Книги: "Perfusion techniques"

1

B, Mongero Linda, and Beck, James R., B.S., eds. On bypass: Advanced perfusion techniques. Totowa, NJ: Humana Press, 2008.

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2

D, Myers R., Knott Peter J, and New York Academy of Sciences., eds. Neurochemical analysis of the conscious brain: Voltammetry and push-pull perfusion. New York, N.Y: New York Academy of Sciences, 1986.

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3

Yasunaru, Kawashima, and Takamoto Shinichi, eds. Brain protection in aortic surgery: Proceedings of the International Symposium on Current Techniques for Brain Protection in Aortic Surgery, Osaka, Japan, 15-16 September 1996. Amsterdam: Elsevier, 1997.

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4

On Bypass Advanced Perfusion Techniques. Humana Press, 2010.

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5

Safety and Techniques in Perfusion. Surgimedics, 1988.

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6

On bypass : advanced perfusion techniques. Humana, 2008.

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7

Clinical Perfusion MRI: Techniques and Applications. Cambridge University Press, 2013.

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8

Golay, Xavier, Gregory Zaharchuk, and Peter B. Barker. Clinical Perfusion MRI: Techniques and Applications. Cambridge University Press, 2013.

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9

Golay, Xavier, Gregory Zaharchuk, and Peter B. Barker. Clinical Perfusion MRI: Techniques and Applications. Cambridge University Press, 2013.

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10

(Editor), Linda B. Mongero, and James R. Beck (Editor), eds. On Bypass: Advanced Perfusion Techniques (Current Cardiac Surgery). Humana Press, 2008.

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11

Strijkers, Gustav J., and Hai-Ling Margaret Cheng. Quantitative Perfusion MRI: Techniques, Applications and Practical Considerations. Elsevier Science & Technology Books, 2023.

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12

Quantitative Perfusion MRI: Techniques, Applications and Practical Considerations. Elsevier Science & Technology, 2023.

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13

Gaddam, Samson Sujit Kumar, and Claudia S. Robertson. Cerebral blood flow and perfusion monitoring in the critically ill. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0222.

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Prevention of secondary cerebral ischaemic insults is an important management strategy in acute neurological conditions. Monitoring of cerebral perfusion may aid in early identification of ischaemic insults and help with management. A number of tools are available for this purpose. Cerebral perfusion pressure (CPP) is the simplest assessment of cerebral perfusion, but in some cases ischaemia can be present even with a normal CPP. Cerebral blood flow (CBF) imaging, either with computed tomography or magnetic resonance imaging techniques, can provide quantitative regional CBF measurement, but only at a single instance in time. Such studies are valuable in the diagnosis of ischaemia, but are difficult for the management of critically-ill patients. CBF can also be measured within the intensive care unit (ICU), either directly or indirectly through the measurement of cerebral oxygenation. These monitors provide a more continuous measure of CBF, and are more useful in assessing response to treatment. Some of the ICU tools monitor global perfusion and some assess perfusion only in a local area of brain surrounding the monitor. With local monitors, the location of the probe is important for interpretation of the findings.

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14

Myers, Robert D., and Peter J. Knott. Neurochemical Analysis of the Conscious Brain: Voltammetry and Push-Pull Perfusion (Annals of the New York Academy of Sciences, Vol 473). New York Academy of Sciences, 1986.

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15

Slomka, Piotr J., Guido Germano, and Daniel S. Berman. Gated SPECT MPI Processing and Quantitation. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199392094.003.0007.

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Gated MPS provides an accurate and reproducible method for measuring myocardial perfusion at stress and rest as well as LVEF, EDV, ESV and diastolic function. It also provides a means of assessing regional wall motion abnormality, either at rest or post-stress. These functions and perfusion measurements obtained from gated MPS complement each other in CAD diagnosis as well as risk stratification. This chapter presents a comprehensive review of techniques used in gated SPECT processing to quantify function and perfusion, including the latest techniques and developments.

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16

Bandettini, Peter A., and Hanzhang Lu. Magnetic Resonance Methodologies. Edited by Dennis S. Charney, Eric J. Nestler, Pamela Sklar, and Joseph D. Buxbaum. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190681425.003.0008.

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Magnetic resonance imaging is a noninvasive tool for assessing brain anatomy, perfusion, metabolism, and function with precision. In this chapter, the basics and the most cutting edge examples of MRI-based measures are described. The first is measurement of cerebral perfusion, including the latest techniques involving spin-labelling as well as the tracking of exogenous contrast agents. Functional MRI is then discussed, along with some of the cutting edge methodology that has yet to make it into routine clinical practice. Next, resting state fMRI is described, a powerful technique whereby the entire brain connectivity can be established. Diffusion-based MRI techniques are useful for diagnosing brain trauma as well as understanding the structural connections in healthy and pathological brains. Spectroscopy is able to make spatially specific and metabolite-specific assessment of brain metabolism. The chapter ends with an overview of structural imaging with MRI, highlighting the developing field of morphometry and its potential for differentially assessing individual brains.

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17

Zaret, Barry L. Nuclear Cardiology. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199392094.003.0001.

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Nuclear cardiology is generally considered a clinical phenomenon of the past four decades. However, the field has its roots in earlier times. This chapter focuses on these historical roots as they have evolved into the present era. The initial application of radioisotopes to cardiac studies occurred in the mid-1920s. Ventricular function was evaluated in the 1960s and 1970s by first pass and equilibrium techniques. Myocardial stress perfusion imaging was first performed using potassium-43 and exercise in 1973. Stress imaging rapidly evolved thereafter with new tracers (thallium-201 and technetium-labeled agents) and from planar to SPECT approaches. Perfusion imaging rapidly proved its value diagnostically and in assessing prognosis. Infarct imaging reached its peak use in the 1970s but is now no longer employed. Advances in hybrid imaging, combining CT with radionuclide imaging has recently allowed attenuation correction as well as providing the combination of anatomic and physiologic data. PET myocardial perfusion studies have recently become a standard approach for evaluating perfusion, absolute coronary blood flow and coronary reserve. PET FDG studies of cardiac sarcoidosis have recently been established as a new approach for defining myocardial inflammation. New SPECT systems provide high sensitivity, high resolution studies, allowing for radiation dose reduction and high quality imaging studies.

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18

De Deyne, Cathy, Ward Eertmans, and Jo Dens. Neurological assessment of the acute cardiac care patient. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199687039.003.0016_update_001.

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Many techniques are currently available for cerebral physiological monitoring in the intensive cardiac care unit environment. The ultimate goal of cerebral monitoring applied during the acute care of any patient with/or at risk of a neurological insult is the early detection of regional or global hypoxic/ischaemic cerebral insults. In the most ideal situation, cerebral monitoring should enable the detection of any deterioration before irreversible brain damage occurs or should at least enable the preservation of current brain function (such as in comatose patients after cardiac arrest). Most of the information that affects bedside care of patients with acute neurologic disturbances is now derived from clinical examination and from knowledge of the pathophysiological changes in cerebral perfusion, cerebral oxygenation, and cerebral function. Online monitoring of these changes can be realized by many non-invasive techniques, without neglecting clinical examination and basic physiological variables—with possible impact on optimal cerebral perfusion/oxygenation—such as invasive arterial blood pressure monitoring or arterial blood gas analysis.

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19

Sabharwal, Nikant, Parthiban Arumugam, and Andrew Kelion. Introduction to myocardial perfusion scintigraphy. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198759942.003.0006.

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Myocardial perfusion scintigraphy (MPS) is used to image relative myocardial blood flow at rest and during stress, thereby defining flow-limiting epicardial coronary stenoses and sometimes microvascular disease. It is commonly used diagnostically in patients with suspected coronary disease, and provides valuable prognostic information even in patients with proven disease. This chapter provides an introduction to MPS, including a brief overview of technique, equipment, and indications.

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20

Staitieh, Bashar S., and Greg S. Martin. Therapeutic goals of fluid resuscitation. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0070.

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Optimizing tissue perfusion by administering intravenous fluids presents a special challenge to the intensive care unit (ICU) clinician. Recent studies have drastically altered how we assess a patient’s fluid responsiveness, particularly with regard to upstream surrogates of tissue perfusion. Central venous pressure and pulmonary capillary wedge pressure have been found to be inaccurate markers of fluid responsiveness and have given way to methods such as cardiac output as assessed by echocardiography and the various forms of arterial waveform analysis. These newer techniques, such as stroke volume variation, systolic pressure variation, and pulse pressure variation, have been found to better delineate which patients will respond to a fluid challenge with an increase in cardiac output, and which will not. In addition, traditional methods of assessing the consequences of excessive fluid administration, such as pulmonary oedema and the non-anion gap acidosis of saline administration, have given way to more sophisticated measurements of extravascular lung water, now available at the bedside. Downstream markers of tissue perfusion, such as base deficit, central venous oxygen saturations, and lactic acid, continue to be useful in particular clinical settings, but are all relatively non-specific markers, and are therefore difficult to use as resuscitation targets for ICU patients in general. Finally, recent data on septic shock and ARDS have demonstrated the importance of conservative fluid strategies, while data in surgical populations have emphasized the need for judicious fluid administration and attention to the balance of blood products used in resuscitation efforts.

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21

Cohen-Inbar, Or, Daniel M. Trifiletti, and Jason P. Sheehan. Stereotatic Radiosurgery and Microsurgery for Brain Metastases. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190696696.003.0024.

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This chapter describes the case of a patient with brain metastases due to metastatic breast cancer. MRI is the best imaging modality for visualizing brain metastases, and advanced techniques such as perfusion imaging and diffusion weighted imaging may provide important additional information beyond standard anatomic imaging. Patients with brain metastases due to systemic cancer may benefit from targeted therapies such as surgery and stereotactic radiosurgery. Understanding the differences between radiation modalities such as stereotactic radiosurgery and whole brain radiotherapy is important for counseling patients.

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22

Kidwell, Chelsea S., and Kambiz Nael. Neuroimaging of Acute Stroke. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199937837.003.0102.

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The neuroimaging workup for patients with suspected acute ischemic stroke has advanced significantly over the past few decades. Evaluation is no longer limited to noncontrast computed tomography (CT), but now frequently also includes vascular and perfusion imaging. Although acute stroke imaging has made significant progress with the development of multimodal approaches, there are still many unanswered questions regarding their appropriate use in daily patient care. It is important for all physicians taking care of stroke patients to be familiar with current multimodal CT and magnetic resonance imaging (MRI) techniques, including their strengths, limitations, and their role in guiding therapy.

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23

Chen, Ji. Phase Analysis for Dyssynchrony by MPI and MUGA. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199392094.003.0022.

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Fourier phase analysis can be used to assess dyssynchrony from nuclear images, such as multi-gated acquisition (MUGA) radionuclide angiography, gated blood-pool SPECT, and gated SPECT myocardial perfusion imaging. This chapter reviews the technical background of Fourier phase analysis with these imaging modalities and demonstrates how it measures ventricular dyssynchrony. The major clinical application of ventricular dyssynchrony assessment is to improve response to cardiac resynchronization (CRT) in patients with heart failure. This chapter introduces the current practice of CRT and the potential factors related to CRT response, and then reviews the clinical studies of the above phase analysis techniques for increasing CRT response.

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24

Navaratnam, M., and C. Ramamoorthy. Hypoplastic Left Heart Syndrome. Edited by Kirk Lalwani, Ira Todd Cohen, Ellen Y. Choi, and Vidya T. Raman. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190685157.003.0009.

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Approximately 960 babies are born per year in the United States with hypoplastic left heart syndrome. Over the last 20 years, advances in surgical techniques, perioperative care, cardiopulmonary bypass, and intensive care unit management have converted this previously fatal condition to one with a neonatal survival rate of 90% to 92% for standard risk patients. Understanding the factors affecting the balance of pulmonary blood flow and systemic blood flow and ensuring adequate cardiac output and end-organ perfusion is critical to successful outcomes. Extracorporeal membrane oxygenation remains an important support modality following stage I palliation. This chapter discusses this syndrome and describes treatment options.

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25

Dorbala, Sharmila, and Katarina H. Nelson. Inflammatory and Infiltrative Diseases and Tumors. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199392094.003.0026.

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This chapter highlights some of the novel clinical radionuclide imaging strategies beyond perfusion imaging including inflammatory diseases, infiltrative diseases and tumors. Targeted molecular imaging techniques to evaluate cardiac amyloidosis as well as myocardial and vascular inflammation are addressed. Clinical 18F-FDG imaging of cardiac sarcoidosis, cardiovascular prosthetic valve and device infections, systemic vasculitis, and tumors are discussed in detail. For each of these pathologies, a concise overview of the disease pathophysiology and management pertinent to understanding of imaging techniques is provided followed by details of imaging including radiotracers, imaging techniques and image interpretation with a reference to societal guidelines. The published data on the utility of radionuclide imaging tests to assess diagnosis, prognosis and to monitor response to therapy are discussed. Clinical scenarios and available societal recommendations on the use of imaging are illustrated. The strengths and limitations of radionuclide techniques are discussed in the context of a comparison to echocardiography, cardiac magnetic resonance imaging, cardiac CT and endomyocardial biopsy. Future directions in imaging and ongoing clinical trials in these areas are listed at the end of each section.

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26

Schwitter, Juerg. Coronary artery disease. Edited by Dudley Pennell. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198784906.003.0105.

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In the work-up of suspected or known coronary artery disease (CAD), cardiovascular magnetic resonance (CMR) is an established technique and it is recommended by most recent guidelines. Stress dobutamine and stress perfusion CMR yield sensitivities and specificities to detect anatomically defined CAD (>50% coronary stenoses) ranging from 83% to 91% and from 83% to 86%, respectively, with areas under the receiver operating characteristic curve (AUCs) of 0.80–0.93. Multicentre trials report AUCs of 0.75–0.91 to detect CAD and showed superiority over scintigraphic techniques. Increasing evidence in thousands of patients demonstrates the highly predictive value of CMR. Exclusion of ischaemia by CMR goes along with excellent event-free survival rates of 0.5–0.9%/year. Cost analyses in large data sets (e.g. in the European CMR registry), suggest considerable cost savings for CMR over first-line invasive strategies in suspected CAD. Tissue characterization by CMR to detect scar, necrosis, oedema, microvascular obstruction, or haemorrhage is of particular importance in the setting of acute coronary syndromes and this application is emerging as the number of centres offering CMR increases.

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27

Waldmann, Carl, Andrew Rhodes, Neil Soni, and Jonathan Handy, eds. Oxford Desk Reference: Critical Care. Oxford University Press, 2019. http://dx.doi.org/10.1093/med/9780198723561.001.0001.

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Oxford Desk Reference: Critical Care second edition is a clinical guide reflecting best practice and training pathways. Each topic is laid out in a concise entry, allowing rapid access to information. The second edition includes new sections on tissue perfusion monitoring and paediatric and maternal critical care, as well as expanded coverage of cardiovascular monitoring, myocardial infarction, and respiratory therapy techniques. New self-assessment questions support FFICM (Fellow of the Faculty of Intensive Care Medicine) and EDIC (European Diploma of Intensive Care) revision as well as continuing medical education reflection. Covering the entire discipline in an easy-to-read format, this is the definitive clinical reference for critical care, ideal for trainees, consultants, advanced care practitioners, and nurses.

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28

Taggart, David, and Yasir Abu-Omar. Heart surgery. Edited by Patrick Davey and David Sprigings. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199568741.003.0098.

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Cardiac surgery is still a relatively young specialty, having been developed only in the latter half of the twentieth century with the introduction of extracorporeal circulation or ‘cardiopulmonary bypass’ (CPB). This initiated the era of open heart surgery, initially allowing the repair of congenital heart defects, then valve replacements, coronary artery bypass grafting (CABG), and, finally, heart transplantation. Over the last two decades, improvements in medical, anaesthetic, and surgical management of patients, allied to refinements in extracorporeal perfusion technology, have resulted in a decreasing mortality and morbidity from heart surgery despite the advanced age and significant comorbidity of many patients. Today, heart surgery continues to improve the prognosis and quality of lives of patients around the world. Surgical techniques and technologies continue to evolve and recent years have witnessed the emergence of, amongst others, the use of long-lasting conduits for CABG procedures, beating-heart (‘off-pump’) surgery, the use of minimally invasive and robotic techniques, and long-term mechanical circulatory support.

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29

De Deyne, Cathy, and Jo Dens. Neurological assessment of the acute cardiac care patient. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199687039.003.0016.

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Many techniques are currently available for cerebral physiological monitoring in the intensive cardiac care unit environment. The ultimate goal of cerebral monitoring applied during the acute care of any patient with/or at risk of a neurological insult is the early detection of regional or global hypoxic/ischaemic cerebral insults. In the most ideal situation, cerebral monitoring should enable the detection of any deterioration before irreversible brain damage occurs or should at least enable the preservation of current brain function (such as in comatose patients after cardiac arrest). Most of the information that affects bedside care of patients with acute neurologic disturbances is now derived from clinical examination and from knowledge of the pathophysiological changes in cerebral perfusion, cerebral oxygenation, and cerebral function. Online monitoring of these changes can be realized by many non-invasive techniques, without neglecting clinical examination and basic physiological variables such as invasive arterial blood pressure monitoring or arterial blood gas analysis.

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30

Ince, Can, and Alexandre Lima. Monitoring the microcirculation in the ICU. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0142.

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The microcirculation is the key physiological compartment of the cardiovascular system where oxygen is delivered by convection and diffusion to respiring parenchymal cells to support cellular, and thereby organ, function. The microcirculation consists of microvessels less than 100 µmin diameter consisting of arterioles, capillaries, and venules. The smallest vessels (<6 µm) are the capillaries where most oxygen leaves the circulation by passive diffusion to cells. The critical role of the microcirculation has long been recognized, although it has recently been possible to image its function at the bedside, thus making it a clinically important compartment to monitor. Prior to this type of monitoring, peripheral perfusion was used as a surrogate before more advanced optical techniques were developed to image microcirculatory function both non-invasively and at the bedside. This chapter provides a brief overview of microcirculatory assessment.

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31

Dangayach, Neha S., Charles L. Francoeur, Stephan A. Mayer, and Tarek Sharshar. Neuroprotection in Sepsis and Acute Respiratory Distress Syndrome. Edited by David L. Reich, Stephan Mayer, and Suzan Uysal. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190280253.003.0013.

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Diffuse cerebral dysfunction in sepsis and acute respiratory distress syndrome (ARDS) patients is highly prevalent. Delirium and alterations in level of consciousness in septic patients are symptoms that constitute sepsis-associated encephalopathy (SAE), which is distinct from hypoxic encephalopathy. SAE is associated with substantial mortality and long-term cognitive impairment. The underlying pathophysiology of SAE is complex and poorly understood. The pathophysiology of SAE includes neuroinflammation, microglial activation, microcirculatory failure, autoregulation impairment, blood–brain barrier disruption, apoptosis, and development of microinfarcts and microhemorrhages. Apart from standard resuscitation techniques targeted at maintaining adequate cerebral perfusion and oxygenation, specific neuroprotective interventions are not currently available. Given the vast unmet need for improving functional outcome among survivors of SAE, it is a priority for the critical care community to better define, understand, and prevent this common and devastating form of neurological injury.

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32

Garcia, Ernest V. Use of Artificial Intelligence Including Decision Support Systems in Cardiac Imaging. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199392094.003.0030.

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Artificial intelligence methods, including clinical decision support systems will continue to evolve with, and adapt to, nuclear cardiology and the changing needs of physicians in specific, and to nuclear medicine technology and the health care system in general. The high level of automation already achieved in myocardial perfusion imaging is unmatched by any other cardiac imaging modality, and continues to be its major strength. In addition, strong statistical evaluations of the accuracy and validity of the various techniques have been made possible simply because of the large amount of objectivity and standardization in the automated processes. These strengths when applied to decision support systems that are affordable and easily accessible should allow most nuclear cardiology physicians to perform at a high level of expertise when interpreting imaging studies to demonstrate the value of nuclear cardiology in patient management, and most importantly, to maintain the highest quality clinical care.

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33

Blaikley, John, and Andrew J. Fisher. Lung transplantation. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780198702948.003.0011.

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This chapter describes common issues along the transplantation journey from assessment to common conditions that are diagnosed post transplantation. Assessment for transplant suitability against several objective criteria is covered as well as the importance of optimizing techniques prior to this. Recent advances mean that some patients can now be bridged to transplant using extracorporeal membrane oxygenation (ECMO) when previously they would have been removed from the transplant list. Drawbacks to ECMO are discussed. Ex-vivo lung perfusion (EVLP) of a donor organ is covered. Follow-up is considered, especially in the early phase whilst being stabilized on their new medications as well as monitoring for the development of lung rejection (acute and chronic). These conditions often present when patients are being seen away from the transplant centre. CF patients have the best outcomes of the groups after lung transplantation, emphasising that lung transplantation should be considered in this specific group of patients.

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34

Kelion, Andrew, Parthiban Arumugam, and Nikant Sabharwal. Nuclear Cardiology (Oxford Specialist Handbooks in Cardiology). Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198759942.001.0001.

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Readable, practical, and concise, the Oxford Specialist Handbook in Nuclear Cardiology is a self-contained guide to this cardiac imaging subspecialty. Including both technical and clinical aspects, it provides a foundation of essential knowledge common to practitioners from any background.This title covers radiation physics, biology and protection, and addresses all areas of imaging including the design and operation of the gamma camera (including solid-state cameras), single photon emission computed tomography (SPECT) acquisition and processing, and image interpretation and writing of reports. Stress testing and radiopharmaceuticals are explained in detail, as is the evidence base underpinning myocardial perfusion scintigraphy. Newer radionuclide imaging techniques are well covered (e.g. phosphate scintigraphy in cardiac amyloidosis), as is the expanding field of cardiac positron emission tomography (PET). Fully updated with coverage of new indications for gamma camera imaging, increased focus on attenuation correction and SPECT-CT, and detail on the design use and clinical implications of solid-state gamma cameras throughout, this second edition of the essential text for nuclear cardiology trainees and practitioners is fully illustrated with colour plates to aid clinical practice. Presented in the bestselling Oxford Handbook format, Nuclear Cardiology provides core knowledge for those training in the subspecialty, whether at a basic or advanced level or from a medical or technical background, and is a key resource for those seeking to accredit in the subspecialty.

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35

Gimelli, Alessia, and Riccardo Liga. Basic principles and technological state of the art: SPECT. Edited by Philipp Kaufmann. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198784906.003.0119.

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Single-photon emission computed tomography (SPECT) photons as a medical imaging technique detects the radiation emitted by radioisotopes injected into the body to provide in vivo measurements of regional tissue function. From its introduction in the cardiologic clinical field, nuclear imaging has classically represented the reference technique for the non-invasive evaluation of myocardial perfusion, becoming the most frequently performed imaging modality for the functional assessment of patients with ischaemic heart disease.

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36

Ferrari, Victor. The EACVI Textbook of Cardiovascular Magnetic Resonance. Edited by Massimo Lombardi, Sven Plein, Steffen Petersen, Chiara Bucciarelli-Ducci, Emanuela Valsangiacomo Buechel, and Cristina Basso. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198779735.001.0001.

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Cardiovascular magnetic resonance imaging (CMR) has become one of the great pillars of cardiac imaging. Modern CMR, as we now practise it, is the result of an enormous method and application development effort that has occurred over the past 25 years and has taken CMR from its humble beginnings of anatomical T₁- and T₂-weighted imaging to the extremely versatile, accurate, and robust technique it is now. The main developments over this time, building on the anatomical imaging, were the establishment of cine imaging for assessment of cardiac function, first-pass perfusion imaging for measurement of perfusion reserve, as well as myocardial blood flow (in millilitres per minute and gram), late gadolinium enhancement for imaging of scar and patchy fibrosis, and two-dimensional flow velocity imaging for assessment of valve and shunt lesions. This textbook intends to explore and evaluate all areas of this fascinating subject.

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37

Nguyen, Kim-Phuong, and Chris D. Glover. Anesthetic Considerations for Scoliosis Repair. Edited by Erin S. Williams, Olutoyin A. Olutoye, Catherine P. Seipel, and Titilopemi A. O. Aina. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190678333.003.0032.

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Scoliosis is an anatomical deformity caused by a lateral and rotational shift in the thoracolumbar spine. Surgical correction involves wide exposure of the spine for placement of stabilizing rods and can result in significant complications from excessive blood loss and neurologic impairments. These procedures require vigilance to acid-base status, hemodynamic fluctuations, coagulation, temperature maintenance, and neurologic monitoring from anesthesiologists. Other major anesthetic considerations discussed include maintaining the integrity of perfusion to the spinal cord, positioning concerns, optimal technique for neuromonitoring, and pain control in the perioperative period. This chapter presents a case study of a 14-year-old girl with adolescent idiopathic scoliosis who presents for posterior spinal instrumentation and fusion from T4-L4 with autologous bone graft.

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38

Galiuto, L., R. Senior, and H. Becher. Contrast echocardiography. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780199599639.003.0007.

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Contrast echocardiography is a non-invasive, well tolerated echocardiographic technique which employs ultrasound contrast agent in order to improve the quality of echocardiographic images, by enhancing blood flow signal.Clinical usefulness of this echocardiographic imaging modality resides in the possibility of providing better acoustic signal in cases of poor quality images, with additional important information related to assessment of myocardial perfusion. Indeed, about one-third of echocardiographic images are affected by poor quality due to high acoustic impedance of the chest wall of the patients secondary to obesity or pulmonary diseases, not allowing detection of left ventricular endocardial border. Moreover, in patients with low ejection fraction and apical left ventricular aneurysm, intraventricular thrombus could be undetectable with standard echocardiography. Furthermore, coronary microcirculation cannot be assessed by standard echocardiography. Contrast echocardiography can be performed in all such conditions to improve diagnostic power of echocardiography.The adjunctive role of contrast echocardiography is well defined in both rest and stress echocardiography in order to detect the endocardial border and intraventricular thrombi, to accurately measure ejection fraction, wall motion, and to assess myocardial perfusion.The purpose of this chapter is to explain basic principles, feasibility, safety, major clinical applications, current indications, and further developments of contrast echocardiography.

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