CHF) undergoing CRT and in ten patients without structural heart disease (control group). NICE is a fusion of data from high-resolution ECG mapping with a model of the patients individual cardiothoracic anatomy created from magnetic resonance imaging. Beat-to-beat endocardial and epicardial ventricular activation sequences were computed during native rhythm as well as during ventricular pacing using a bidomain theory-based heart model to solve the related inverse problem. During right ventricular (RV) pacing control patients showed a deterioration of the ventricular activation sequence similar to the intrinsic activation pattern of CHF patients. Left ventricular propagation velocities were significantly decreased in CHF patients as compared to the control group (1.6±0.4 versus 2.1±0.5 m/sec; p<0.05). CHF patients showed right-to-left septal activation with the latest activation epicardially in the lateral wall of the left ventricle. Biventricular pacing resulted in a resynchronization of the ventricular activation sequence and in a marked decrease of total LV activation duration as compared to intrinsic conduction and RV pacing (129±16 versus 157±28 and 173±25 ms; both p<0.05). Conclusions/Significance Endocardial and epicardial ventricular activation can be visualized noninvasively by NICE. Identification of individual ventricular activation properties may help identify responders to CRT and to further improve response to CRT by facilitating a patient-specific lead placement and device programming.

Cardiac troponin T and creatine kinase predict mid‐term infarct size and left ventricular function after acute myocardial infarction: A cardiac MR study

To assess the relation of cardiac troponin T (cTnT) and creatine kinase (CK) release with infarct size and left ventricular function evaluated during the subacute phase as well as four months after acute myocardial infarction (AMI) by contrast‐enhanced MRI (CE‐MRI).

Quantification of regional functional improvement of infarcted myocardium after primary PTCA by contrast-enhanced magnetic resonance imaging.

To assess with cardiac magnetic resonance imaging (CMR) the relationship between treatment delay and improvement of regional left ventricular function after primary percutaneous transluminal coronary angioplasty (p‐PTCA) for acute myocardial infarction (AMI).

Isolated numerical skills in posterior cortical atrophy- : An fMRI study

Posterior cortical atrophy (PCA) is characterized by bilateral parieto-occipito-temporal atrophy and hypometabolism. Neuropsychological impairments include complex visual disturbances, alexia, agraphia, finger agnosia, right-left disorientation and dyscalculia. A recent case study reported severe numerical deficits with some selectively preserved numerical skills in a patient affected by PCA [Delazer, M., Karner, E., Zamarian, L., Donnemiller, E., & Benke, T. (2006). Number processing in posterior cortical atrophy--a neuropsycholgical case study. Neuropsychologia]. In a functional magnetic resonance imaging (fMRI) study brain activation patterns related to these selectively preserved numerical skills were analyzed. Recitation of multiplication tables and counting forward were contrasted to word recitation in a block design. Contrasts between experimental conditions and control condition yielded significant activation of inferior and medial temporal structures. Since numerical processing is generally associated with parietal activation, it was hypothesized that preserved brain structures would compensate for the functional deficits.