Medical Project

Recommendations (9)


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Hospital clinicians have recently expressed concern
over the diagnosis of extrahepatic biliary ducts and gall bladder lesions.
Rapid advances in magnetic resonance technology have
led to the extensive use of magnetic resonance
cholangiopancreatography (MRCP) as a non-invasive diagnostic
method for evaluating the biliary tree and pancreatic duct.
Some invasive techniques, including endoscopic retrograde
cholangiopancreatography (ERCP) and percutaneous transhepatic
cholangiography (PTC), use either an endoscope or a guided wire
inside the patients body to obtain an image of the digestive system
image, often creating patient discomfort and possibly leading to
infection. (NOTE : Add 2 sentences that describe characteristics of the
problem or statistics that reflect its severity)
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For instance, the conventional procedure
utilizes an invasive approach in which the procedure lasts an
average of nearly 40 minutes, longer than a patient can tolerate.
Despite the long procedure time, the incidence rate of infection
of MRCP is 0%, obviously, better than the conventional
procedure. However, MRI instrumentation
has its limitations. Patients with a pacemaker or implanted
ferromagnetic metal should avoid MRCP scanning. Additionally,
a stone may be misdiagnosed as another type of intraluminal
filling defect, such as an intraductal tumor, blood clot, or gas
bubble. Moreover, ascites or ileus may occasionally hinder the
diagnosis of extrahepatic biliary ducts and gall bladder lesions.
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Therefore, we recommend developing a
therapeutic method that combines MRCP with conventional
MR images to diagnose cholangiocarcinoma, pancreatic
adenocarcinoma and liver tumor accurately. Doing so can
clearly display various pancreaticobiliary obstruction lesions,
including stones, cholangitis, pancreatitis and choledochal
cysts. To do so, upgraded computer
software and improvements in scanning techniques can
facilitate the production of high quality cholangiograms, even
providing super visualization of normal pancreaticobiliary
anatomy. Additionally, adopting the patient respiratory-trigger
procedure can obviously decreases the motion artifact
caused by a patients respiratory system, as facilitated by
proper training of technical personnel to execute the
standard examination procedure.
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As anticipated, the proposed therapeutic method can
eliminate the motion artifact through the most appropriate pulse
sequence chosen, better signal receive coil, and the respiratory-trigger
procedure. Thoroughly training the instrumentation operator can
significantly reduce both procedural time and patient discomfort.
Moreover, the image work station and advanced computer hardware can
reconstruct the raw data, subsequently decreasing the false diagnosis
rate and increasing diagnosis accuracy to 99%. While
incorporating MRCP for direct visualization of the biliary and pancreatic
ducts without the need for an invasive procedure, ionizing radiation or
iodine contrast media administration, the proposed therapeutic method
can produce MRCP with sufficient contrast and spatial resolution by
incorporating the volume sequence of respiratory trigger turbo spine
echocardiogram with MIP algorithm, even when a 0.5T MR unit is used.
Given its increasing accessibility, lowering cost and enhanced spatial
resolution, MRCP will become the preferred choice for imaging the
pancreaticobiliary system.
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At a recent meeting, members discussed ways in
which to evaluate the bone marrow leukemia more precisely.
Ranking eighth among all cancers in Taiwan and first among
children, leukemia is on the rise. In vivo detection of leukemia in
children can be determined using hydrogen 1 magnetic resonance
spectroscopy (MRS). Although capable of differentiating
between red bone marrow and yellow bone marrow, the MRS signal for
the bone marrow only has two peaks: a red bone marrow-like water
signal at 4.6~4.8ppm and a yellow bone marrow-like fat signal at
1.1~1.3ppm. Also, examinations performed at 1.5T magnetic do not
yield a clear MRS signal, explaining why in vivo detection of bone
marrow in qualitative and quantitative analyses is extremely difficult.
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Earlier investigations on bone marrow
biochemical analysis adopted the biopsy technique. Given
advances in medical modalities in recent years,
characterization of MRS is not invasive and surveys
continue in different echo times. Further investigation could
help differentiate between the percentage of normal and
abnormal bone marrow of Leukemia.
The inability to analyze the MRS signal for the bone
marrow of leukemia makes it impossible to develop a
method that is not invasis and more effective than
conventional therapeutic follow up methods. Therefore, a
photon MRS in vivo method must be developed, capable of
assessing the bone marrow of leukemia to supersede
conventional examinations.
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Therefore, we recommend developing a photon MRS in
vivo method, capable of assessing the bone marrow of leukemia to
supersede conventional examinations. To do so, bone
marrow can be detected using either single-voxel spectroscopy or 2D
chemical shift imaging. The lesion portion of the voxel can then be
detected on the bone marrow, followed by modulation of the pulse
sequence. Next, the MRS signal for the bone marrow can be analyzed,
capable of differentiating between the MRS of normal children and
children with leukemia. As anticipated, the proposed photon
MRS in vivo method can be used to determine why physiological
variation of the bone marrow of Leukemia occurs, which can supersede
conventional examinations. Capable of determining the
bone marrow (including red bone marrow and yellow bone marrow) of
leukemia, the proposed method can also be used to interpret the
magnetic resonance spectroscopy for the bone marrow of leukemia.
Moreover, while most MRS investigations have focused on brain signals,
MRS has seldom been studied with respect to signals of bone marrow,
making it a valuable reference for future investigations.
Further details can be found at
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