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Stroke: Options for Optimising Radiology Imaging
Kremeňová, Karin ; Malíková, Hana (advisor) ; Tomek, Aleš (referee) ; Lambert, Lukáš (referee)
CT perfusion (CTP) is applied to assess brain tissue viability in patients with acute ischemic stroke. CTP results are one of the most significant indication criteria for mechanical thrombectomy (MT) in case of large vessel occlusion in the late time window > 6 hours or in wake-up strokes. However, CTP is not the modality of choice to determine candidates suitable for MT in the early time window < 6 hours, as the benefits of CTP are questionable in this time setting. We studied cohort of patients after technically successful MT performed regardless of CTP results with follow-up imaging 24 ± 2 hours after MT. In the first part of the study, we evaluated the accuracy of 3 types of NeuroPerfusion Suite syngo.via SW parameter settings for CTP aiming to determine the most accurate one in predicting the final infarct volume (FIV) measured on follow-up MRI. The ischemic core was defined as follows: A) cerebral blood flow (CBF) < 30 % compared with the contralateral hemisphere; B) CBF < 20 %; C) cerebral blood volume < 1,2 ml/100 ml. We studied 47 patients. The absolute agreement between ischemic core volume and FIV was poor (ICC 0.64-0.69, RMSE 58.9-66.0). Setting A and C overestimated FIV in 53%, setting B in 26% patients. According to our results, none of the settings was optimal, but we consider...
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Possibilities of using advanced MR techniques in pelvic imaging
Ryznarová, Zuzana ; Malíková, Hana (advisor) ; Büchler, Tomáš (referee) ; Lisý, Jiří (referee)
(AJ) The three aims of the work were as follows: 1. Comparison of prostate magnetic resonance (MR) examination results from 1.5 T and 3 T scanners in patients with prostate carcinoma (PCa). MR findings of 103 patients (ages 44-72 years) were compared with histopathological results after radical prostatectomy. The work was focused on the accuracy of predicting local cancer staging and determining prostate tumour location. Patients were divided into three groups (A, B and C) based on the type of MR scanner and protocol used. Patient groups A and B were examined in 1.5T and 3T MR scanners equipped with surface coils in the identical multiparametric MR imaging protocol included dynamic contrast examination (DCE). Patient group C was examined in a 3T MR scanner without DCE. The highest accuracy of predicting the stage of PCa was seen in patients examined in 3 T MR scanner with DCE included in the protocol, however, no significant differences were seen between results from 1.5 T and 3.T MR scanners. No significant difference was also found in the accuracy of determining the location of prostate tumour between 1.5 T and 3T MR examinations, however, there were significant differences between sequences used, with the highest accuracy attained by using a combination of T2 weighted sequences and diffusion...
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Magnetic resonance imaging of central nervous system lymphoma.
Koubská, Eva ; Malíková, Hana (advisor) ; Kalvach, Pavel (referee) ; Druga, Rastislav (referee)
Background: The aim of this study was to describe the morphological signs of the central nervous system lymphoma (CNSL) in magnetic resonance imaging (MRI). We compared morphological characteristics of primary CNSL (PCNSL) and secondary CNSL (SCNSL) and also of PCNSL and glioblastoma (GBM). Methods: We included 64 patients with PCNSL (ten of them were immunocompromised), 21 patients with SCNSL and 54 patients with GBM. The diagnosis was confirmed histologically in all patients. We evaluated morphological signs on the first MRI examination. Additionally, in patients with PCNSL, we evaluated the development of the disease on follow-up examination before histological confirmation of the diagnosis, if available. Results: In most patients with PCNSL (62.5%) the tumor was localized supratentorially and presented as multiple lesions (53.1%) or as a diffuse infiltrative lesion (23.4%). In 87.5% of the patients the lesions reached the brain surface. Infiltration of ependyma was seen in 56.3%, infiltration of meninges in 39.1% and infiltration of cranial nerves in 48.5% of patients. Restriction of diffusion in some part of the tumor was apparent in nearly all patients (97.6%) with PCNSL. After administration of contrast media, marked enhancement was usually seen. In immunocompetent patients, homogenous...
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Computed tomography in tissue characterization of the myocardium.
Černý, Vladimír ; Mašek, Martin (advisor) ; Malíková, Hana (referee) ; Zemánek, David (referee)
Introduction: Magnetic resonance (MR) represents still the gold standard in myocardial imaging. There are some studies suggesting that the computed tomography (CT) might be a valid alternative for some patients (especially the ones who are unable to undergo MR). Aims: We had two aims. Aim number 1: To evaluate the ability of CT in the evaluation of delayed contrast enhancement (DCE) in patients with dilated cardiomyopathy. Aim number 2: To assess the possibilities of CT originally performed for a different indication in myocardial tissue characterization. Methods: Part 1: We prospectively enrolled 17 patients with dilated cardiomyopathy. All the patients underwent both cardiac CT and cardiac MR. We compared the findings of DCE on CT with the findings of DCE on MR. Part 2: We retrospectively evaluated 96 patients who underwent both CT for any indication and cardiac MR. We compared the findings of a hypodense area in the myocardium with the findings of DCE on MR. Results: Part 1: CT detected DCE in 3 patients and MR detected DCE in 6 patients. The agreement between both modalities was in v 82% cases (kappa 0.56). The sensitivity and specificity of CT were 50% and 100%, respectively and the positive predictive value was 100%. In patients with positive findings on CT, the localization of DCE was almost...
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Magnetic resonance imaging of central nervous system lymphoma.
Koubská, Eva ; Malíková, Hana (advisor) ; Kalvach, Pavel (referee) ; Druga, Rastislav (referee)
Background: The aim of this study was to describe the morphological signs of the central nervous system lymphoma (CNSL) in magnetic resonance imaging (MRI). We compared morphological characteristics of primary CNSL (PCNSL) and secondary CNSL (SCNSL) and also of PCNSL and glioblastoma (GBM). Methods: We included 64 patients with PCNSL (ten of them were immunocompromised), 21 patients with SCNSL and 54 patients with GBM. The diagnosis was confirmed histologically in all patients. We evaluated morphological signs on the first MRI examination. Additionally, in patients with PCNSL, we evaluated the development of the disease on follow-up examination before histological confirmation of the diagnosis, if available. Results: In most patients with PCNSL (62.5%) the tumor was localized supratentorially and presented as multiple lesions (53.1%) or as a diffuse infiltrative lesion (23.4%). In 87.5% of the patients the lesions reached the brain surface. Infiltration of ependyma was seen in 56.3%, infiltration of meninges in 39.1% and infiltration of cranial nerves in 48.5% of patients. Restriction of diffusion in some part of the tumor was apparent in nearly all patients (97.6%) with PCNSL. After administration of contrast media, marked enhancement was usually seen. In immunocompetent patients, homogenous...
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Possibilities of using advanced MR techniques in pelvic imaging
Ryznarová, Zuzana ; Malíková, Hana (advisor) ; Büchler, Tomáš (referee) ; Lisý, Jiří (referee)
(AJ) The three aims of the work were as follows: 1. Comparison of prostate magnetic resonance (MR) examination results from 1.5 T and 3 T scanners in patients with prostate carcinoma (PCa). MR findings of 103 patients (ages 44-72 years) were compared with histopathological results after radical prostatectomy. The work was focused on the accuracy of predicting local cancer staging and determining prostate tumour location. Patients were divided into three groups (A, B and C) based on the type of MR scanner and protocol used. Patient groups A and B were examined in 1.5T and 3T MR scanners equipped with surface coils in the identical multiparametric MR imaging protocol included dynamic contrast examination (DCE). Patient group C was examined in a 3T MR scanner without DCE. The highest accuracy of predicting the stage of PCa was seen in patients examined in 3 T MR scanner with DCE included in the protocol, however, no significant differences were seen between results from 1.5 T and 3.T MR scanners. No significant difference was also found in the accuracy of determining the location of prostate tumour between 1.5 T and 3T MR examinations, however, there were significant differences between sequences used, with the highest accuracy attained by using a combination of T2 weighted sequences and diffusion...
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Mesial temporal epilepsy: comparison of morphological changes after different neurosurgery approaches with clinical seizure outcome
Malíková, Hana ; Vymazal, Josef (advisor) ; Kršek, Pavel (referee) ; Hájek, Milan (referee)
Background: Mesial temporal lobe epilepsy (MTLE) is the most surgically amenable epilepsy diagnosis and the results of epilepsy surgery are clearly superior to prolonged medical therapy. Stereotactic radiofrequency amygdalohippocampectomy (SAHE) is an alternative therapy of MTLE to the open neurosurgery approaches. In our hospital SAHE has been used since 2004. We produced lesions from the occipital access with a single trajectory in the long axis of amygdalohippocampal complex (AHK) using the probe with a flexible active tip. The aim of this study was to correlate the morphological changes after different neurosurgical approaches including volume reduction of the target structures / the hippocampus, the amygdala, entorhinal (EC) and perirhinal (PRC) cortices/ with the clinical seizure outcome. Methods: We included 26 consecutive patients, who underwent SAHE using Leksell stereotactic system and 10 patients treated by microsurgical amygdalohippocampectomy (AHE). MR volumetry of hippocampus, amygdale, EC and PRC was performed 1 year after the procedure. The clinical outcome was assessed 2 years after the procedure according to Engel's Classification. Results: No serious adverse events occurred after both procedures. One year after SAHE, the hippocampal volume decreased by 55.5 18.0% (p<10-4 ), the...
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Sustainable development of tourism in National Park Šumava
Horák, David ; Nekardová, Olga (advisor) ; Malíková, Hana (referee)
Sumava National Park is a vast area in the southwestern part of the Czech Republic, adjacented to the border with Germany and Austria. Due to its relief, the area is easily accessible and therefore very appealing for tourists of all ages and various physical conditions. The first part of the thesis deals with the characteristics of the most practiced activities in the Sumava National Park. In the second part I deal with the concept
of sustainable tourism development in the context of monitoring tourist traffic, direct damage to the environment due to tourist traffic, monitoring methods of erosion, degradation of land cover and preferences of visitors to the National Park Sumava.
The aim of the thesis is to evaluate methods of monitoring tourism on the basis of the available literature. Using one of the monitoring methods, questionnaire survey, I evaluate preferences of visitors of the National Park Sumava in the areas of activity
and the duration and frequency of their visits. The result of the thesis represents a comprehensive view of the concept of sustainable tourism development and its monitoring.
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Employment of persons older 50 years
MALÍKOVÁ, Hana
This thesis deals with the employment of people over 50 years in the region of Jindřichův Hradec. A person older than 50 - years has particular characteristics on labour market. This workforce has on one side enough experience and practice. But on the other hand they are persons who, when they become unemployed, very quickly lose their skills. The secondary objective was to design a solution for the application of older persons in the labour market.
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