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Imaging algorithm in suspected non-accidental injury
Popelová, Eliška ; Kynčl, Martin (advisor) ; Burgetová, Andrea (referee) ; Jezberová, Michaela (referee)
Imaging algorithm in suspected non-accidental injury Abstract This thesis focuses on radiologic investigations in children with suspected non-accidental injury (NAI) with emphasis on children below two years of age. It is the first Czech ori- ginal and review work on this topic. The aim of this work is to evaluate current practise in Czech hospitals and to assess benefits of skeletal imaging in children younger than two years with suspected NAI. The theoretical part of the thesis presents a summary of up-to- -date information on radiologic imaging of children with suspected NAI and provides an overview of international expert literature. The empirical part of the thesis presents four scientific projects: a survey among Czech radiologists and three studies aimed at skeletal imaging in children with trauma suggestive of NAI. The results of these works show that evaluation of children with suspected NAI is not standardized and that skeletal imaging is not performed in all appropriate situations. At the same time, the results show that skele- tal imaging may show clinically occult fractures, while the effective dose is reasonably low. The thesis also brings suggestions for improvements and topics for further research. The appendices to this work include the recommendations Postavme se na stranu dětí....
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MRI mapping of brain iron deposition in patients with neurological diseases with a focus on multiple sclerosis and neuromyelitis optica
Pudlač, Adam ; Burgetová, Andrea (advisor) ; Lisý, Jiří (referee) ; Ryška, Pavel (referee)
Background: Neuromyelitis optica (NMO) and multiple sclerosis (MS) often manifest similar symptoms. However, the distinction between the two diseases is particularly important for different therapies. The aim of this study is to determine whether these diseases can be distinguished based on cerebral iron deposits in the deep grey matter and whether there is a correlation between iron deposits, local deep grey matter atrophy and clinical severity of the disease. Methods: 40 patients with relapsing-remitting MS (RRMS), 20 patients with NMO and 20 healthy subjects were examined at the MRI department of the 1st Faculty of Medicine of Charles University in Prague from December 2013 to March 2015. All patients with RRMS fulfilled the revised McDonald criteria, the diagnosis of NMO was based on Wingerchuk criteria. All 20 patients with NMO had positive AQP4-IgG. Quantitative susceptibility mapping (QSM) and volumometry of individual deep gray matter structures were performed. All patients with NMO and MS underwent simultaneous examination by a specialist in demyelinating diseases. Neurological disability was assessed by the Kurtzke Disability Status Scale (EDSS). Results: Patients with NMO have higher magnetic susceptibility values in the substantia nigra compared to healthy controls. Patients with RRMS...
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The role of untrasound assessment of adverse prognostic factors for surgical procedure tailoring in endometrial cancer patients
Frühauf, Filip ; Fischerová, Daniela (advisor) ; Halaška, Michael (referee) ; Burgetová, Andrea (referee)
Objectives: Preoperative ultrasound including assessment of local extent of disease in uterus, adnexal involvement and pelvic spread is recommended staging examination in patients with endometrial cancer. It is routinely based on subjective assessment by experienced sonographists. The main aim of the study was to assess if the objective methods based on simple measurements and calculations have diagnostic performance comparable to that of subjective evaluation in detection of deep myometrial invasion. Two traditional objective techniques were tested - (1) deepest invasion / normal myometrium width ratio proposed by Gordon and (2) tumor / uterine anteroposterior diameter ratio introduced by Karlsson. Methods: The prospective diagnostic accuracy study was initiated at Gynecologic Oncology Centre. All consecutive patients with histologically verified endometrial cancer undergoing transvaginal or transrectal sonography using predefined study protocol followed by surgical staging procedure were prospectively enrolled . Local staging of each endometrial tumor was subjectively evaluated by one of experienced sonographists, myometrial invasion was assessed as deep (≥ 50 %) or superficial (˂ 50 %) and cervical stromal involvement as present or absent. Concurrently, the depth of myometrial invasion was...
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Multiple sclerosis and the measurement of T2 relaxation time in the central gray matter structures of the brain
Burgetová, Andrea ; Vaněčková, Manuela (advisor) ; Süssová, Jana (referee) ; Lisý, Jiří (referee)
Objective: The aim is to adduce the quantitative evidence of increased iron accumulation in the basal ganglia in multiple sclerosis (MS) patients in comparison with the control group. Another aim is to determine the relationship between iron accumulation and other parameters determined in MS: lesion load (LL), brain parenchymal fraction (BPF). Patients and methods: T2 relaxometry (T2) was used for the measurement. 970 patients with clinically defined MS and 117 controls, incl. the MultiechoGrase sequence, were examined by MR to calculate T2. Patients were then divided into 3 subgroups according to LL value and into 3 subgroups according to BPF. T2 was correlated between groups age matched. Conclusions: This work provided quantitative evidence of the increased accumulation of iron in the basal ganglia in patients with MS in comparison with the healthy controls. We subsequently found a higher accumulation of iron in the basal ganglia in the subgroup with a smaller volume of plaques (according to LL) than in healthy controls and in the subgroup with a larger volume of LL. The hypothesis of a neurodegenerative component to this disease is supported by the changes in iron content in the brain.
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