bluuebunny/crossref_metadata_2025 huggingface dataset:
CT Appearances of Normal and Obstructed Submandibular Duct
Authors: Aasen S. , Kolbenstvedt A.
Published: June 2015

CT scans of 40 patients without pathology in the floor of the mouth or the submandibular glands were reviewed. Intraglandular ducts were visualized in 27 and extraglandular ducts in 3 patients. The CT appearances of dilated submandibular ducts are described in 4 patients with proven causes of obstruction. Widening of the narrow gutter between the mylohyoid and hyoglossus muscles in one scan level is a prominent feature. An intra- or extraglandular duct diameter of 3 mm or more indicates possible obstruction, and the CT images should be scrutinized to reveal the cause.
Calcified Bladder Tumors
Authors: Moon W. K. , Kim S. H. , Cho J. M. , Han M. C.
Published: June 2015

CT scans of the pelvis in 132 patients with bladder tumor were reviewed. Calcifications in the bladder tumor were found in 11 men (8%) including transitional cell carcinoma (n = 6), mucinous adenocarcinoma (n = 4), and malignant mixed mesodermal tumor (n = 1). Calcifications in transitional cell carcinoma were located on the surface of the tumor in all 6 cases: they were nodular in 4 cases, nodular and arched in one, and plaque-like massive calcification in one. In mucinous adenocarcinoma multiple fine punctate calcifications were scattered within the mass in all 4 cases. The CT appearance of calcifications in bladder tumors may be helpful in predicting the histologic type of the tumor.
Comparison of Dual Energy X-Ray Absorptiometry of the Proximal Femur with Morphologic Data
Authors: Hübsch P. , Kocanda H. , Youssefzadeh S. , Schneider B. , Kainberger F. , Seidl G. , Kurtaran A. , Gruber S.
Published: June 2015

Measurements of bone mineral density (BMD) of the proximal femur (including femoral neck, Ward's triangle and trochanteric region) were compared with the Singh index grading in 40 normal subjects (20 male, 20 female) and in 116 patients (18 male, 98 female) referred for assessment of possible osteoporosis. Additionally, the BMD and the Singh index of 12 cadaver specimens (6 male, 6 female) of the proximal femur were compared with each other and with the histomorphology of the femoral necks of the specimens. Although there was a good correlation of Singh index with BMD in the group of male patients with suspected osteoporosis and in the series of bone specimens, there was a poor correlation in the group of female patients as well as in the normal controls and in the patient population as a whole. There was also poor correlation of Singh index values with histomorphologic data, whereas the BMD measurements correlated well with the amount of calcified bone found histologically in the femoral necks of the bone specimens. We conclude that the Singh index cannot be used to predict BMD of the proximal femur accurately.
CT Attenuation of Normal Liver Parenchyma on Delayed Scanning with Iohexol
Authors: Tidebrant G. , Lukes P. , Wihed A.
Published: June 2015

Twenty patients were examined with CT of the liver before, during, and 4 to 6 hours after i.v. administration of 60 g iodine (200 ml iohexol). The attenuation of normal liver parenchyma was measured. The mean attenuation of normal liver parenchyma on nonenhanced scanning was 62.6 HU and on delayed scanning 78.7 HU. It seems that iohexol is a suitable contrast medium for delayed scanning of the liver.
Comparison of 12-Bit and 8-Bit Gray Scale Resolution in Mr Imaging of the CNS
Authors: Smith H.-J. , Bakke S. J. , Smevik B. , Hald J. K. , Moen G. , Rudenhed B. , Abildgaard A.
Published: June 2015

A reduction in gray scale resolution of digital images from 12 to 8 bits per pixel usually means halving the storage space needed for the images. Theoretically, important diagnostic information may be lost in the process. We compared the sensitivity and specificity achieved by 4 radiologists in reading laser-printed films of original 12-bit MR images and cathode ray tube displays of the same images which had been compressed to 8 bits per pixel using a specially developed computer program. Receiver operating characteristic (ROC) curves showed no significant differences between film reading and screen reading. A paired 2-tailed t-test, applied on the data for actually positive cases, showed that the combined, average performance of the reviewers was significantly better at screen reading than at film reading. No such differences were found for actually negative cases. Some individual differences were found, but it is concluded that gray scale resolution of MR images may be reduced from 12 to 8 bits per pixel without any significant reduction in diagnostic information.
CT Compared to Angiography for Staging of Tumors of the Pancreatic Head
Authors: Aspestrand F. , Kolmannskog F.
Published: June 2015

A retrospective study of 32 patients with malignant tumor of the pancreatic head and ampullary region is presented. The aim of the study was to compare the ability of CT and angiography to evaluate the peripancreatic vessels, and to correlate the results of tumor staging based upon CT criteria to angiographic and surgical findings. In 5 patients (16%) CT disclosed contiguous tumor growth around vessels not discernible at angiography and, in contradiction to previous reports, angiography added no valuable information regarding main vessel involvement. In terms of sensitivity, specificity, and positive predictive value CT was more accurate in predicting unresectable than resectable tumors, the former with a sensitivity of 92% and a specificity and positive predictive value of 100%.
Splenic Abscess
Authors: Tikkakoski T. , Siniluoto T. , Päivänsalo M. , Taavitsainen M. , Leppänen M. , Dean K. , Koivisto M. , Suramo I.
Published: June 2015

We reviewed the imaging findings of 14 splenic abscesses in 13 patients. All patients underwent chest radiography, 12 ultrasonography (US), 9 CT, 4 plain abdominal radiography, 2 99mTc-HMPAO leukocyte scan and 2 99mTc-HIG scan. Three patients were treated with percutaneous catheter drainage, and 5 with diagnostic or therapeutic fine-needle aspiration (FNA). At US the abscess was hypoechoic (n = 9), anechoic (n = 2), or anechoic with gasbubbles (n = 1), or the entire spleen was inhomogeneous with gasbubbles (n = 1). At CT the abscesses appeared as low density (18–30 HU) lesions with (n = 2) or without (n = 7) gas. In 2 cases 99mTc-HMPAO leukocyte scan, and in one case 99mTc-HIG scan showed an intrasplenic defect, and in one case 99mTc-HIG scan was considered normal. At plain abdominal radiography extraintestinal gas was suggested in 2 patients, and the findings were normal in 2. US-guided FNA confirmed infectious etiology of the lesion in 4 patients, and a necrotic specimen suggested infection in one. One patient was cured with repeated aspirations. Catheter drainage was successful in all 3 patients who underwent the procedure. We conclude that US and CT are accurate in detecting splenic abscesses. Our results in splenic interventions advocate wider use of the procedures.
Acute Renal Failure Secondary to Rhabdomyolysis
Authors: Kim S. H. , Han M. C. , Kim S. , Lee J. S.
Published: June 2015

MR imaging of the kidney was performed in 6 patients with acute renal failure (ARF) secondary to rhabdomyolysis caused by snake bite (n = 4), crush injury (n = 1), and carbon monoxide poisoning (n = 1). A test for urine myoglobin was positive in all 6 patients and MR imaging was done 6 to 18 days after the causative event of the rhabdomyolysis. MR images in all 6 patients showed globular swelling of the kidneys, preserved corticomedullary contrast on T1-weighted images, and obliteration of corticomedullary contrast on T2-weighted images. Unlike other medical renal diseases in which corticomedullary contrast is lost on T1-weighted images, preservation of the corticomedullary contrast on T1-weighted MR images with globular renal swelling was a constant finding in patients with ARF secondary to rhabdomyolysis.
MR Imaging with Stir Technique and Air Insufflation for Local Staging of Bladder Neoplasms
Authors: Bartolozzi C. , Caramella D. , Zampa V. , Olmastroni M. , Innocenti P. , Menchi I. , Lapini A. , Amorosi A.
Published: June 2015

Fifty-six patients with bladder carcinoma were studied with MR imaging for the assessment of the local stage, using the inversion recovery pulse sequence with fat suppression (STIR) with air in the bladder. With this technique images of the inner and the outer parts of the bladder wall were obtained, showing high contrast between the latter and the tumor (tumor/muscle contrast 89.9%). Four tumor stages were recognized: superficial neoplasms (Tis, Ta, and T1), partial wall infiltrating neoplasms (T2); total wall infiltrating neoplasms (T3a, T3b), and neoplasms involving other pelvic organs (T4). MR imaging was compared with histopathologic diagnosis obtained at transurethral resection or cystectomy. True-positive diagnosis was obtained in 80.4%; false-positive in 14.3% of cases; false-negative in 5.3%. Despite the relatively high incidence of over-staged neoplasms, STIR technique combined with air in the bladder allowed a good accuracy in local staging.
One or Two Samples for Determination of Total Plasma Clearance of a Nonionic Contrast Medium in Patients Undergoing Enhanced CT
Authors: Thomsen H. S. , Vestergaard A. , Golman K. , Dorph S.
Published: June 2015

Plasma clearance of nonionic iopamidol (300 mg I/ml) was measured in 50 patients in connection with enhanced CT. Before injection of either 50 or 100 ml of the contrast medium, S-creatinine and urine osmolality were measured. Employing Renalyzer PRX 90, the plasma concentration of iodine was determined in blood samples drawn approximately 3 and 4 h after injection of iopamidol. The glomerular filtration rate was calculated by the Renalyzer using 2 different formulas, one requiring only a single sample, and one requiring at least 2 samples (standard). Both the 3- and 4-h single sample values correlated well with the glomerular filtration rate expressed by the standard sample value. The result was independent of whether 50 or 100 ml had been administered and whether or not water soluble contrast medium had been given orally before CT. As could be expected S-creatinine and urine osmolality correlated poorly with the clearance values. It is concluded that in patients receiving either 50 or 100 ml contrast medium for enhanced CT, the glomerular filtration rate can be determined in a single sample as well as with 2 samples taken between 3 and 4 h after contrast medium injection.
Influence of Contrast Media on Single Nephron Glomerular Filtration Rate in Rat Kidney: A Comparison between Diatrizoate, Iohexol, Ioxaglate, and Iotrolan
Authors: Ueda J. , Nygren A. , Hansell P. , Erikson U.
Published: June 2015

The effects of slow (10 min) i.v. infusions of contrast media (CM, 1 600 mg I/kg b.w.) on single nephron glomerular filtration rate (SNGFR) in the rat kidney were investigated using a micropuncture technique. Diatrizoate, iohexol, or ioxaglate did not change SNGFR, although a tendency towards a transient suppression was seen during the infusion phase. Iotrolan infusion, however, decreased SNGFR (p < 0.05) and the value still remained below the control value 25 min after the start of infusion. Iotrolan is a nonionic dimeric CM and has a lower osmotic effect in the tubules than the ionic dimeric CM and the monomeric CM when given in iodine equivalent doses. These characteristics of iotrolan have probably some influence on the depression of SNGFR after iotrolan injection.
Mr Lymphography Using Iron Oxide Particles
Authors: Taupitz M. , Wagner S. , Hamm B. , Dienemann D. , Lawaczeck R. , Wolf K.-J.
Published: June 2015

MR images of the iliac lymph nodes of 25 VX2 carcinoma-bearing rabbits and of 5 tumor-free rabbits were obtained at 1.5 T before and after endolymphatic administration of superparamagnetic iron oxide particles (SPIO) at a dose of 1 μmol Fe per extremity. Imaging results were correlated with histology. In unenhanced images intranodal metastases were not detectable with any of the pulse sequences used and the signal intensities of tumor-free and metastatic lymph nodes did not differ significantly. After administration of the contrast medium, a significant signal loss (p≤0.05) occurred in the healthy lymph node tissue, whereas the signal intensity of lymph node metastases remained unchanged. In SPIO enhanced images, the threshold size for detection of lymph node metastases was 2 mm. Metastatic involvement was detected in 28 of the 30 tumorous lymph nodes with the SE 2 000/15 sequence but in a smaller number of lymph nodes with the sequences SE 500/22 (n = 27) and 2 000/65 (n = 21).
Conversion Factors between Energy Imparted to the Patient and Air Collision Kerma Integrated over Beam Area in Pediatric Radiology
Authors: Persliden J. , Sandborg M.
Published: June 2015

Conversion factors between the energy imparted to the patient in pediatric radiography and air collision kerma integrated over beam area are presented. The values have been derived from Monte Carlo calculations in soft tissue phantoms and extend results published earlier to cover children from early infancy to the age of 15 years. Variations related to phantom size as well as to focus-phantom distance, radiation field size, orientation of view (a.p., lateral), tube potential, and beam filtration are given. We show that the conversion factor increases with increasing half-value layer of the X-ray beam and the anterioposterior width of the simulated child. Increasing the focus-phantom distance increases the conversion factor, while increasing the field size decreases the factors due to more scattered radiation escaping laterally from the phantom.
Radiographic Evaluation of the Urethral Kock Ileal Bladder Substitute
Authors: Dorph S. , Steven K. , Mygind T. , Thomsen H. S.
Published: June 2015

Fifty male patients who had undergone bladder substitution with a urethral Kock pouch after radical cystectomy for bladder cancer, were evaluated in the immediate postoperative period by retrograde pyelography and pouch cystography, and at later follow-up by pouch cystography. Other radiologic procedures (urography, ultrasonography, CT, etc.) were not part of a routine program, but were used when clinically indicated. In 12% a ureteroileal anastomotic leakage was found; the leaks resolved with continued ureteral stenting. Extravasation at the anastomosis between the pouch and the urethra was seen in 55% at the first cystography. It resolved within one month in all cases by simply leaving a catheter in the bladder. On the late cystograms reflux was observed in 6% of patients, whereas stone formation in the pouch was not encountered. A careful radiologic follow-up of patients with urinary diversions is essential to minimize postoperative complications.
Oral Magnetic Particles
Authors: Øksendal A. N. , Bach-Gansmo T. , Jacobsen T. Flem , Eide H. , Andrew E.
Published: June 2015

Oral magnetic particles (OMP) have been evaluated in a clinical phase II trial program comprising 216 patients in 7 European centers. Adult patients referred for MR imaging for various abdominal pathologies were examined. The patients received OMP at a concentration of 0.1 g/l (ultralow field) or 0.5 g/l (mid/high field) and OMP was diluted in water or in a more viscous liquid formulation. Depending on the area of interest, OMP was ingested in a volume of 300 to 800 ml. OMP was well tolerated with no serious adverse events and the patient acceptability was good. OMP had a good contrast effect on all applied pulse sequences. The viscous formulation of OMP was homogeneously distributed through the entire gastrointestinal tract without inducing disturbing susceptibility artifacts. The postcontrast diagnostic information was improved in 70% of the cases. Based on the encouraging results in phase II, OMP has been advanced to phase III clinical trials.
CT Measurement of Mediastinal Anterior Junction Line in Emphysema Patients
Authors: Hagen G. , Kolbenstvedt A.
Published: June 2015

The anterior junction line (AJL), the sterno-aortic distance and the sagittal thoracic diameter were measured in CT sections at the carinal level in 22 patients with emphysema and 22 controls. The measured distances were all significantly larger in the emphysema patients. An AJL of 3 cm or more and a sterno-aortic distance of 4 cm or more was found in respectively 10 and 16 of the 22 emphysema patients but in none of the control patients.
Incidence of Roentgen Contrast Medium Reactions after Intravenous Injection in Pre-Registration Trials and Post-Marketing Surveillances
Authors: Andrew E. , Haider T.
Published: June 2015

The relative risk of adverse drug reactions of ionic versus non-ionic contrast media injected i.v. were compared for different types of trials using odds-ratio. The absolute and relative risk found in large post-marketing trials were compared with that found in the iohexol pre-registration trials. The absolute risks were 2 to 10 times higher in the pre-registration trials compared to the post-marketing surveillances. The relative risk for all adverse drug reactions was 3 to 6 times higher for ionic vs. non-ionic media and independent of pre- or post-registration studies. The odds-ratio seems to be a feasible method of comparing the relative risk of adverse reactions in various trials.
Contrast Media-Induced Renal Morphologic Lesions in Diabetic Rats
Authors: Tervahartiala P. , Kivisaari L. , Kivisaari R. , Virtanen I.
Published: June 2015

Diabetes mellitus was induced in rats with streptozotocin and after 3 months the animals (n = 48) received an i.v. injection of 1 or 3 g I/kg in the form of high-osmolar diatrizoate, low-osmolar iopromide or iohexol, or of 0.6 g I/kg of high-osmolar Gd-DTPA. The controls were given an i.v. injection of physiologic saline. After 2 hours the kidneys were fixed by perfusion and the renal morphologic changes were semiquantitatively analyzed by two independent observers unaware of the agent administered. The contrast media (CM) induced pronounced cytoplasmic vacuolization in the proximal convoluted tubular cells. Such a lysosomal alteration may indicate CM uptake into the cell, and the ultrastructural evaluation revealed intracellular injuries related to the process. The alterations were most marked following administration of iohexol, but diatrizoate also induced a statistically highly significant vacuolization (p < 0.001). The lysosomal alterations following iopromide administration were not as striking, and Gd-DTPA induced only minor changes.
Increased Urinary Excretion of Iohexol after Enteral Administration in Patients with Ileal Crohn's Disease
Authors: Halme L. , Edgren J. , von Smitten K. , Linden H.
Published: June 2015

Iohexol is a water-soluble contrast medium that is partly absorbed/permeated through mucosa of the small bowel and excreted unchanged in the urine. Iohexol was administered orally to 12 patients with Crohn's disease of the ileum and to 10 healthy controls to measure its excretion in the urine. The location and activity of Crohn's disease were determined by barium double-contrast radiography in all patients and by ileoscopy and biopsy in 9 patients. Iohexol concentrations in serum and 24-hour urine were measured using reversed phase high-performance liquid chromatography. Urinary excretion of iohexol was significantly greater in patients with active Crohn's disease than in controls. We suggest this method as a new way of measuring Crohn's disease activity and mucosal damage in the small bowel. Bowel inflammation and mucosal cell damage are strongly indicated if the iohexol excreted in the urine is over 1% of the oral intake.
Treatment of Tuberculous Bronchial Stenosis with Expandable Metallic Stents
Authors: Sawada S. , Fujiwara Y. , Furui S. , Tanabe Y. , Tanigawa N. , Kobayashi M. , Iwamiya T. , Morioka N. , Ohta Y.
Published: June 2015

Gianturco expandable metallic stents were placed in 5 patients with dyspnea on exercise due to tuberculous bronchial stenosis. The stents were placed after dilatation with a 10-mm diameter high pressure balloon catheter. In all 5 patients, obstructive changes disappeared following the procedure, and dyspnea on exercise improved markedly. No complications related to the procedure were encountered. At follow-up during a period of up to 38 months, 2 patients showed bronchial restenosis at 11 and 17 months, respectively, after stent placement. Restenosis by granulomatous tissue was successfully treated by laser ablation. One patient showed slight one-day hemoptysis 26 months after stent placement.
Percutaneous Rotational Lithotripsy of Gallbladder Stones
Authors: Lindberg C.-G. , Jeppsson B. , Lundstedt C. , Willner J. , Stridbeck H.
Published: June 2015

Ten patients (aged 39–94 years) with cholecystolithiasis were selected for percutaneous rotational lithotripsy with the Rotolith lithotriptor either because they were considered high-risk patients for cholecystectomy or because they had refused surgery. The procedure was completed in 7 patients. Five of these were stone-free at cholangiography 1 to 2 days after lithotripsy. Conclusive cholangiograms were not obtained in 2 patients due to gallbladder leakage, which in itself did not cause any serious sequelae. At ultrasonography after one month, one of these 2 patients had no visible gallbladder, the other one had small residual gallbladder stones. Rotational lithotripsy is an alternative to cholecystectomy in patients at high surgical risk, especially elderly patients who have undergone cholecystostomy as an emergency treatment for acute cholecystitis.
On the Pulsatile Nature of Intracranial and Spinal CSF-Circulation Demonstrated by MR Imaging
Authors: Greitz D. , Franck A. , Nordell B.
Published: June 2015

Cerebrospinal fluid (CSF) flow was studied in 24 healthy volunteers using gated MR phase imaging. The subarachnoid space (SAS) was divided into 5 compartments depending on the magnitude of the pulsatile CSF flows: a high velocity compartment in the area of the brain stem and spinal cord, 2 slow ones at the upper and lower extremes of the SAS, and finally 2 intermediate velocity compartments in between. The main pulsatile spinal flow channel had a meandering pattern. The extraventricular CSF-circulation can be explained by pulsatile CSF flow without the necessity of assuming existence of a net flow. A successive time offset during the cardiac cycle has been found in the fronto-occipital direction of the interplay between the arterial expansion, brain expansion, volume changes of the CSF spaces and of the veins. It is proposed to name this time offset the intracranial “volume wave” (VoW).
Intravascular Ultrasonography
Authors: Bolz K.-D. , Myhre H. O. , Angelsen B. A. J. , Nordby A.
Published: June 2015

The intravascular ultrasonographic findings in normal and diseased veins after transfemoral catheterization of 25 patients are presented. The iliac veins, the inferior and superior vena cava, the renal veins, the right atrium, both brachiocephalic veins, and the right internal jugular vein were studied. In 4 cases valves or valvelike structures were observed. Anatomic variants such as spurs and webs were seen in 3 and mural thrombi or postthrombotic wall changes in 4 patients. In one case a sphincter-like ostium venae cavae was observed. In 2 patients thin filaments within the right atrium, most likely a Chiari net, were seen. Two patients had an abnormal, stratified “artery-like” vessel wall structure. This new imaging modality has several potential applicabilities in the veins and may contribute new information about anatomy and function of the venous system. It provides cross-sectional in vivo visualization and the demonstration of motility of small intraluminal structures which cannot be revealed by traditional diagnostic methods. Because of the wide range of anatomic variation in the venous system, knowledge of its normal intravascular ultrasonographic appearance is a prerequisite for further clinical investigations.
CT of a Parathyroid Lipoadenoma
Authors: Frennby B. , Nyman U. , Aspelin P. , Udén P. , Ljungberg O.
Published: June 2015

A 54-year-old woman with primary hyperparathyroidism underwent parathyroid exploration following negative ultrasonography, CT and 99Tc-201T1 scintigraphy. A 2 × 1.5 × 1-cm large mass dorsal to the midportion of the left thyroid lobe was extirpated and a hyperfunctional lipoadenoma containing 70% or more of fatty tissue was verified microscopically. Retrospective evaluation of CT revealed a well demarcated lipomatous mass with a homogeneous density similar to that of subcutaneous fat corresponding to the surgical finding.
Treatment of Hepatocellular Carcinoma by Intraarterial Injection of Adriamycin/Mitomycin C Oil Suspension (ADMOS) Alone or Combined with CIS-Diaminodichloroplatinum (CDDP)
Authors: Inoue H. , Miyazono N. , Hori A. , Miyake S. , Satake M. , Kanetsuki I. , Nishida H. , Ikeda K. , Nakajo M.
Published: June 2015

We evaluated the effects of intraarterial injection of Adriamycin/Mitomycin C oil (Lipiodol) suspension (ADMOS) alone and ADMOS + cis-diaminodichloroplatinum (CDDP) in 135 patients with hepatocellular carcinoma (HCC). A total of 59 patients received ADMOS alone and 76 patients received ADMOS + CDDP (ADMOS/CDDP). Tumor size was reduced by over 25% in 13 (34%) of the evaluable 38 patients in the ADMOS-alone group and in 39 (51%) of the 76 evaluable patients in the ADMOS/CDDP group. Serum alpha-fetoprotein (AFP) levels decreased by more than 50% in 10 (59%) of 17 ADMOS-alone patients and in 23 (70%) of 33 ADMOS/CDDP patients whose pretreatment AFP levels were above 0.2 mg/l. The overall one- and 2-year survival rates were 68% and 41%, respectively. No severe complications and no significant changes in laboratory values were observed, except for one patient in the ADMOS/CDDP group who developed a liver abscess. Although the tumor response was significantly better in patients treated by ADMOS/CDDP than in those treated by ADMOS-alone (p < 0.05), there was no significant difference in the survival rates between the 2 groups. The intraarterial injection of ADMOS and CDDP was concluded to be effective in treating HCC judging by tumor response.
Ultrasonography of the Achilles Tendon in Hypercholesterolemia
Authors: Kainberger F. , Seidl G. , Traindl O. , Trattnig S. , Breitenseher M. , Schneider B. , Gisinger C.
Published: June 2015

The ultrasonographic (US) appearance of Achilles tendon was examined in 34 patients with hypercholesterolemia (10 with familial (FH), and 24 with secondary hypercholesterolemia (SH)), and in 22 patients with normal tendons. US findings were compared with clinical, laboratory, and radiologic results. In patients with FH, typical xanthomas in the form of hyperechoic tendinal tumors were found in only 15% while various forms of inhomogeneity of tendon structure without xanthoma formation were found in 75%. The high rate of tendon inhomogeneity may be due to the concomitant occurrence of both xanthomas and degeneration of tendon fibers. Physical examination revealed abnormalities in 60% of these patients. At CT of the tendons, abnormalities were found in 65% of the FH patients and in 40%, abnormalities were shown by plain radiography. In SH, the results did not differ significantly from normal controls. In our opinion US should be used to prove or rule out Achilles tendon abnormalities in patients with FH for prophylaxis and treatment of tendinitis and tendon rupture.
CT, MR Imaging and Angiography in Pancreatic Apudomas
Authors: Aspestrand F. , Kolmannskog F. , Jacobsen M.
Published: June 2015

Findings at CT, MR imaging and angiography in 29 patients with pancreatic apudomas are presented. CT and angiography were performed in all the patients, MR imaging in 10. Twenty-five patients underwent laparotomy. The ability of the different imaging methods to localize the primary tumor and detect hepatic metastases was compared. CT and MR imaging depicted the primary tumor in 79% and 88% of the cases respectively, angiography in 72%. Enhancement patterns at CT and signal intensity variations at MR imaging were unspecific parameters regarding different types of tumors. CT and MR imaging were considerably more accurate than angiography in evaluating local tumor resectability. Angiography revealed more numerous small hepatic metastases (<0.5 cm) than CT or MR imaging, but missed metastases in the left lobe in 5 patients. MR imaging seems promising in localizing and characterizing pancreatic apudomas, but further evaluation is needed before any conclusion can be drawn. At present dynamic incremental CT seems mandatory in the evaluation of pancreatic apudomas. Angiography is of value for preoperative and preembolization vascular mapping, and in localizing small pancreatic apudomas not shown at CT or MR imaging. Faster dynamic thin slice CT scanning and fast-sequence MR imaging may increase the sensitivity of detecting small primary pancreatic apudomas.
MR Imaging of Monostotic Fibrous Dysplasia of the Clivus
Authors: Maeda M. , Kimura H. , Tsuchida C. , Ishii Y. , Kubota T.
Published: June 2015

We describe the MR appearance of a case of monostotic fibrous dysplasia confined to the clivus. The lesion showed intermediate signal intensity on T2-weighted images which is uncommon among clival diseases.
Detection of Breast Cancer Metastases in the Cervical Spine
Authors: Petrén-Mallmin M. , Andréasson I. , Nyman R. , Hemmingsson A.
Published: June 2015

Thirty women with breast cancer and indications of possible cervical spine metastases underwent skeletal scintigraphy, conventional radiography, MR imaging and CT. By combining all examinations a diagnosis was settled in each patient and the different imaging techniques were compared. For all of the 26 patients with metastases in the cervical spine the correct diagnosis was found with MR imaging and CT. Both modalities also revealed paravertebral tumour growth, MR (n = 8) more than CT (n = 3). The sensitivity of skeletal scintigraphy in detecting metastases in the cervical spine was rather low, but as these examinations cover the whole body they are still convenient screening procedures, and combined with conventional radiography of selected areas are probably sufficient in many cases. Supplementary examinations with CT or MR would be valuable in patients with equivocal findings at screening for metastases or with clinical indications of metastases that remain unexplained after scintigraphy and radiography.
MR Evaluation of Tuberculous Spondylitis
Authors: Liu G.-C. , Chou M.-S. , Tsai T.-C. , Lin S.-Y. , Shen Y.-S.
Published: June 2015

A total of 29 proven tuberculous spondylitis patients underwent MR studies. Gd-DTPA enhancement was performed in 10 patients. Contiguous 2 vertebral involvement, subligamental spread of para-spinal abscesses and cord indentation were observed in 93% of the cases. Destruction of the vertebral body occurred in 76%. Intermediate or low T1 signal intensity and high T2 signal intensity were observed by MR. A combination of these characteristic findings strongly suggests the diagnosis of tuberculous spondylitis. Gd-DTPA administration did not facilitate diagnosis. MR examination should be considered as the main imaging modality for patients with suspected tuberculous spondylitis.
Hematogeneous Pulmonary Metastasis
Authors: Kim W. S. , Im J.-G. , Chung E. C. , Han M. H. , Han J. K. , Han M. C. , Ham E. K.
Published: June 2015

The purpose of this study was to develop an experimental model of pulmonary metastases using VX-2 tumor, and to describe sequential radiologic and pathologic findings with special attention to the interstitial changes around the metastatic nodules. Through ear veins of 25 rabbits, VX-2 tumor cell suspension was injected with 0.8-mm scalp needles. Chest radiographs were taken every other day after tumor injection. The rabbits were sacrificed at scheduled times from 3 to 30 days after tumor injection. The inflated and fixed lungs were examined with visual inspection, low-kV radiography, high resolution CT (HRCT), microradiography of the sliced lung and with histopathologic studies. Hematogeneous pulmonary metastases occurred in 24 of 25 rabbits. In addition to the metastatic nodules, perinodular and peribronchovascular infiltrations were seen on low-kV radiography, HRCT, microradiography and histologic studies.
Cine-MR Imaging of Aqueductal CSF Flow in Normal Pressure Hydrocephalus Syndrome before and after CSF Shunt
Authors: Mascalchi M. , Arnetoli G. , Inzitari D. , Dal Pozzo G. , Lolli F. , Caramella D. , Bartolozzi C.
Published: June 2015

Reproducibility of the aqueductal CSF signal intensity on a gradient echo cine-MR sequence exploiting through plane inflow enhancement was tested in 11 patients with normal or dilated ventricles. Seven patients with normal pressure hydrocephalus (NPH) syndrome were investigated with the sequence before and after CSF shunting. Two patients exhibiting central flow void within a hyperintense aqueductal CSF improved after surgery and the flow void disappeared after shunting. One patient with increased maximum and minimum aqueductal CSF signal as compared to 18 healthy controls also improved and the aqueductal CSF signal was considerably decreased after shunting. Three patients with aqueductal CSF values similar to those in the controls did not improve, notwithstanding their maximum aqueductal CSF signals decreasing slightly after shunting. No appreciable aqueductal CSF flow related enhancement consistent with non-communicating hydrocephalus was found in the last NPH patient who improved after surgery. Cine-MR with inflow technique yields a reproducible evaluation of flow-related aqueductal CSF signal changes which might help in identifying shunt responsive NPH patients. These are likely to be those with hyperdynamic aqueductal CSF or aqueductal obstruction.
Combined Embolization and Gamma Knife Radiosurgery for Cerebral Arteriovenous Malformations
Authors: Guo W. Y. , Wikholm G. , Karlsson B. , Lindquist C. , Svendsen P. , Ericson K.
Published: June 2015

In a study of 46 patients with cerebral arteriovenous malformations (AVMs) the value of combining embolization and gamma knife radiosurgery was assessed. In 35 patients with large grade III to V AVMs (Spetzler-Martin system) staged combined treatment was planned. In 11 patients, radiosurgery complemented embolization for a residual AVM. The number of embolization sessions ranged from 1 to 7 (median 2). Twenty-six patients needed multiple embolization sessions. In 28 patients the grade of AVMs decreased as a result of embolization. In 16 patients collateral feeding vessels developed after embolization which made delineation of the residual nidus difficult. The time lag between the last embolization and radiosurgery ranged from 1 to 24 months (median 4). Nineteen of 35 large grade III to V AVMs were possible to treat by radiosurgery following embolization. In the 46 patients complications occurred in 9 from embolization and in 2 from radiosurgery. Two patients had transient and 9 had permanent neurologic deficits. It is concluded that embolization facilitates radiosurgery for some large AVMs and therefore this combined treatment has a role in the management of AVMs.
Hyperparathyroidism — Comparison of Flash Imaging with Spin ECHO MR Imaging
Authors: Noguchi Y. , Takashima S. , Ikezoe J. , Yoshii M. , Koide T. , Kozuka T.
Published: June 2015

MR images of the neck were prospectively studied in 19 patients with hyperparathyroidism. Fast low angle shot (FLASH) sequence was performed in addition to T1- and T2-weighted spin echo (SE) sequences. FLASH images were obtained with 320/12/20° (TR/TE/flip angle) using presaturation technique. TE of 12 ms was chosen to eliminate high signal of fat tissue. In the evaluation of detectability, a combination of T1-weighted SE and FLASH images (T1WI + FLASH) was compared with a combination of T1- and T2-weighted SE images (T1WI + T2WI). MR imaging correctly depicted 20 of 30 abnormal glands on both T1WI + FLASH and T1WI + T2WI. FLASH imaging effectively eliminated high signal of fat tissue. Nineteen abnormal glands demonstrated higher signal than surrounding tissues on FLASH images, whereas 12 glands were high-intense on T2-weighted SE images. We conclude that FLASH imaging provides improved tissue contrast and anatomic delineation and, thus, may replace T2-weighted SE imaging in the neck.
Duplex Doppler Sonography and Angiography in the Evaluation for Liver Transplantation
Authors: Kolmannskog F. , Jakobsen J. Å. , Schrumpf E. , Bergan A.
Published: June 2015

Duplex Doppler sonography (DDS) and angiography were performed in a prospective study comprising 22 adult patients with hepatic failure. The ability of the 2 methods to visualize the different splanchnic vessels was compared, as well as any abnormality in the liver parenchyma and vessels. The purpose of the study was to decide if DDS could replace angiography in the pretransplantation work-up in these patients. The portal vein was correctly identified as open in 20 patients using DDS and in 21 patients at angiography. Portal vein thrombosis in one patient was correctly diagnosed by both methods. The identification of other vascular structures in the upper part of the abdomen, e.g., liver arteries and splenic vein, was demonstrated in 14 and 16 patients respectively at DDS. Hepatoma in one patient was correctly identified by both methods, as well as the presence of ascites. Splenic artery aneurysms were found in 4 patients at angiography, and in none of these was DDS able to show this abnormality. We conclude that abdominal angiography still seems superior to DDS in the evaluation of patients with hepatic failure prior to orthotopic liver transplantation, especially to demonstrate possible splenic artery aneurysms and detailed mapping of the hepatic arteries.
Ultrasound Monitored Laser-Induced Local Hyperthermia in the Liver
Authors: Löfberg A.-M. , Arvidsson D. , Andersson T. , Lindgren P. G. , Lörelius L.-E. , Nordlinder H.
Published: June 2015

Ultrasound (US) was used to monitor the size of tissue necrosis generated by Nd-YAG laser-induced local interstitial hyperthermia and tissue coagulation in 8 normal pig livers. Four treatments were done in each liver with 4 different energy settings. The size of the tissue necrosis measured on specimens was compared to the size measured on US. The laser energy caused a round tissue necrosis with some charring in the centre surrounded by a zone of white necrosis and a thin border of hyperaemia. A good correlation was found between the true and US-measured size of the necrosis diameters. It therefore seems possible to safely guide and monitor local laser hyperthermia in the liver with real-time US. The water-cooled quartz fibre used in this study has, however, some limitations.
Sister Chromatid Exchanges in Cultured Amniocytes Exposed to Diagnostic Ultrasound in Vitro
Authors: Porfirio B. , Dallapiccola B. , Cittantl C. , Colamussi P. , Giganti M. , Piffanelll A.
Published: June 2015

An in vitro system has been set up to study the possible genetic effects of diagnostic ultrasound (US) on the developing fetus. Amniotic cells were cultured by the in situ technique. Well established clones were exposed to US for various lengths of time using a linear array transducer within a sound transparent apparatus. Cells were then grown in the presence of 5-bromo-2'-deoxyuridine and processed for scoring the number of sister chromatid exchanges (SCE) as the cytogenetic endpoint. There was no linear relationship between the SCE frequency and the duration of US exposure. Variance analysis showed that only interindividual variability was a significant component of total variation. Neither the main effect of treatment nor the interaction effect were statistically significant. The data suggest that US delivered from a diagnostic unit to actively growing cultured fetal cells in a system closely mimicking the conditions of US exposure during amniocentesis does not induce SCE.
CT Assessment of Normal Splenic Size in Children
Authors: Prassopoulos P. , Cavouras D.
Published: June 2015

The size of the normal spleen was estimated by CT in 153 children, examined with indication unrelated to splenic disease. In each patient the width, thickness, length and volume of the spleen were calculated. Measurements were also normalized to the transverse diameter of the body of the first lumbar vertebra. The spleen underwent significant growth during the first 4 years of life and reached maximum size at the age of 13. There were no differences in splenic volume between boys and girls. Splenic thickness correlated best with normal splenic volume. The strongest correlation was also found between splenic thickness and volume in a group of 45 children with clinically evident splenomegaly. Splenic thickness, an easy-to-use measurement, may be employed in everyday practice to represent splenic volume on CT.
Prognostic Significance of Contrast Enhancement and Tumor Demarcation at CT of Squamous Cell Carcinomas of the Oral Cavity and Oropharynx
Authors: Aspestrand F. , Boysen M. , Engh Y.
Published: June 2015

A retrospective analysis of the CT examinations of 45 patients with squamous cell carcinomas of the tongue, floor of the mouth and tongue base with long-term follow-up is presented. The aim of the study was to determine whether differences in tumor contrast enhancement and tumor demarcation at contrast-enhanced CT were correlated to prognosis in terms of posttreatment residual tumor or local recurrence. Ill-defined tumor margins were by means of multiple regression analysis significantly correlated to local failures (p = 0.043). This feature was, however, not associated with a significant decreased survival. The degree of tumor contrast enhancement did not parallel variations in the histopathologic composition of the tumors.
Angiography and Colour Flow Duplex Ultrasonography in the Evaluation of Peripheral Ischaemic Occlusive Arterial Disease
Authors: Zeuchner J. , Geitung J. T. , Lukes P. , Göthlin J. H.
Published: June 2015

Colour flow duplex ultrasonography (CFDUS) was performed in 50 patients with advanced peripheral ischaemic disease scheduled for conventional angiography. Atherosclerosis was diagnosed by the appearance of plaque and spectral broadening. Haemodynamically significant stenosis was represented as a doubling of peak systolic velocity expressed as peak velocity ratio. Occlusion was diagnosed by the lack of colour saturation and absence of Doppler wave form. In the pelvis and thigh/knee region the sensitivity and specificity exceeded 90% except for stenoses, where the sensitivity was lower. The run-off was evaluated by examination of the tibial and peroneal arteries to at least midcalf. If 2 open arteries were identified, or, if only the posterior tibial artery was patent, the run-off was considered good. Compared to angiography the sensitivity and specificity exceeded 90%. We conclude that CFDUS is an accurate non-invasive method for preoperative screening of patients with peripheral ischaemic disease.
Mr Imaging of Benign Peripheral Nerve Sheath Tumors
Authors: Söderlund V. , Göranson H. , Bauer H. C. F.
Published: June 2015

In a retrospective, nonblind review of MR imaging of 15 benign peripheral nerve neoplasms in 13 patients, the signal pattern of the tumors (including contrast-enhanced images) and stage were assessed. One lesion was subcutaneous, 9 intramuscular, 2 intermuscular and 3 extracompartmental. One lesion was located to the trunk, 5 to the upper extremity and 9 to the lower. The signal on T1-weighted spin-echo images was homogeneous isointense compared to adjacent muscle in 11 lesions and in 2 slightly hyper- and in 2 slightly hypointense. T2-weighted spin-echo images, acquired in all but one examination, showed a hyperintense signal, homogeneous in 8 and centrally inhomogeneous in 6 lesions. Postcontrast T1-weighted images of 11 lesions showed a strong signal, with an inhomogeneous enhancement in the center of the lesion similar to that obtained in T2-weighted images. In 2 cases there were signal characteristics indicating bleeding in the tumor. In one lesion both the nonenhanced and contrast-enhanced T1-weighted images showed a hypointense signal in the tumor center suggestive of intramuscular myxoma. All lesions were well delineated without reactive edema. In all cases, anatomic tumor location was correctly assessed. Although the findings were not pathognomonic for neurinoma, MR imaging provided valuable information confirming the clinical and cytologic assessments.
Radiation Exposure to Children in Diagnosing and at Hydrostatic Reduction of Intussusception
Authors: Karlsson A. , Schuwert P. , Mortensson W.
Published: June 2015

The energy imparted to the children in diagnosing and hydrostatic reduction of intussusception was measured in 45 children by means of an area-dose measurement device and the mean absorbed dose was estimated. The device was provided with data on tube kVp, mAs and shutter positions and the results were presented as dGy × cm2. The device had been calibrated against a 30 cm3 ionisation chamber at the relevant kVp range. The median energy imparted and mean absorbed dose were 10.8 mJ and 0.94 mGy, respectively. 70% of the total dose was delivered during fluoroscopy. The complex irradiation situation with varying field collimation, tube voltage and amount of photon absorbing barium sulphate in the intestines renders organ dose and hazards estimations less reliable. However, even leaving the radiation shielding effect of the barium sulphate out, the radiation load is justifiable for a combined diagnostic and interventional procedure.
Accuracy of Digital Videodensitometry in Quantitating Contrast Medium Concentration
Authors: Yang X. M. , Manninen H. , Ji H. X. , Vainio P. , Soimakallio S.
Published: June 2015

To evaluate the accuracy of digital videodensitometric technique in directly quantitating concentration of contrast medium, iohexol 300 mg I/ml was injected into a 2-mm-diameter plastic tube, in which clean water was circulated at a 190 ml/min flow, for digital subtraction angiography. Altogether 27 injections were performed with 3, 4 and 5 ml volumes at 3-, 4- and 5-ml/s flows of the contrast medium. A time-density curve was achieved by selecting a “vessel” region of interest (ROI) and a background ROI. Then, a frame corresponding to the maximum opacification of the contrast medium could be calculated. Finally, the average density and the time to peak density of the contrast medium were obtained. The average density was statistically higher (p < 0.01) with 5 ml/s flow than with 4- and 3-ml/s flows. Times to peak density reduced as injection flows or volumes increased. The results support the conclusion that digital videodensitometric technique is an accurate method for quantitation of contrast medium concentration during angiography. The angiographic opacification may be improved by injecting the iodine contrast medium with higher flows or larger volumes.
Systemic and Pulmonary Haemodynamic Effects of Intravenous Infusion of Non-Ionic Isoosmolar Dimeric Contrast Media
Authors: Sørensen L. , Sunnegårdh O. , Svanegård J. , Lundquist S. , Hietala S.-O.
Published: June 2015

The systemic and pulmonary haemodynamic effects of i.v. infusion (1 ml/s) of high doses (4 ml/kg) of 2 non-ionic, isoosmolar dimeric contrast media (CM) were investigated in 17 female pigs. The 2 CM were iodixanol and iotrolan. Both CM induced a significant increase of the following parameters: mean arterial, mean right atrial, mean pulmonary arterial, mean pulmonary arterial occlusion pressure, cardiac output, stroke volume, and diuresis. The plasma concentration of atrial natriuretic peptide was significantly increased following infusion of the 2 CM. A significant decrease was seen in the systemic and pulmonary vascular resistance.