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Posts tagged ‘MRI’

BBC News – MRI detects early damage to chemotherapy child hearts

Detecting early damage to a child’s heart following chemotherapy is possible using MRI scans, says a study from Canada.

Even when children’s heart function appeared to be normal, a new MRI method of mapping the heart was able to identify damage, University of Alberta researchers said.

A UK cardiologist said the impact of anthracycline treatment on children’s hearts was only now being understood.

Early detection was crucial, he said.

While chemotherapy treatment with anthracyclines is known to be effective against many types of cancer, it can lead to irreversible changes to the heart muscle which may not become apparent until several years after treatment.

Writing in the Journal of Cardiovascular Magnetic Resonance, the researchers said they performed MRI scans on children and young adults aged seven to 19 who were in remission following this type of treatment.

Using an emerging MRI method called T1 mapping, they said they were able to identify the early effects on patients’ hearts.

This happened even in children whose heart function appeared normal by ultrasound.

Scanning the heart is more difficult than other organs because it is constantly in motion. But with modern scanners the images are fantastic.”

Dr Chris Plummer

Freeman Hospital, Newcastle

Dr Edythe Tham and Dr Richard Thompson, who led the study, said: “In childhood cancer survivors, MRI changes were related to anthracycline dose given to the children.

“These changes are also mirrored by thinning of the heart wall and a reduction in the exercise capacity.”

Early protection

Dr Chris Plummer, consultant cardiologist at the Freeman Hospital in Newcastle, said the side effects of chemotherapy were well-known.

“Chemotherapy with anthracyclines is a very effective treatment for cancer but it can be quite toxic to the heart.

“We’ve known that for a long time but the number of children affected is only becoming appreciated now.

“We have to look for ways to protect the heart and intervene earlier when damage occurs.

“Waiting for visible heart damage to appear is too long to wait.”

But Dr Plummer said carrying out an MRI scan of a child’s heart was not an easy thing to do.

“Scanning the heart is more difficult than other organs because it is constantly in motion. But with modern scanners the images are fantastic.

“It’s the best way of looking at the structure and function of the heart – and it’s entirely safe.

“It is an excellent way of precisely monitoring heart function in children.”

via BBC News – MRI detects early damage to chemotherapy child hearts.

Screening clinic shows “huge promise” for hidden heart problems

A genetic flaw can cause heart muscle to thicken


By Adam Brimelow Health Correspondent, BBC News

The Bolton footballer Fabrice Muamba has said his survival from sudden cardiac arrest was “more than a miracle”, but his case has highlighted the limitations of screening for hidden heart problems. He was examined several times but nothing was picked up.

I have been looking at efforts to detect these abnormalities, which kill 12 young people in the UK every week.

When you see Rishi Chandarana charging around his garden in his beloved Arsenal shirt, he seems like any sports-mad 12 year-old, straining every sinew to be first to the ball.

But his father and grandfather both have a condition called Hypertrophic Cardiomyopathy (HCM). This inherited genetic flaw causes the heart muscle to thicken, interfering with its ability to beat.

The condition affects one in 500 people. Some never have any symptoms. Others develop chest pain, dizziness or palpitations which can be treated.

But some – a small minority – suffer cardiac arrest without warning. HCM is the biggest cause of sudden death in young people.

Suspected risk

When I first met Rishi he had been for some initial tests at a new clinic for inherited cardiac conditions at London’s Royal Brompton Hospital. He was concerned that if he had HCM, it could affect his enjoyment of sports.

“If I’m not able to play football it will be devastating because I really love playing sport. And if I can’t play sport because of a heart condition, I’d be really upset.”

The clinic sees people of all ages from across the UK – some with a suspected risk because of problems in the family, and some to assess and manage conditions such as HCM.

Many of the tests carried out are similar to those used routinely at other screening centres, including an electrocardiogram (ECG) and echocardiogram.

Scarring in the heart

But the Royal Brompton team also use MRI scans and genetic testing to provide more detailed information. The cardiologist in charge, Dr Sanjay Prasad says this approach is unique.

“Over and above other tests it gives you an idea of what’s happening at the tissue level. Is there scarring in the heart? Is there inflammation?”

He says the genetic tests they offer address not just ‘what is happening’ but ‘why?’

“Because it is a familial condition often patients suffer the dilemma of not knowing whether their offspring have the condition. And the genetics allows us to take things to a higher level where we can reassure patients that if they haven’t got the gene abnormality, they should be leading a normal lifestyle.”

Dr Prasad says a biobank of DNA samples collected at the clinic will – over time – provide a better understanding of who is most at risk.

“Welcome development”

“I think that’s hugely exciting and that programme is certainly a very welcome development, but I have to say at the moment it’s still research.””

Dr Amanda Varnava Consultant Cardiologist

The clinic has won praise from another leading specialist in this field, Dr Amanda Varnava, from St Mary’s hospital in London. But she says the value of genetic testing remains limited, at least for the time being.

“I think that’s hugely exciting and that programme is certainly a very welcome development, but I have to say at the moment it’s still research.”

Dr Varnava also carries out cardiac checks on players for several premiership football clubs. She says the game’s authorities should consider a more systematic and rigorous approach to screening.

“What we’re not doing is further testing such as exercise testing, looking at the ECG under stress. And we’re not looking at the heart monitor over 24-hours to see if we can pick up any extra beats that may give us a clue to future problems. Those are the additional tests perhaps we should be thinking about”

For the wider population the charity Cardiac Risk in the Young (CRY) says the immediate priority must be an extension of basic screening. This would focus on family history, a physical examination and an ECG – followed up if necessary by ultrasound.

Protection from “catastrophe”

A cardiology consultant for CRY, professor Sanjay Sharma, says the charity has been inundated with requests for screening in the last few weeks.

“What we’re saying is that there should be an infrastructure that’s available, that people know about, and they can go and seek help or tests in this area so that they are well-informed and can protect themselves from catastrophe.

He says this should be offered to all 14-35 year-olds, and he points to the success of wider screening in Italy, where he says sudden cardiac deaths have fallen by 90% in 25 years.

The Department of Health in England says it is keeping this issue under review.

Back at the Royal Brompton clinic I joined Rishi as he was told that tests so far indicated he did not have HCM. Dr Prasad told him to carry on playing football, “as long as it’s not for Arsenal!”


台南新樓醫院 正式啟用核磁共振系統儀器





黃院長說,今年為嘉惠更多患者,引進先進的醫療器材廠商西門子公司所推出的「MAGNETOM Avanto」磁振造影儀,以全方位完整的治療系統來服務,為影像診斷治療帶來新的契機。

影像醫學科連振東主任指出,新樓醫院影像醫學科所引進的核磁技術對於腫瘤鑑別具有不可替代的優勢,一是分辨率好,二是反映的特性比較多,和原來的設備比 較,至少提高了2倍以上的清晰度和分辨率。在臨床上獲得更好的影像品質,拓展研究領域,提高對血管疾病的診斷能力,此套檢驗模式為醫界最新、最好之核磁共 振診斷治療技術之ㄧ。



原文網址: 今日新聞網

Scientists shift on brain speech center



The part of the brain used for speech processing is in a different location than originally believed, according to a US study Monday that researchers said will require a rewrite of medical texts.


Wernicke’s area, named after the German neurologist who proposed it in the late 1800s, was long believed to be at the back of the brain’s cerebral cortex, behind the auditory cortex which receives sounds.


But a review by scientists at Georgetown University Medical Center of more than 100 imaging studies has shown it is actually three centimeters closer to the front of the brain, and is in front of the auditory cortex, not behind.


“Textbooks will now have to be rewritten,” said neuroscience professor Josef Rauschecker, lead author of the study which appears in the Proceedings of the National Academy of Sciences.


“We gave old theories that have long hung a knockout punch.”


Rauschecker and colleagues based their research on 115 previous peer-reviewed studies that investigated speech perception and used brain imaging scans—either MRI (functional magnetic resonance imaging) or PET (positron emission tomography).


An analysis of the brain imaging coordinates in those studies pointed to the new location for Wernicke’s area, offering new insight for patients suffering from brain damage or stroke.


“If a patient can’t speak, or understand speech, we now have a good clue as to where damage has occurred,” said Rauschecker.


It also adds an intriguing wrinkle to the origins of language in humans and primates, who have also been shown to process audible speech in the same region of the brain.


“This finding suggests the architecture and processing between the two species is more similar than many people thought.”


Lead author Iain DeWitt, a PhD candidate in Georgetown’s Interdisciplinary Program in Neuroscience, said the study confirms what others have found since brain imaging began in earnest in the 1990s, though some debate has persisted.


“The majority of imagers, however, were reluctant to overturn a century of prior understanding on account of what was then a relatively new methodology,” he said.


“The point of our paper is to force a reconciliation between the data and theory.”


Read More: Japan Today

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