We studied medial dorsal superficial peroneal (MDSP) nerves in 52 patients wit h clinical evidence of mild chronic sensorimotor polyneuropathy and normal sural nerve responses, in order to assess the diagnostic sensit...We studied medial dorsal superficial peroneal (MDSP) nerves in 52 patients wit h clinical evidence of mild chronic sensorimotor polyneuropathy and normal sural nerve responses, in order to assess the diagnostic sensitivity and usefulness o f MDSP nerve testing in electrodiagnostic practice. To determine the effect of a ge on MDSP nerve parameters, 98 normal subjects were also examined. Electrodiagn ostic evaluation involved studies of motor nerve conduction in tibial, peroneal, and median nerves;sensory nerve conduction in sural, MDSP, median, and radialne rves; tibial and peroneal nerve F waves; H reflexes from the soleus muscles; and needle electromyography of gastrocnemius and abductor hallucis muscles. Among t he patients, 49%had low-amplitude sensory responses in MDSP nerves and 57%had either slowing of sensory conduction velocity or no sensory responseson proxima l stimulation. MDSP nerve amplitude, tibial nerve motor velocity, and H reflexes were the most sensitive for detection of mild chronic symmetrical axonal sensor imotor polyneuropathy. MDSP nerve testing should be included in the routine elec trodiagnostic evaluation of patients with suspected polyneuropathy and normal su ral nerve responses.展开更多
Objective: To determine long term reproducibility of the late enhancement(LE) signal in contrast enhanced magnetic resonance imaging(MRI) and potential changes of the signal after revascularisation. Methods: 33 patien...Objective: To determine long term reproducibility of the late enhancement(LE) signal in contrast enhanced magnetic resonance imaging(MRI) and potential changes of the signal after revascularisation. Methods: 33 patients(29 men, mean(SD)61(11) years) with coronary artery disease(CAD) and left ventricular dysfunction(ejection fraction 30(7)%) underwent two contrast enhanced MRI procedures within 9(3) months. Fifteen patients(group A: 14 men, 59(12) years) had no interventions between the two studies. Eighteen patients underwent revascularisation after MRI 1(group B: 15 men, 62(9) years). Changes in the LE signal between the first and second MRIs were investigated in both groups as well as intraobserver and interobserver variabilities for delineation of the signal. Results: The LE signal was highly reproducible in groups A and B for segmental analysis(concordance 86%v 82%, respectively; κ=0.70 v 0.67) and summed scores(group A: r=0.97, p< 0.001; group B: r=0.93, p< 0.001). The LE signal was quantified as 27(27) cm3 in group A versus 30(16) cm3 in group B in the first MRI and 26(25) cm3 versus 30(15) cm3, respectively, for the second MRI(both not significant). Moreover, low intraobserver and interobserver variabilities were observed in segmental analysis(κ=0.86 and 0.74, respectively, for group A, and κ=0.87 and 0.82, respectively, for group B). Conclusion: In patients with chronic CAD, the LE signal in contrast enhanced MRI is very stable over an extended time period. These results further characterise contrast enhanced MRI as a useful tool for myocardial viability assessment. Low intraobserver and interobserver variabilities promise robustness of the method for clinical application.展开更多
文摘We studied medial dorsal superficial peroneal (MDSP) nerves in 52 patients wit h clinical evidence of mild chronic sensorimotor polyneuropathy and normal sural nerve responses, in order to assess the diagnostic sensitivity and usefulness o f MDSP nerve testing in electrodiagnostic practice. To determine the effect of a ge on MDSP nerve parameters, 98 normal subjects were also examined. Electrodiagn ostic evaluation involved studies of motor nerve conduction in tibial, peroneal, and median nerves;sensory nerve conduction in sural, MDSP, median, and radialne rves; tibial and peroneal nerve F waves; H reflexes from the soleus muscles; and needle electromyography of gastrocnemius and abductor hallucis muscles. Among t he patients, 49%had low-amplitude sensory responses in MDSP nerves and 57%had either slowing of sensory conduction velocity or no sensory responseson proxima l stimulation. MDSP nerve amplitude, tibial nerve motor velocity, and H reflexes were the most sensitive for detection of mild chronic symmetrical axonal sensor imotor polyneuropathy. MDSP nerve testing should be included in the routine elec trodiagnostic evaluation of patients with suspected polyneuropathy and normal su ral nerve responses.
文摘Objective: To determine long term reproducibility of the late enhancement(LE) signal in contrast enhanced magnetic resonance imaging(MRI) and potential changes of the signal after revascularisation. Methods: 33 patients(29 men, mean(SD)61(11) years) with coronary artery disease(CAD) and left ventricular dysfunction(ejection fraction 30(7)%) underwent two contrast enhanced MRI procedures within 9(3) months. Fifteen patients(group A: 14 men, 59(12) years) had no interventions between the two studies. Eighteen patients underwent revascularisation after MRI 1(group B: 15 men, 62(9) years). Changes in the LE signal between the first and second MRIs were investigated in both groups as well as intraobserver and interobserver variabilities for delineation of the signal. Results: The LE signal was highly reproducible in groups A and B for segmental analysis(concordance 86%v 82%, respectively; κ=0.70 v 0.67) and summed scores(group A: r=0.97, p< 0.001; group B: r=0.93, p< 0.001). The LE signal was quantified as 27(27) cm3 in group A versus 30(16) cm3 in group B in the first MRI and 26(25) cm3 versus 30(15) cm3, respectively, for the second MRI(both not significant). Moreover, low intraobserver and interobserver variabilities were observed in segmental analysis(κ=0.86 and 0.74, respectively, for group A, and κ=0.87 and 0.82, respectively, for group B). Conclusion: In patients with chronic CAD, the LE signal in contrast enhanced MRI is very stable over an extended time period. These results further characterise contrast enhanced MRI as a useful tool for myocardial viability assessment. Low intraobserver and interobserver variabilities promise robustness of the method for clinical application.
