Detection Of Inflammation In Patients Research Articles

High-definition endoscopy with iScan and Lugol's solution for the detection of inflammation in patients with nonerosive reflux disease: histologic evaluation in comparison with a control group.

Nonerosive reflux disease (NERD) is commonly diagnosed in patients with symptoms of reflux. The aim of the present study was to determine whether high-definition endoscopy (HD) plus equipped with the iScan function or chromoendoscopy with Lugol's solution might permit the differentiation of NERD patients from those without reflux symptoms, proven by targeted biopsies of endoscopic lesions. A total of 100 patients without regular intake of proton pump inhibitors and with a normal conventional upper endoscopy were prospectively divided into NERD patients and controls. A second upper endoscopy was performed using HD+ with additional iScan function and then Lugol's solution was applied. Biopsy specimens were taken from the gastroesophageal junction in all patients. A total of 65 patients with reflux symptoms and 27 controls were included. HD(+) endoscopy with iScan revealed subtle mucosal breaks in 52 patients; the subsequent biopsies confirmed esophagitis in all cases. After Lugol's solution, 58 patients showed mucosal breaks. Sensitivity for the iScan procedure was 82.5%, whereas that for Lugol's solution was 92.06%. Excellent positive predictive values of 100% and 98.3%, respectively, were noted. The present study suggests that the majority of patients with NERD and typical symptoms of reflux disease can be identified by iScan or Lugol's chromoendoscopy as minimal erosive reflux disease (ERD) patients.

Role of quantitative MRI diffusion-weighted imaging (DWI) in detecting lesion activity in patients with Crohn’s disease

Aim and objectivesTo evaluate the value of diffusion-weighted magnetic resonance imaging (DWI) in localization of diseased bowel segment and to determine the value of apparent diffusion coefficient (ADC) to diagnose activity in patients with Crohn’s disease. Materials and methods30 patients of Crohn’s disease and 45 normal persons as a control underwent DWI and ADC maps and the results were compared to the postendoscopic and pathologic post-operative results. ResultsOn DWI bowel segments with active inflammation revealed higher signal compared to inactive and normal segments. Using ADC, statistical high significance was found between both active and inactive segment values when correlated to normal segment values with P<0.05. Correlating mean ADC value and range of active and inactive segments, a statistical difference was noted (P<0.05). Using 1.65×10−3mm2s−1 as the cutoff point, the sensitivity of ADC values for differentiating active and inactive bowels was 88.7%, and the specificity was 80%, PPV 89.7%, NPV 79.0%, Kappa 0.65 and P<0.05. ConclusionAdding DWI and quantitative ADC value study to MRI imaging is a promising technique for the detection of inflammation in patients with Crohn’s disease and differentiating between active and inactive diseased bowel segments.

T2-Mapping CMR increases the diagnostic sensitivity for detection of myocardial inflammation in patients with possible myocarditis - a prospective endomyocardial biopsy-controlled study

Myocarditis has been reported in up to 20% of sudden cardiac death in young adults and is a frequent precursor of dilated cardiomyopathy. Unfortunately, the diagnostic tools for detection of myocarditis are still imperfect: Sensitivity of endomyocardial biopsy (EMB) is reduced largely due to the inherent sampling error. Cardiac magnetic resonance (CMR) offers the advantage of analysing the whole myocardium, but contrast-enhanced as well as T2weighted CMR exhibit inadequate sensitivity, especially during early stages of inflammation. Our hypothesis was that quantitative T2 relaxation mapping increases diagnostic sensitivity in CMR-based diagnosis of myocarditis. Methods We carried out a prospective observational study in patients with probable acute myocarditis characterized by clinical presentation, new global or regional wall abnormalities or arrhythmias or hsTNT-elevation. Of the 55 patients screened, two patients did not undergo CMR (1 pacemaker, 1 ECLS-support) and 16 patients refused EMB. The remaining 37 patients underwent EMB and CMR examination (1.5 T, Archieva, Philips) within 36h. Histological evaluation was performed by two independent pathologists (hematoxylin eosin staining, picrosirius red, IH CD68, CD45R0 and CD3) and by molecular analysis for viral replication/genome. CMR data were analysed blinded with respect to ventricular volumes and ejection fraction as well as T2, LGE and Strain Encoded (SENC)Imaging. A GRASE sequence (15 Echoes separated by 10ms, res: 2x2x10 mm2, 3 short axis slices) was used for localized T2 mapping. Age-matched volunteers (37) served as controls for ROC curve analysis in terms of quantitative T2-mapping. Results were compared by two-sided t-Test; p<0.05 was considered significant. Results

Mo1513 High Definition Endoscopy With I-SCAN and Lugol Solution for the Detection of Inflammation in Patients With NERD and Histologic Evaluation in Comparison to a Control Group

Mo1513 High Definition Endoscopy With I-SCAN and Lugol Solution for the Detection of Inflammation in Patients With NERD and Histologic Evaluation in Comparison to a Control Group

AB1202 Visualization of remission of arthritis under tnf-inhibition in a patient with juvenile idiopathic arthritis using ICG-enhanced fluorescence optical imaging

BackgroundClosed to medical history and clinical examination imaging tools are useful for valid detection of inflammation in patients with juvenile idiopathic arthritis (JIA). Prognosis is different in oligo- or polyarticular...

Neutrophil-derived S100A12 as novel biomarker of inflammation in familial Mediterranean fever

ObjectiveFamilial Mediterranean fever (FMF) is characterised by recurrent periodic febrile attacks and persistent subclinical inflammation. The damage-associated molecular pattern (DAMP) protein S100A12 has proven to be a sensitive marker for...

Evaluation of Diffusion-weighted MR Imaging for Detection of Bowel Inflammation in Patients with Crohn's Disease

The aims of this study were to determine the feasibility of diffusion-weighted magnetic resonance imaging (DWI) in the detection of bowel inflammation and to investigate the changes in apparent diffusion coefficient (ADC) values in the inflamed bowel in patients with Crohn's disease. Eleven patients who underwent magnetic resonance enterography (including DWI) for Crohn's disease and colonoscopy or surgery within 4 weeks of examination were recruited. Two radiologists reviewed diffusion-weighted images and ADC maps to evaluate for inflammation in each bowel segment (terminal ileum, cecum, ascending colon, transverse colon, descending colon, and rectosigmoid colon) and measured the ADC values of each bowel segment. Endoscopic and pathologic results were correlated with DWI findings. Fifty-three segments (19 with inflammation, 34 normal) were included. DWI detected inflammation in 18 of 19 segments (94.7%) and showed normal results in 28 of 34 segments (82.4%). On diffusion-weighted images, bowel segments with inflammation revealed higher signal compared to normal segments. Artifact levels were none or minimal in 10 of 11 patients (90.9%) and moderate in one patient. On quantitative analysis, ADC values of inflamed and normal bowel were measured as 0.47 - 2.60 x 10(-3) and 1.39 - 4.03 x 10(-3) mm(2)/s, respectively (P < .05). DWI with parallel imaging is a feasible technique for the detection of inflammation in patients with Crohn's disease. ADC values are decreased in inflamed bowel segments, indicating restricted diffusion.

Detection of inflammation in patients with acute aortic syndrome: comparison of FDG-PET/CT imaging and serological markers of inflammation

Objective:A substantial number of patients with acute aortic syndrome (AAS) require invasive therapy because of disease progression. Our study aimed to assess the impact of positron emission tomography (PET)/computed tomography...