Cited by 391
University of Freiburg
Publishes on Parasites and Host Interactions, Amoebic Infections and Treatments, Neonatal and fetal brain pathology. 48 papers and 965 citations.
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PURPOSE: Quantification of left and right ventricular function using MRI in young cancer patients treated with cardiotoxic anthracyclines. MATERIALS AND METHODS: Twenty-eight patients (mean age 16.4 years) underwent cardiac MRI at 1.5 T. The study protocol consisted of morphologic T2-weighted images with fat suppression and cine steady-state free precession sequences (SSFP) for functional analysis. Seven patients were examined at the end of chemotherapy, two of them also repeatedly during therapy, and 21 patients following an average period of three years after finishing chemotherapy (range one month--20 years) RESULTS: The end-systolic volume index increased and the ejection fraction of the left and right ventricle decreased during anthracycline therapy. Two of seven patients showed a myocardial edema at the end of the therapy. In 15 of all 28 patients, the left ventricular ejection fraction was reduced to less than 55 % (minimum 44 %). No clinical signs of cardiac insufficiency or cardiomyopathy were observed. CONCLUSION: MRI is able to detect acute as well as chronic subclinical cardiotoxic effects of anthracyclines. Impairment of the right ventricular function should be considered in the diagnosis of anthracycline-induced cardiomyopathy.
Increase in renal volume and asymmetry in kidney size determined by sonography proved to be a valuable diagnostic criterion for differentiation between infections of the upper and lower urinary tract in 175 children: acute bacterial interstitial nephritis (79) and lower urinary tract infection (96). Kidney volume in acute pyelonephritis increased to an average of 175% of normal. In 71% of cases, affected kidneys showed an enlargement of at least 2 SD when compared with a group of 325 children without kidney pathology. Most impressive kidney enlargement was seen during the first year of life. In 50% of cases, acute pyelonephritis caused a bilateral increase in renal size and/or distinct volume asymmetry. Kidneys of patients with lower urinary tract infections had a mean volume of 99.68% and a physiologic volume asymmetry comparable to normal kidneys.