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Use of the prenatal MRI in the orofacial cleft diagnosis
Bělobrádek, Zdeněk ; Eliáš, Pavel (advisor) ; Skotáková, Jarmila (referee) ; Vaněčková, Manuela (referee)
Use of the prenatal MRI in the orofacial cleft diagnostics Aim: To evaluate the accuracy and credibility of MRI in the assessment of the fetal facial cleft lip defects severity using interobserver agreement between several specialists. Material and method: Our study consists of 23 MRI examinations of fetuses in gestation age before 24 week with differently severe lip clefts, which was detected by ultrasound as well as other 17 examinations without face anomaly (40 cases in total). Datasets were anonymized and analyzed by 3 radiologists and statistical analysis was performed. According to standardised protocol presence of cleft and degree of severity was evaluated - alveolar ridge involvement, continuation or noncontinuation to the pallate. The examinations were perfomed by Siemens Magnetom Symfony Masestro Class 1,5T with use of array coils. Results: Result of MRI was in 20 cases (87 %) in agreement with clinical findings. We found 3 discrepancies (13 %), mainly due to graphically limited examination caused by fetal movements. The best degree of interpretative agreement was in the evaluation of alveolar ridge involvement - 94 % (generalized kappa 0,894, SE 0,106), for isolated cleft lip it was 90 % (generalized kappa 0,848, SE 0,083) and for defect of palatte 86 % (generalized kappa 0,711, SE...
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The assessment of the presence of the intracranial hypertension by means of the compression Doppler-ultrasound in posthaemorhagic newborns' hydrocephalu
Rejtar, Pavel ; Eliáš, Pavel (advisor) ; Šprindrich, Jan (referee) ; Skotáková, Jarmila (referee)
Aim. In our study we focused on the ultrasound diagnostics of intracranial hypertension in neonates with diagnosis of posthemorrhagic hydrocephalus (PHH). We wanted to try and verify the method of "pressure provocation test". When performing this test, the great fonticulus is compressed by ultrasound probe and simultaneously systolic and diastolic velocities are being measured in the internal genu of the anterior cerebral artery with resisistive index calculation. Pressure on fonticulus during examination shows us the reserve capacity of liquor spaces and the response in cerebral arteries blood flow. The primary objective was to verify, if the basic and compressive resistive index correlates with the presence and eventually with the severity of intracranial hypertension. The secondary objective was to find relationship between the degree of intracranial hypertension and the diameter of cerebral ventricles, to asses the rapidity of PHH developement and to find out, in which period is PHH the most common. Method. In years 1999 - 2008, 52 children with diagnosis of posthemorrhagic hydrocephalus were examined in our department. The average birth weight in children with PHH was 1436 g (550 - 4090 g, median 1150 g). The average age was 29,6 weeks (24 - 41 weeks, median 28 weeks). Totally, 73 % of children...
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