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Ortiz-Nieto, Francisco
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Publications (10 of 22) Show all publications
Marchesi, S., Ortiz-Nieto, F., Ahlgren, K. M., Roneus, A., Feinstein, R., Lipcsey, M., . . . Hedenstierna, G. (2019). Abdominal organ perfusion and inflammation in experimental sepsis: a magnetic resonance imaging study. American Journal of Physiology - Gastrointestinal and Liver Physiology, 316(1), G187-G196
Open this publication in new window or tab >>Abdominal organ perfusion and inflammation in experimental sepsis: a magnetic resonance imaging study
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2019 (English)In: American Journal of Physiology - Gastrointestinal and Liver Physiology, ISSN 0193-1857, E-ISSN 1522-1547, Vol. 316, no 1, p. G187-G196Article in journal (Refereed) Published
Abstract [en]

Diffusion-weighted magnetic resonance imaging (DW-MRI) uses water as contrast and enables the study of perfusion in many organs simultaneously in situ. We used DW-MRI in a sepsis model, comparing abdominal organs perfusion with global hemodynamic measurements and inflammation. Sixteen anesthetized piglets were randomized into 3 groups: HighMAP (mean arterial pressure, MAP > 65 mmHg), LowMAP (MAP between 50 and 60 mmHg) and Healthy Controls (HC). Sepsis was obtained with endotoxin and the desired MAP maintained with noradrenaline. After 6 hours DW-MRI was performed. Acute inflammation was assessed with IL-6 and TNFα in abdominal organs, ascites, and blood and by histology of intestine (duodenum). Perfusion of abdominal organs was reduced in the LowMAP group compared to the HighMAP group and HC. Liver perfusion was still reduced by 25% in the HighMAP group compared with HC. Intestinal perfusion did not differ significantly between the study groups. Cytokines concentration were generally higher in the LowMAP group but did not correlate with global hemodynamics. However, cytokines correlated with regional perfusion and, for liver and intestine, also with intra-abdominal pressure. Histopathology of intestine worsened with decreasing perfusion. In conclusion, although a low MAP (≤60 mmHg) indicated impeded abdominal perfusion in experimental sepsis, it did not predict inflammation, nor did other global measures of circulation. Decreased abdominal perfusion predicted partially inflammation but intestine, occupying most of the abdomen, and liver, were also affected by intra-abdominal pressure.

Keywords
Abdominal organs, inflammation, magnetic resonance, perfusion, sepsis
National Category
Surgery Anesthesiology and Intensive Care
Identifiers
urn:nbn:se:uu:diva-364356 (URN)10.1152/ajpgi.00151.2018 (DOI)000455670700012 ()30335473 (PubMedID)
Funder
Swedish Heart Lung FoundationSwedish Research Council
Available from: 2018-10-25 Created: 2018-10-25 Last updated: 2019-02-05Bibliographically approved
Hellström, J., Romanos Zapata, R., Libard, S., Wikström, J., Ortiz-Nieto, F., Alafuzoff, I. & Raininko, R. (2019). Evaluation of the INTERPRET decision-support system: can it improve the diagnostic value of magnetic resonance spectroscopy of the brain?. Neuroradiology, 61(1), 43-53
Open this publication in new window or tab >>Evaluation of the INTERPRET decision-support system: can it improve the diagnostic value of magnetic resonance spectroscopy of the brain?
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2019 (English)In: Neuroradiology, ISSN 0028-3940, E-ISSN 1432-1920, Vol. 61, no 1, p. 43-53Article in journal (Refereed) Published
Abstract [en]

Purpose: We evaluated in a clinical setting the INTERPRET decision-support system (DSS), a software generated to aid in MRS analysis to achieve a specific diagnosis for brain lesions.

Methods: The material consisted of 100 examinations of focal intracranial lesions with confirmed diagnoses. MRS was obtained at 1.5 T using TE 20–30 ms. Data were processed with the LCModel for conventional analysis. The INTERPRET DSS 3.1. was used to obtain specific diagnoses. MRI and MRS were reviewed by one interpreter. DSS analysis was made by another interpreter, in 80 cases by two interpreters. The diagnoses were compared with the definitive diagnoses. For comparisons between DSS, conventional MRS analysis, and MRI, the diagnoses were categorised: high-grade tumour, low-grade tumour, non-neoplastic lesion.

Results: Interobserver agreement in choosing the diagnosis from the INTERPRET database was 75%. The diagnosis was correct in 38/100 cases, incorrect in 57 cases. No good match was found in 5/100 cases. The diagnostic category was correct with DSS/conventional MRS/MRI in 67/58/52 cases, indeterminate in 5/8/20 cases, incorrect in 28/34/28 cases. Results with DSS were not significantly better than with conventional MRS analysis. All definitive diagnoses did not exist in the INTERPRET database. In the 61 adult patients with the diagnosis included in the database, DSS/conventional MRS/MRI yielded a correct diagnosis category in 48/32/29 cases (DSS vs conventional MRS: p = 0.002, DSS vs MRI: p = 0.0004).

Conclusion: Use of the INTERPRET DSS did not improve MRS categorisation of the lesions in the unselected clinical cases. In adult patients with lesions existing in the INTERPRET database, DSS improved the results, which indicates the potential of this software with an extended database.

Keywords
Brain, Computer-aided diagnosis, Decision-support system, Magnetic resonance imaging, Magnetic resonance spectroscopy
National Category
Radiology, Nuclear Medicine and Medical Imaging Clinical Laboratory Medicine
Research subject
Pathology
Identifiers
urn:nbn:se:uu:diva-366791 (URN)10.1007/s00234-018-2129-7 (DOI)000456076500010 ()30443796 (PubMedID)
Available from: 2018-11-24 Created: 2018-11-24 Last updated: 2019-03-29Bibliographically approved
Hellström, J., Romanos Zapata, R., Libard, S., Wikström, J., Ortiz-Nieto, F., Alafuzoff, I. & Raininko, R. (2018). The value of magnetic resonance spectroscopy as a supplement to MRI of the brain in a clinical setting. PLoS ONE, 13(11), Article ID e0207336.
Open this publication in new window or tab >>The value of magnetic resonance spectroscopy as a supplement to MRI of the brain in a clinical setting
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2018 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 13, no 11, article id e0207336Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: There are different opinions of the clinical value of MRS of the brain. In selected materials MRS has demonstrated good results for characterisation of both neoplastic and non-neoplastic lesions. The aim of this study was to evaluate the supplemental value of MR spectroscopy (MRS) in a clinical setting.

MATERIAL AND METHODS: MRI and MRS were re-evaluated in 208 cases with a clinically indicated MRS (cases with uncertain or insufficient information on MRI) and a confirmed diagnosis. Both single voxel spectroscopy (SVS) and chemical shift imaging (CSI) were performed in 105 cases, only SVS or CSI in 54 and 49 cases, respectively. Diagnoses were grouped into categories: non-neoplastic disease, low-grade tumour, and high-grade tumour. The clinical value of MRS was considered very beneficial if it provided the correct category or location when MRI did not, beneficial if it ruled out suspected diseases or was more specific than MRI, inconsequential if it provided the same level of information, or misleading if it provided less or incorrect information.

RESULTS: There were 70 non-neoplastic lesions, 43 low-grade tumours, and 95 high-grade tumours. For MRI, the category was correct in 130 cases (62%), indeterminate in 39 cases (19%), and incorrect in 39 cases (19%). Supplemented with MRS, 134 cases (64%) were correct, 23 cases (11%) indeterminate, and 51 (25%) incorrect. Additional information from MRS was beneficial or very beneficial in 31 cases (15%) and misleading in 36 cases (17%).

CONCLUSION: In most cases MRS did not add to the diagnostic value of MRI. In selected cases, MRS may be a valuable supplement to MRI.

National Category
Radiology, Nuclear Medicine and Medical Imaging Clinical Laboratory Medicine
Research subject
Pathology
Identifiers
urn:nbn:se:uu:diva-366792 (URN)10.1371/journal.pone.0207336 (DOI)000450254000069 ()30440005 (PubMedID)
Available from: 2018-11-24 Created: 2018-11-24 Last updated: 2019-03-29Bibliographically approved
Weis, J., von Below, C., Tolf, A., Ortiz-Nieto, F., Wassberg, C., Haggman, M., . . . Ahlström, H. (2017). Quantification of metabolite concentrations in benign and malignant prostate tissues using 3D proton MR spectroscopic imaging. Journal of Magnetic Resonance Imaging, 45(4), 1232-1240
Open this publication in new window or tab >>Quantification of metabolite concentrations in benign and malignant prostate tissues using 3D proton MR spectroscopic imaging
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2017 (English)In: Journal of Magnetic Resonance Imaging, ISSN 1053-1807, E-ISSN 1522-2586, Vol. 45, no 4, p. 1232-1240Article in journal (Refereed) Published
Abstract [en]

PURPOSE: To estimate concentrations of choline (Cho), spermine (Spm), and citrate (Cit) in prostate tissue using 3D proton magnetic resonance spectroscopic imaging (MRSI) with water as an internal concentration reference as well as to assess the relationships between the measured metabolites and also between the metabolites and apparent diffusion coefficient (ADC).

MATERIALS AND METHODS: Forty-six prostate cancer patients were scanned at 3T. Spectra were acquired with the point-resolved spectroscopy (PRESS) localization technique. Single-voxel spectra of four healthy volunteers were used to estimate T1 relaxation time of Spm. Spm, Cho concentrations, and ADC values of benign prostate tissues were correlated with Cit content.

RESULTS: The T1 value, 708 ± 132 msec, was estimated for Spm. Mean concentrations in the benign peripheral zone (PZ) were Cho, 4.5 ± 1 mM, Spm, 13.0 ± 4.4 mM, Cit, 64.4 ± 16.1 mM. Corresponding values in the benign central gland (CG) were Cho, 3.6 ± 1 mM, Spm, 13.3 ± 4.5 mM, Cit, 34.3 ± 12.9 mM. Concentrations of Cit and Spm were positively correlated in the benign PZ zone (r = 0.730) and CG (r = 0.664). Positive correlation was found between Cit and Cho in the benign CG (r = 0.705). Whereas Cit and ADC were positively correlated in the benign PZ (r = 0.673), only low correlation was found in CG (r = 0.265).

CONCLUSION: We have shown that it is possible to perform water-referenced quantitative 3D MRSI of the prostate at the cost of a relatively short prolongation of the acquisition time. The individual metabolite concentrations provide additional information compared to the previously used metabolite-to-citrate ratios.

National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
urn:nbn:se:uu:diva-304633 (URN)10.1002/jmri.25443 (DOI)000397489100030 ()27556571 (PubMedID)
Available from: 2016-10-06 Created: 2017-05-30 Last updated: 2017-05-30Bibliographically approved
Hellström, J., Romanos Zapata, R., Libard, S., Alafuzoff, I., Wikström, J., Ortiz-Nieto, F. & Raininko, R. (2015). Clinical value of MR spectroscopy: How often does MRS yield more information than MRI?. Paper presented at 38th Annual Meeting of European Society of Neuroradiology, Neapel, Italy.. Neuroradiology, 57(Suppl1), 143-144
Open this publication in new window or tab >>Clinical value of MR spectroscopy: How often does MRS yield more information than MRI?
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2015 (English)In: Neuroradiology, ISSN 0028-3940, E-ISSN 1432-1920, Vol. 57, no Suppl1, p. 143-144Article in journal (Refereed) Published
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-264483 (URN)
Conference
38th Annual Meeting of European Society of Neuroradiology, Neapel, Italy.
Available from: 2015-10-13 Created: 2015-10-13 Last updated: 2017-12-01
Marchesi, S., Larsson, A., Ahlgren, K. M., Lattuada, M., Ortiz-Nieto, F. & Hedenstierna, G. (2015). Enhanced Abdominal Inflammation In Acute Respiratory Failure - Is The Culprit Ventilator Associated Abdominal Edema Or Inadequate Perfusion?: A Magnetic Resonance Imaging Pilot Study. Paper presented at International Conference of the American-Thoracic-Society (ATS), MAY 15-20, 2015, Denver, CO. American Journal of Respiratory and Critical Care Medicine, 191
Open this publication in new window or tab >>Enhanced Abdominal Inflammation In Acute Respiratory Failure - Is The Culprit Ventilator Associated Abdominal Edema Or Inadequate Perfusion?: A Magnetic Resonance Imaging Pilot Study
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2015 (English)In: American Journal of Respiratory and Critical Care Medicine, ISSN 1073-449X, E-ISSN 1535-4970, Vol. 191Article in journal, Meeting abstract (Other academic) Published
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:uu:diva-300001 (URN)000377582805571 ()
Conference
International Conference of the American-Thoracic-Society (ATS), MAY 15-20, 2015, Denver, CO
Available from: 2016-08-01 Created: 2016-08-01 Last updated: 2017-11-28Bibliographically approved
Hellström, J., Romanos Zapata, R., Ortiz-Nieto, F., Libard, S., Alafuzoff, I., Wikström, J. & Raininko, R. (2015). Evaluation of INTERPRET Decision Support System (DSS) in clinical MRS of intracranial lesions and comparison to conventional MRS analysis and MRI.. Paper presented at 38th Annual Meeting of European Society of Neuroradiology, Neapel, Italy.. Neuroradiology, 57(Suppl1), 67-68
Open this publication in new window or tab >>Evaluation of INTERPRET Decision Support System (DSS) in clinical MRS of intracranial lesions and comparison to conventional MRS analysis and MRI.
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2015 (English)In: Neuroradiology, ISSN 0028-3940, E-ISSN 1432-1920, Vol. 57, no Suppl1, p. 67-68Article in journal (Refereed) Published
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-264585 (URN)
Conference
38th Annual Meeting of European Society of Neuroradiology, Neapel, Italy.
Available from: 2015-10-15 Created: 2015-10-15 Last updated: 2018-09-06
Weis, J., Bruvold, M., Ortiz-Nieto, F. & Ahlström, H. (2014). High-resolution echo-planar spectroscopic imaging of the human calf. PLoS ONE, 9(1), e87533
Open this publication in new window or tab >>High-resolution echo-planar spectroscopic imaging of the human calf
2014 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 9, no 1, p. e87533-Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: This study exploits the speed benefits of echo-planar spectroscopic imaging (EPSI) to acquire lipid spectra of skeletal muscle. The main purpose was to develop a high-resolution EPSI technique for clinical MR scanner, to visualise the bulk magnetic susceptibility (BMS) shifts of extra-myocellular lipid (EMCL) spectral lines, and to investigate the feasibility of this method for the assessment of intra-myocellular (IMCL) lipids.

METHODS: The study group consisted of six healthy volunteers. A two dimensional EPSI sequence with point-resolved spectroscopy (PRESS) spatial localization was implemented on a 3T clinical MR scanner. Measurements were performed by means of 64×64 spatial matrix and nominal voxel size 3×3×15 mm(3). The total net measurement time was 3 min 12 sec for non-water-suppressed (1 acquisition) and 12 min 48 sec for water-suppressed scans (4 acquisitions).

RESULTS: Spectra of the human calf had a very good signal-to-noise ratio and linewidths sufficient to differentiate IMCL resonances from EMCL. The use of a large spatial matrix reduces inter-voxel signal contamination of the strong EMCL signals. Small voxels enabled visualisation of the methylene EMCL spectral line splitting and their BMS shifts up to 0.5 ppm relative to the correspondent IMCL line. The mean soleus muscle IMCL content of our six volunteers was 0.30±0.10 vol% (range 0.18-0.46) or 3.6±1.2 mmol/kg wet weight (range: 2.1-5.4).

CONCLUSION: This study demonstrates that high-spatial resolution PRESS EPSI of the muscle lipids is feasible on standard clinical scanners.

National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
urn:nbn:se:uu:diva-218636 (URN)10.1371/journal.pone.0087533 (DOI)000330617100091 ()24498129 (PubMedID)
Funder
Swedish Research Council
Available from: 2014-02-13 Created: 2014-02-13 Last updated: 2017-12-06Bibliographically approved
Sohlberg, S., Mulic-Lutvica, A., Lindgren, P., Ortiz-Nieto, F., Wikström, A.-K. & Wikström, J. (2014). Placental perfusion in normal pregnancy and early and late preeclampsia: A magnetic resonance imaging study.. Placenta, 35(3), 202-206
Open this publication in new window or tab >>Placental perfusion in normal pregnancy and early and late preeclampsia: A magnetic resonance imaging study.
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2014 (English)In: Placenta, ISSN 0143-4004, E-ISSN 1532-3102, Vol. 35, no 3, p. 202-206Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: Our primary aim was to investigate if women with early or late preeclampsia have different placental perfusion compared with normal pregnancies. A secondary aim was to investigate if placental perfusion changes with increasing gestational age in normal pregnancy.

METHODS: The study population included thirteen women with preeclampsia (five with early and eight with late preeclampsia) and nineteen women with normal pregnancy (ten with early and nine with late pregnancy). Early was defined as <34 weeks and late as ≥34 weeks gestation. All women underwent a magnetic resonance imaging (MRI) examination including a diffusion weighted sequence at 1.5 T. The perfusion fraction was calculated.

RESULTS: Women with early preeclampsia had a smaller placental perfusion fraction (p = 0.001) and women with late preeclampsia had a larger placental perfusion fraction (p = 0.011), compared to women with normal pregnancies at the corresponding gestational age. The placental perfusion fraction decreased with increasing gestational age in normal pregnancies (p = 0.001).

CONCLUSION: Both early and late preeclampsia differ in placental perfusion from normal pregnant women. Observed differences are however in the opposite direction, suggesting differences in pathophysiology. Placental perfusion decreases with increasing gestational age in normal pregnancy.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-221884 (URN)10.1016/j.placenta.2014.01.008 (DOI)000333495900008 ()24529946 (PubMedID)
Available from: 2014-04-07 Created: 2014-04-07 Last updated: 2017-12-05Bibliographically approved
Rhodin, A., von Ehren, M., Skottheim, B., Grönbladh, A., Ortiz-Nieto, F., Raininko, R., . . . Nyberg, F. (2014). Recombinant human growth hormone improves cognitive capacity in a pain patient exposed to chronic opioids. Acta Anaesthesiologica Scandinavica, 58(6), 759-765
Open this publication in new window or tab >>Recombinant human growth hormone improves cognitive capacity in a pain patient exposed to chronic opioids
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2014 (English)In: Acta Anaesthesiologica Scandinavica, ISSN 0001-5172, E-ISSN 1399-6576, Vol. 58, no 6, p. 759-765Article in journal (Refereed) Published
Abstract [en]

During recent decades, the increasing use of opioids for chronic non-cancer pain has raised concerns regarding tolerance, addiction, and importantly cognitive dysfunction. Current research suggests that the somatotrophic axis could play an important role in cognitive function. Administration of growth hormone (GH) to GH-deficient humans and experimental animals has been shown to result in significant improvements in cognitive capacity. In this report, a patient with cognitive disabilities resulting from chronic treatment with opioids for neuropathic pain received recombinant human growth hormone (rhGH) replacement therapy. A 61-year-old man presented with severe cognitive dysfunction after long-term methadone treatment for intercostal neuralgia and was diagnosed with GH insufficiency by GH releasing hormone-arginine testing. The effect of rhGH replacement therapy on his cognitive capacity and quality of life was investigated. The hippocampal volume was measured using magnetic resonance imaging, and the ratios of the major metabolites were calculated using proton magnetic resonance spectroscopy. Cognitive testing revealed significant improvements in visuospatial cognitive function after rhGH. The hippocampal volume remained unchanged. In the right hippocampus, the N-acetylaspartate/creatine ratio (reflecting nerve cell function) was initially low but increased significantly during rhGH treatment, as did subjective cognitive, physical and emotional functioning. This case report indicates that rhGH replacement therapy could improve cognitive behaviour and well-being, as well as hippocampal metabolism and functioning in opioid-treated patients with chronic pain. The idea that GH could affect brain function and repair disabilities induced by long-term exposure to opioid analgesia is supported.

National Category
Anesthesiology and Intensive Care
Identifiers
urn:nbn:se:uu:diva-223926 (URN)10.1111/aas.12309 (DOI)000337967300016 ()24712862 (PubMedID)
Available from: 2014-04-28 Created: 2014-04-28 Last updated: 2017-12-05Bibliographically approved
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