Characterization of focal liver lesions: use of mangafodipir trisodium (MnDPDP)-enhanced MR images

We evaluated the characterization and detection of liver lesions using mangafodipir trisodium. A total of 51 patients with liver lesions [13 hepatocellular carcinomas, 18 metastases, 14 hemangiomas, three cholangiocellular carcinomas, two hydatic cysts, and one focal nodular hyperplasia (FNH)] were...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:The Turkish journal of gastroenterology 2006-09, Vol.17 (3), p.164-171
Hauptverfasser: Karabacakoğlu, Aydin, Adigüzel, Yüksel, Karaköse, Serdar, Kayaçetin, Ertuğrul, Haykir, Rahime
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
container_end_page 171
container_issue 3
container_start_page 164
container_title The Turkish journal of gastroenterology
container_volume 17
creator Karabacakoğlu, Aydin
Adigüzel, Yüksel
Karaköse, Serdar
Kayaçetin, Ertuğrul
Haykir, Rahime
description We evaluated the characterization and detection of liver lesions using mangafodipir trisodium. A total of 51 patients with liver lesions [13 hepatocellular carcinomas, 18 metastases, 14 hemangiomas, three cholangiocellular carcinomas, two hydatic cysts, and one focal nodular hyperplasia (FNH)] were examined by unenhanced and mangafodipir trisodium-enhanced MRI. After administration of mangafodipir trisodium by slow intravenous infusion, mangafodipir trisodium-enhanced MRI was performed at 15-30 min and 24 h. The enhancement appeared in normal liver parenchyma and all of the hepatocellular lesions (HCCs and FNH). The lesions in hepatocellular carcinomas patients showed a non-homogeneous enhancement pattern. Non-hepatocellular lesions (hemangiomas, metastases, CCCs) had no enhancement on mangafodipir trisodium-enhanced MRI examinations. The rim-like enhancement pattern was demonstrated in all patients with cholangiocellular carcinomas, and in 14 metastases and 11 hemangiomas. Mangafodipir trisodium-enhanced MRI permits reliable distinction between hepatocellular and non-hepatocellular tumors. Mangafodipir trisodium-enhanced MRI can show more functional and morphologic features of hepatocellular lesions. Some non-hepatocellular lesions which went undetected on unenhanced MRI were visualized after contrast enhancement of the liver. The rim-like enhancement pattern is not specific for metastases. Mangafodipir trisodium-enhanced MRI is safe and well tolerated and may aid in noninvasive diagnosis of liver lesions.
format Article
fullrecord <record><control><sourceid>proquest_ulakb</sourceid><recordid>TN_cdi_ulakbim_primary_75950</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>68815064</sourcerecordid><originalsourceid>FETCH-LOGICAL-p1450-f340d10a02dcdaa52a8119af38651d6153887028d42f628ca260e9415c8e21a03</originalsourceid><addsrcrecordid>eNo9kElLA0EQhfugmBj9ByJ9Ej0M9J4eb5K4QYJB9DxUeklaZ7N7RtBf74SopyrqezzeqwM0ppyQTORCj9BxSm-EcE0VO0IjqnJBmdBjtJ5tIYLpXAzf0IWmxo3HvjFQ4jJ8uohLl4ZrusZ9cjtWQb0B39jQhoi7GNKw9hW-XNbz1Xx1lbl6C7VxFi-fcahg49IJOvRQJnf6Oyfo9e72ZfaQLZ7uH2c3i6ylQpLMc0EsJUCYNRZAMtCU5uC5VpJaRSXXekqYtoJ5xbQBpogbakijHaNA-ASd7X37Et7XoSraOASIX8VU5nKHL_a4jc1H71JXVCEZV5ZQu6ZPhdKaSqLEIDz_Ffbrytl_m7-n8R_-9GXe</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>68815064</pqid></control><display><type>article</type><title>Characterization of focal liver lesions: use of mangafodipir trisodium (MnDPDP)-enhanced MR images</title><source>MEDLINE</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><creator>Karabacakoğlu, Aydin ; Adigüzel, Yüksel ; Karaköse, Serdar ; Kayaçetin, Ertuğrul ; Haykir, Rahime</creator><creatorcontrib>Karabacakoğlu, Aydin ; Adigüzel, Yüksel ; Karaköse, Serdar ; Kayaçetin, Ertuğrul ; Haykir, Rahime</creatorcontrib><description>We evaluated the characterization and detection of liver lesions using mangafodipir trisodium. A total of 51 patients with liver lesions [13 hepatocellular carcinomas, 18 metastases, 14 hemangiomas, three cholangiocellular carcinomas, two hydatic cysts, and one focal nodular hyperplasia (FNH)] were examined by unenhanced and mangafodipir trisodium-enhanced MRI. After administration of mangafodipir trisodium by slow intravenous infusion, mangafodipir trisodium-enhanced MRI was performed at 15-30 min and 24 h. The enhancement appeared in normal liver parenchyma and all of the hepatocellular lesions (HCCs and FNH). The lesions in hepatocellular carcinomas patients showed a non-homogeneous enhancement pattern. Non-hepatocellular lesions (hemangiomas, metastases, CCCs) had no enhancement on mangafodipir trisodium-enhanced MRI examinations. The rim-like enhancement pattern was demonstrated in all patients with cholangiocellular carcinomas, and in 14 metastases and 11 hemangiomas. Mangafodipir trisodium-enhanced MRI permits reliable distinction between hepatocellular and non-hepatocellular tumors. Mangafodipir trisodium-enhanced MRI can show more functional and morphologic features of hepatocellular lesions. Some non-hepatocellular lesions which went undetected on unenhanced MRI were visualized after contrast enhancement of the liver. The rim-like enhancement pattern is not specific for metastases. Mangafodipir trisodium-enhanced MRI is safe and well tolerated and may aid in noninvasive diagnosis of liver lesions.</description><identifier>ISSN: 1300-4948</identifier><identifier>PMID: 16941248</identifier><language>eng</language><publisher>Turkey: Türk Gastroenteroloji Vakfı</publisher><subject>Adult ; Aged ; Bile Duct Neoplasms ; Bile Duct Neoplasms - pathology ; Bile Ducts, Intrahepatic ; Bile Ducts, Intrahepatic - pathology ; Carcinoma, Hepatocellular ; Carcinoma, Hepatocellular - pathology ; Cholangiocarcinoma ; Cholangiocarcinoma - pathology ; Contrast Media ; Echinococcosis, Hepatic ; Echinococcosis, Hepatic - pathology ; Edetic Acid ; Edetic Acid - analogs &amp; derivatives ; Edetik asit ; Ekinokokkoz, hepatik ; Female ; Focal Nodular Hyperplasia ; Focal Nodular Hyperplasia - pathology ; Fokal nodüler hiperplazi ; Görüntü büyütme ; Hemangioma ; Hemangioma - pathology ; Hemanjiyom ; Humans ; Image Enhancement ; Infusions, Intravenous ; İnfüzyonlar, ven içi ; Karaciğer neoplazmları ; Karsinom, hepatosellüler ; Kolanjiokarsinom ; Kontrast ortamı ; Liver Neoplasms ; Liver Neoplasms - pathology ; Liver Neoplasms - secondary ; Magnetic Resonance Imaging ; Magnetic Resonance Imaging - methods ; Male ; Manyetik rezonans görüntüleme ; Middle Aged ; N,N'-bis(piridoksal-5-fosfate)etilenediyamin-N,N'-diasetik asit ; N,N'-bis(pyridoxal-5-phosphate)ethylenediamine-N,N'-diacetic acid ; Neoplasms ; Neoplazmlar ; Piridoksal fosfat ; Pyridoxal Phosphate ; Pyridoxal Phosphate - analogs &amp; derivatives ; Safra kanalı neoplazmları ; Safra kanalları, intrahepatik</subject><ispartof>The Turkish journal of gastroenterology, 2006-09, Vol.17 (3), p.164-171</ispartof><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16941248$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Karabacakoğlu, Aydin</creatorcontrib><creatorcontrib>Adigüzel, Yüksel</creatorcontrib><creatorcontrib>Karaköse, Serdar</creatorcontrib><creatorcontrib>Kayaçetin, Ertuğrul</creatorcontrib><creatorcontrib>Haykir, Rahime</creatorcontrib><title>Characterization of focal liver lesions: use of mangafodipir trisodium (MnDPDP)-enhanced MR images</title><title>The Turkish journal of gastroenterology</title><addtitle>Turk J Gastroenterol</addtitle><description>We evaluated the characterization and detection of liver lesions using mangafodipir trisodium. A total of 51 patients with liver lesions [13 hepatocellular carcinomas, 18 metastases, 14 hemangiomas, three cholangiocellular carcinomas, two hydatic cysts, and one focal nodular hyperplasia (FNH)] were examined by unenhanced and mangafodipir trisodium-enhanced MRI. After administration of mangafodipir trisodium by slow intravenous infusion, mangafodipir trisodium-enhanced MRI was performed at 15-30 min and 24 h. The enhancement appeared in normal liver parenchyma and all of the hepatocellular lesions (HCCs and FNH). The lesions in hepatocellular carcinomas patients showed a non-homogeneous enhancement pattern. Non-hepatocellular lesions (hemangiomas, metastases, CCCs) had no enhancement on mangafodipir trisodium-enhanced MRI examinations. The rim-like enhancement pattern was demonstrated in all patients with cholangiocellular carcinomas, and in 14 metastases and 11 hemangiomas. Mangafodipir trisodium-enhanced MRI permits reliable distinction between hepatocellular and non-hepatocellular tumors. Mangafodipir trisodium-enhanced MRI can show more functional and morphologic features of hepatocellular lesions. Some non-hepatocellular lesions which went undetected on unenhanced MRI were visualized after contrast enhancement of the liver. The rim-like enhancement pattern is not specific for metastases. Mangafodipir trisodium-enhanced MRI is safe and well tolerated and may aid in noninvasive diagnosis of liver lesions.</description><subject>Adult</subject><subject>Aged</subject><subject>Bile Duct Neoplasms</subject><subject>Bile Duct Neoplasms - pathology</subject><subject>Bile Ducts, Intrahepatic</subject><subject>Bile Ducts, Intrahepatic - pathology</subject><subject>Carcinoma, Hepatocellular</subject><subject>Carcinoma, Hepatocellular - pathology</subject><subject>Cholangiocarcinoma</subject><subject>Cholangiocarcinoma - pathology</subject><subject>Contrast Media</subject><subject>Echinococcosis, Hepatic</subject><subject>Echinococcosis, Hepatic - pathology</subject><subject>Edetic Acid</subject><subject>Edetic Acid - analogs &amp; derivatives</subject><subject>Edetik asit</subject><subject>Ekinokokkoz, hepatik</subject><subject>Female</subject><subject>Focal Nodular Hyperplasia</subject><subject>Focal Nodular Hyperplasia - pathology</subject><subject>Fokal nodüler hiperplazi</subject><subject>Görüntü büyütme</subject><subject>Hemangioma</subject><subject>Hemangioma - pathology</subject><subject>Hemanjiyom</subject><subject>Humans</subject><subject>Image Enhancement</subject><subject>Infusions, Intravenous</subject><subject>İnfüzyonlar, ven içi</subject><subject>Karaciğer neoplazmları</subject><subject>Karsinom, hepatosellüler</subject><subject>Kolanjiokarsinom</subject><subject>Kontrast ortamı</subject><subject>Liver Neoplasms</subject><subject>Liver Neoplasms - pathology</subject><subject>Liver Neoplasms - secondary</subject><subject>Magnetic Resonance Imaging</subject><subject>Magnetic Resonance Imaging - methods</subject><subject>Male</subject><subject>Manyetik rezonans görüntüleme</subject><subject>Middle Aged</subject><subject>N,N'-bis(piridoksal-5-fosfate)etilenediyamin-N,N'-diasetik asit</subject><subject>N,N'-bis(pyridoxal-5-phosphate)ethylenediamine-N,N'-diacetic acid</subject><subject>Neoplasms</subject><subject>Neoplazmlar</subject><subject>Piridoksal fosfat</subject><subject>Pyridoxal Phosphate</subject><subject>Pyridoxal Phosphate - analogs &amp; derivatives</subject><subject>Safra kanalı neoplazmları</subject><subject>Safra kanalları, intrahepatik</subject><issn>1300-4948</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2006</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo9kElLA0EQhfugmBj9ByJ9Ej0M9J4eb5K4QYJB9DxUeklaZ7N7RtBf74SopyrqezzeqwM0ppyQTORCj9BxSm-EcE0VO0IjqnJBmdBjtJ5tIYLpXAzf0IWmxo3HvjFQ4jJ8uohLl4ZrusZ9cjtWQb0B39jQhoi7GNKw9hW-XNbz1Xx1lbl6C7VxFi-fcahg49IJOvRQJnf6Oyfo9e72ZfaQLZ7uH2c3i6ylQpLMc0EsJUCYNRZAMtCU5uC5VpJaRSXXekqYtoJ5xbQBpogbakijHaNA-ASd7X37Et7XoSraOASIX8VU5nKHL_a4jc1H71JXVCEZV5ZQu6ZPhdKaSqLEIDz_Ffbrytl_m7-n8R_-9GXe</recordid><startdate>200609</startdate><enddate>200609</enddate><creator>Karabacakoğlu, Aydin</creator><creator>Adigüzel, Yüksel</creator><creator>Karaköse, Serdar</creator><creator>Kayaçetin, Ertuğrul</creator><creator>Haykir, Rahime</creator><general>Türk Gastroenteroloji Vakfı</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope><scope>GIY</scope><scope>GIZ</scope><scope>GJA</scope><scope>GJB</scope></search><sort><creationdate>200609</creationdate><title>Characterization of focal liver lesions: use of mangafodipir trisodium (MnDPDP)-enhanced MR images</title><author>Karabacakoğlu, Aydin ; Adigüzel, Yüksel ; Karaköse, Serdar ; Kayaçetin, Ertuğrul ; Haykir, Rahime</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p1450-f340d10a02dcdaa52a8119af38651d6153887028d42f628ca260e9415c8e21a03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2006</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Bile Duct Neoplasms</topic><topic>Bile Duct Neoplasms - pathology</topic><topic>Bile Ducts, Intrahepatic</topic><topic>Bile Ducts, Intrahepatic - pathology</topic><topic>Carcinoma, Hepatocellular</topic><topic>Carcinoma, Hepatocellular - pathology</topic><topic>Cholangiocarcinoma</topic><topic>Cholangiocarcinoma - pathology</topic><topic>Contrast Media</topic><topic>Echinococcosis, Hepatic</topic><topic>Echinococcosis, Hepatic - pathology</topic><topic>Edetic Acid</topic><topic>Edetic Acid - analogs &amp; derivatives</topic><topic>Edetik asit</topic><topic>Ekinokokkoz, hepatik</topic><topic>Female</topic><topic>Focal Nodular Hyperplasia</topic><topic>Focal Nodular Hyperplasia - pathology</topic><topic>Fokal nodüler hiperplazi</topic><topic>Görüntü büyütme</topic><topic>Hemangioma</topic><topic>Hemangioma - pathology</topic><topic>Hemanjiyom</topic><topic>Humans</topic><topic>Image Enhancement</topic><topic>Infusions, Intravenous</topic><topic>İnfüzyonlar, ven içi</topic><topic>Karaciğer neoplazmları</topic><topic>Karsinom, hepatosellüler</topic><topic>Kolanjiokarsinom</topic><topic>Kontrast ortamı</topic><topic>Liver Neoplasms</topic><topic>Liver Neoplasms - pathology</topic><topic>Liver Neoplasms - secondary</topic><topic>Magnetic Resonance Imaging</topic><topic>Magnetic Resonance Imaging - methods</topic><topic>Male</topic><topic>Manyetik rezonans görüntüleme</topic><topic>Middle Aged</topic><topic>N,N'-bis(piridoksal-5-fosfate)etilenediyamin-N,N'-diasetik asit</topic><topic>N,N'-bis(pyridoxal-5-phosphate)ethylenediamine-N,N'-diacetic acid</topic><topic>Neoplasms</topic><topic>Neoplazmlar</topic><topic>Piridoksal fosfat</topic><topic>Pyridoxal Phosphate</topic><topic>Pyridoxal Phosphate - analogs &amp; derivatives</topic><topic>Safra kanalı neoplazmları</topic><topic>Safra kanalları, intrahepatik</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Karabacakoğlu, Aydin</creatorcontrib><creatorcontrib>Adigüzel, Yüksel</creatorcontrib><creatorcontrib>Karaköse, Serdar</creatorcontrib><creatorcontrib>Kayaçetin, Ertuğrul</creatorcontrib><creatorcontrib>Haykir, Rahime</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><collection>ULAKBIM - Mühendislik ve Temel Bilimler Veri Tabani</collection><collection>ULAKBIM - Yaşam Bilimleri Veri Tabani</collection><collection>ULAKBIM - Turk Sosyal Bilimler Veri Tabani</collection><collection>ULAKBIM - Türk Tıp Veri Tabani</collection><jtitle>The Turkish journal of gastroenterology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Karabacakoğlu, Aydin</au><au>Adigüzel, Yüksel</au><au>Karaköse, Serdar</au><au>Kayaçetin, Ertuğrul</au><au>Haykir, Rahime</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Characterization of focal liver lesions: use of mangafodipir trisodium (MnDPDP)-enhanced MR images</atitle><jtitle>The Turkish journal of gastroenterology</jtitle><addtitle>Turk J Gastroenterol</addtitle><date>2006-09</date><risdate>2006</risdate><volume>17</volume><issue>3</issue><spage>164</spage><epage>171</epage><pages>164-171</pages><issn>1300-4948</issn><abstract>We evaluated the characterization and detection of liver lesions using mangafodipir trisodium. A total of 51 patients with liver lesions [13 hepatocellular carcinomas, 18 metastases, 14 hemangiomas, three cholangiocellular carcinomas, two hydatic cysts, and one focal nodular hyperplasia (FNH)] were examined by unenhanced and mangafodipir trisodium-enhanced MRI. After administration of mangafodipir trisodium by slow intravenous infusion, mangafodipir trisodium-enhanced MRI was performed at 15-30 min and 24 h. The enhancement appeared in normal liver parenchyma and all of the hepatocellular lesions (HCCs and FNH). The lesions in hepatocellular carcinomas patients showed a non-homogeneous enhancement pattern. Non-hepatocellular lesions (hemangiomas, metastases, CCCs) had no enhancement on mangafodipir trisodium-enhanced MRI examinations. The rim-like enhancement pattern was demonstrated in all patients with cholangiocellular carcinomas, and in 14 metastases and 11 hemangiomas. Mangafodipir trisodium-enhanced MRI permits reliable distinction between hepatocellular and non-hepatocellular tumors. Mangafodipir trisodium-enhanced MRI can show more functional and morphologic features of hepatocellular lesions. Some non-hepatocellular lesions which went undetected on unenhanced MRI were visualized after contrast enhancement of the liver. The rim-like enhancement pattern is not specific for metastases. Mangafodipir trisodium-enhanced MRI is safe and well tolerated and may aid in noninvasive diagnosis of liver lesions.</abstract><cop>Turkey</cop><pub>Türk Gastroenteroloji Vakfı</pub><pmid>16941248</pmid><tpages>8</tpages><oa>free_for_read</oa></addata></record>
fulltext fulltext
identifier ISSN: 1300-4948
ispartof The Turkish journal of gastroenterology, 2006-09, Vol.17 (3), p.164-171
issn 1300-4948
language eng
recordid cdi_ulakbim_primary_75950
source MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals
subjects Adult
Aged
Bile Duct Neoplasms
Bile Duct Neoplasms - pathology
Bile Ducts, Intrahepatic
Bile Ducts, Intrahepatic - pathology
Carcinoma, Hepatocellular
Carcinoma, Hepatocellular - pathology
Cholangiocarcinoma
Cholangiocarcinoma - pathology
Contrast Media
Echinococcosis, Hepatic
Echinococcosis, Hepatic - pathology
Edetic Acid
Edetic Acid - analogs & derivatives
Edetik asit
Ekinokokkoz, hepatik
Female
Focal Nodular Hyperplasia
Focal Nodular Hyperplasia - pathology
Fokal nodüler hiperplazi
Görüntü büyütme
Hemangioma
Hemangioma - pathology
Hemanjiyom
Humans
Image Enhancement
Infusions, Intravenous
İnfüzyonlar, ven içi
Karaciğer neoplazmları
Karsinom, hepatosellüler
Kolanjiokarsinom
Kontrast ortamı
Liver Neoplasms
Liver Neoplasms - pathology
Liver Neoplasms - secondary
Magnetic Resonance Imaging
Magnetic Resonance Imaging - methods
Male
Manyetik rezonans görüntüleme
Middle Aged
N,N'-bis(piridoksal-5-fosfate)etilenediyamin-N,N'-diasetik asit
N,N'-bis(pyridoxal-5-phosphate)ethylenediamine-N,N'-diacetic acid
Neoplasms
Neoplazmlar
Piridoksal fosfat
Pyridoxal Phosphate
Pyridoxal Phosphate - analogs & derivatives
Safra kanalı neoplazmları
Safra kanalları, intrahepatik
title Characterization of focal liver lesions: use of mangafodipir trisodium (MnDPDP)-enhanced MR images
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-27T23%3A18%3A13IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_ulakb&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Characterization%20of%20focal%20liver%20lesions:%20use%20of%20mangafodipir%20trisodium%20(MnDPDP)-enhanced%20MR%20images&rft.jtitle=The%20Turkish%20journal%20of%20gastroenterology&rft.au=Karabacako%C4%9Flu,%20Aydin&rft.date=2006-09&rft.volume=17&rft.issue=3&rft.spage=164&rft.epage=171&rft.pages=164-171&rft.issn=1300-4948&rft_id=info:doi/&rft_dat=%3Cproquest_ulakb%3E68815064%3C/proquest_ulakb%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=68815064&rft_id=info:pmid/16941248&rfr_iscdi=true