radiology research journals
Impact of Hiatal Hernia on Pediatric Gastroesophageal Reflux Disease
Although the relationship between hiatal hernia (HH) and gastroesophageal reflux disease (GERD) has long been recognized, there are many unknown aspects to the long-term impact of HH on GERD in children. Inthat early detection and conventional treatment of sliding HH in children resulted in a favorable outcome for children with persistent vomiting . However, about one-third of the children without treatment continued to suffer from GERD after their fourth birthday with a 10% chance of developing an esophageal stricture. HH is defined as an axial displacement of the proximal part of the stomach through the diaphragmatic hiatus.
Type I HH is caused by widening of the muscular hiatal tunnel and circumferential laxity of the phrenoesophageal membrane, thus allowing the gastric cardia to herniate above the diaphragm.Adult patients with a large HH are known to be more prone to GERD development than those with a smaller HH. It has an estimated prevalence of 10-80%, and usually is asymptomatic. In infants and children, invasive procedures are not routinely used to diagnose GERD, but rather clinical signs and symptoms. Therefore, the incidence of HH could be under-diagnosed since the diagnosis of HH requires radiographic or endoscopic examinations. Read more……………..
Would Sub-regional Analysis Improve Sensitivity in Knee dGEMRIC?
Spin-lattice relaxation time (T1) of articular cartilage after contrast administration of Gd-DTPA2- (T1Gd) has been commonly used as a dGEMRIC index to determine relative glycosaminoglycan (GAG) level within articular cartilage. It has been argued that tracking ΔR1, i.e. the change in relaxation rate (R1 = 1/T1) before (R1pre) and after Gd-DTPA2- administration (R1post), is necessary. A previous report showed that T1Gd and ΔR1 were similarly effective in differentiating knees with osteoarthritis (OA) from the healthy. To-date, quantification of T1Gd and ΔR1 has been based on the analysis of regions of interest (ROIs) covering full thickness of cartilage.
It has been reported that the GAG concentration profile in canine articular cartilage was tissue depth dependent. Degeneration of cartilage in aging and osteoarthritis generally progresses from the surface of the cartilage. A recent report on asymptomatic subjects suggested that when performing an analysis of the knee based on the depth of the cartilage, the superficial layer of articular cartilage showed longer T1pre, shorter T1Gd, and hence larger ΔR1 compared to the deep layer. These reports then put forward a practically interesting question: would dGEMRIC analysis be more sensitive if sub-regional ROI of cartilage, instead of full thickness of ROI, was used to quantify the biomarkers for assessing health status of articular cartilage? Read more………..
OMICS Journals 