Purpose:To optimize intravoxel incoherent motion (IVIM) diffusion-weighted (DW) imaging by estimating the effects of diffusion gradient polarity and breathing acquisition scheme on image quality, signal-to-noise ratio (SNR), IVIM parameters, and parameter reproducibility, as well as to investigate the potential of IVIM in the detection of hepatic fibrosis.
Materials and Methods:In this institutional review board-approved prospective study, 20 subjects (seven healthy volunteers, 13 patients with hepatitis C virus infection; 14 men, six women; mean age, 46 years) underwent IVIM DW imaging with four sequences: (a) respiratory-triggered ( Mixed-model analysis of variance was used to compare image quality, SNR, IVIM parameters, and interexamination variability between the four sequences, as well as the ability to differentiate areas of liver fibrosis from normal liver tissue.
Results:Image quality with RT sequences was superior to that with FB acquisitions (P = .02) and was not affected by gradient polarity. SNR did not vary significantly between sequences. IVIM parameter reproducibility was moderate to excellent for PF and D, while it was less reproducible for D*. PF and D were both significantly lower in patients with hepatitis C virus than in healthy volunteers with the RT BP sequence (PF = 13.5% 6 5.
Conclusion:The RT BP DW imaging sequence had the best results in terms of image quality, reproducibility, and ability to discriminate between healthy and fibrotic liver with biexponential fitting.q RSNA, 2012
Sequencing studies of the glycoprotein G gene were performed in human respiratory syncytial virus (hRSV) strains detected by reverse-transcription polymerase chain reaction directly from nasopharyngeal aspirates of hospitalized children < or =3 years old over 2 winters. Clinical data were compared between 106 children infected with group A hRSV (96 GA2 genotypes) and 94 children infected with hRSV group B (62 GB3 genotypes). A severity index was defined by assigning 1 point each for the use of >30% supplemental oxygen, admission to an intensive-care unit, and duration of hospital stay of >5 days. Group A and genotype GA2 strains were associated with greater severity of hRSV disease than were group B strains.
Trial results are used to support licensure, inform cost-effectiveness analyses, and guide clinical decision making. We found the majority of coinfected patients were not included in clinical trials of direct-acting antivirals, raising concerns about the generalizability of these trial results.
During the fall/winter season of 2004–05, we found 9 respiratory specimens positive for human parainfluenza virus type 4 (HPIV-4) in our laboratory (43% of all HPIVs) from patients with mild to moderate respiratory illnesses. Sequencing studies identified 8 different HPIV-4A strains and 1 HPIV-4B strain.
SummaryHepatitis C virus reinfection rates after cure in HIV coinfection were highest in those injecting cocaine or methamphetamines and in men who have sex with men reporting risky sexual behavior. Interventions addressing these risks are needed to achieve HCV elimination.
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