bluuebunny/crossref_metadata_2025 huggingface dataset:
Multi‐modality diagnostic imaging of a cervical articular process fracture in a Thoroughbred horse including a novel C‐Arm imaging technique
Authors: Withers J. M. , Voûte L. C. , Lischer C. J.
Published: October 2009

Interpretation of cervical radiographs can be challenging due to the complex anatomy and superimposition of osseous structures on either side of the vertebrae. This report describes the investigation of neck pain in a Thoroughbred gelding following a traumatic fall. Several imaging modalities were used to demonstrate the presence of a fracture of the left cranial articular process of the fourth cervical vertebra (C4), including nuclear scintigraphy, ultrasonography, oblique radiographic projections and a novel cineradiographic technique. Oblique radiographs were superior to standard lateral‐lateral radiographs in both the diagnosis and for monitoring the progression of healing of the articular process fracture in this case.
MR Imaging with Gadolinium in Patients with and without Post-Lumbar Puncture Headache
Authors: Hannerz Jan , Ericson K. , Bro Skejø H. P.
Published: October 2009

Purpose: To study frequency and extent of meningeal enhancement in patients with and without post-lumbar puncture headache (PLPH) with cerebral MR with Gd-DTPA.

Material and Methods: Ten consecutive patients with PLPH and 9 consecutive patients without PLPH were included in the study. Nine of the PLPH patients were reinvestigated when the PLPH was over and all non-PLPH patients during the week after the lumbar puncture.

Results: Eight of the 9 patients with PLPH showed more enhancement of meningeal structures during PLPH than when PLPH had disappeared. The differences were slight in 5, more marked in 2, and pronounced in 1 patient. The 9th patient showed no change at all. In the 9 patients without PLPH, there was mainly slight enhancement before lumbar puncture and no change in enhancement after lumbar puncture as compared with before.

Conclusion: PLPH is related to increased Gd-DTPA enhancement of the meninges, although the increase in enhancement during PLPH is minor in most cases. Pronounced enhancement of the meninges after lumbar puncture may predict long duration of the PLPH.
High Intensity Signal of the Posterior Pituitary
Authors: Arslan Arzu , Karaarslan E. , Dinçer A.
Published: October 2009

Purpose: To evaluate the consistency of fat in the high intensity signals of the normal neurohypophysis and to differentiate the high signal of posterior pituitary from that of dorsum sella. Sagittal SE T1-weighted images with frequency encoding in the horizontal direction were used in order to differentiate the high signal of posterior pituitary and dorsum sella by the vertically-oriented chemical shift artifact.

Material and Methods: The sellae of 46 normal volunteers were imaged with a commercially available fat suppression technique and SE sequences with frequency encoding in vertical (25 cases) and horizontal (21 cases) axes.

Results: The high signal intensity was absent in 9% of the normal volunteers with no predilection to any specific age group. None of the cases with posterior pituitary high intensity signals showed suppression of the signal with fat suppression technique. A fat suppression technique was helpful in documenting the hyperintensity in 7% of normal volunteers. Nineteen of the 21 (90%) cases with high signal intensity were detected by routine SE T1-weighted images, whereas 18 of the 19 (95%) cases were detected by imaging with frequency encoding in the horizontal direction.

Conclusion: The high signal does not indicate the presence of fat. Fat suppression technique and a horizontal direction of frequency encoding help in differentiating the high signal of the neurohypophysis from that of dorsum sella.
Kinematic MR Imaging in Surgical Management of Cervical Disc Disease, Spondylosis and Spondylotic Myelopathy
Authors: Muhle Claus , Metzner J. , Weinert D. , Schön R. , Rautenberg E. , Falliner A. , Brinkmann G. , Mehdorn H. M. , Heller M. , Resnick D.
Published: October 2009

Purpose: To estimate the clinical value and influence of kinematic MR imaging in patients with degenerative diseases of the cervical spine.

Material and Methods: Eighty-one patients were examined with a 1.5 T whole body magnet using a positioning device. Cervical disc disease was classified according to clinical and radiographic findings into 4 stages: stage I=cervical disc disease (n=13); stage II=spondylosis (n=42); stage III=spondylosis with restricted motion (n=11); and stage IV=cervical spondylotic myelopathya (n=15). Findings on kinematic MR images were compared to those on flexion and extension radiographs, myelography, CT-myelography and static MR imaging. Furthermore, the influence of kinematic MR imaging on surgical management and intra-operative patient positioning was determined.

Results: Additional information obtained by kinematic MR imaging changed the therapeutic management in 7 of 11 (64%) patients with stage III disease, and in 13 of 15 (87%) patients with stage IV disease. Instead of an anterior approach, a posterior surgical approach was chosen in 3 of 11 patients (27%) with stage III disease and in 6 of 15 patients (40%) with stage IV disease. Hyperextension of the neck was avoided intra-operatively in 4 patients (27%) with cervical spondylotic myelopathy, and in 1 patient with stage II (2%) and in 1 patient with stage III (9%) disease. Kinematic MR imaging provided additional information in all patients with stages III and IV disease except in 1 patient with stage III disease, when compared to flexion and extension radiographs, myelography, CT-myelography and static MR examination.

Conclusion: Kinematic MR imaging adds additional information when compared to conventional imaging methods in patients with advanced stages of degenerative disease of the cervical spine.
Thoracic CT Findings in Long-Term Hemodialysis Patients
Authors: Coşkun Mehmet , Boyvat F. , Bozkurt B. , Agildere A. M. , Niron E. A.
Published: October 2009

Purpose: To evaluate thoracic CT findings of long-term hemodialysis patients.

Material and Methods: Thoracic CT findings of 117 uremic patients (61 men, 56 women) with complaints of cough, dyspnea, low-grade pyrexia, malaise, weight loss, and profuse perspiration were retrospectively documented.

Results: Atelectasis (60%), cardiomegaly (60%), pleural effusion (51%), vascular congestion (44%), parenchymal consolidation (38%), parenchymal scarring-fibrosis (31%), and lymphadenopathy (29%) were the most common CT findings in the thoraces of the long-term hemodialysis patients. Staphylococcus aureus was detected in 13 patients (11%) who had parenchymal infiltration. Thoracic tuberculosis was identified in 15 patients (13%), 11 of these cases being confined to the lung parenchyma, 3 to the pleura, and 1 involving the pleura and pericardium.

Conclusion: In patients under long-term hemodialysis treatment, parenchymal consolidation, secondary to infectious agents such as S. aureus and Mycobacterium tuberculosis, is the most important CT finding since these lesions can be detected and treated successfully if they are considered as etiologic factors early on.
CT in Malignancy Grading and Prognostic Prediction of Non-Hodgkin's Lymphoma
Authors: Rodriguez Miriam , Rehn S. M. , Nyman R. S. , Sundström J. C. , Ahlström H. , Glimelius B. L. G.
Published: October 2009

Purpose: The presence of tumor inhomogeneities in MR images of non-Hodgkin's lymphoma (NHL) provides information about malignancy grade and prognosis. The aim of this study was to determine whether CT images are also informative in these respects.

Material and Methods: Sixty-three CT examinations in patients with NHL (32 high-grade and 31 low-grade tumors) were reviewed retrospectively by two senior radiologists. The tumor patterns were classified subjectively as homogeneous, slightly inhomogeneous or severely inhomogeneous and their relations to malignancy grade, clinical characteristics and prognosis were determined.

Results: Sixteen out of 17 patients with a severely inhomogeneous tumor pattern had high-grade NHL tumors while 21 out of 29 patients with a homogeneous tumor appearance had low-grade NHL tumors. Among chemotherapy-treated patients, those with the highest degree of inhomogeneity had a significantly worse prognosis (9 out of 11 patients died). This relationship was not found in patients treated with radiotherapy.

Conclusion: A severely inhomogeneous tumor pattern on CT images was found to be associated with a high malignancy grade in NHL. This CT pattern was also compatible with a poor prognosis in patients treated with chemotherapy.
MR Pyelography and Conventional MR Imaging in Urinary Tract Obstruction
Authors: Catalano C. , Pavone P. , Laghi A. , Scipioni A. , Panebianco V. , Brillo R. , Fraioli F. , Passariello R.
Published: October 2009

Purpose: To evaluate the possible role of MR imaging in the assessment of patients with urinary tract obstruction by combining conventional MR imaging and MR pyelography (MRP).

Material and Methods: Forty-three patients with dilated upper urinary tract were studied with a high gradient strength 0.5 T magnet. Respiratory compensated T1-weighted, SE and T2-weighted TSE sequences were acquired in all patients. MRP images were obtained by using a respiratory compensated 3D T2-weighted TSE sequence. MRP images were reconstructed with a MIP algorithm. In all cases, urography and/or ascending pyelography were also performed. Images were independently evaluated by two radiologists.

Results: The dilated tract ureter and the level of the obstruction could be correctly demonstrated in all cases. The cause of the obstruction was correctly demonstrated by examiner 1 in 90% and by examiner 2 in 88%. The interobserver agreement was high with a kappa-value of 0.96.

Conclusion: In cases of obstructive hydroureteronephrosis MR imaging, combining MRP and conventional sequences, can be proposed as an accurate technique in the assessment of level and cause of obstruction.
Renal Diuretic Duplex Doppler Sonography in Childhood Hydronephrosis
Authors: Akata D. , Haliloglu M. , Caglar M. , Tekgul S. , Özmen M. N. , Akhan O.
Published: October 2009

Objective: The purpose of this study was to determine the diagnostic value of diuretic duplex Doppler sonography in distinguishing between obstructive and nonobstructive hydronephrosis in children by calculating the resistive indices (RI) before and after administration of furosemide.

Material and Methods: We prospectively evaluated 28 kidneys (2 solitary) in 15 patients with unilateral or bilateral neonatal hydronephrosis. All patients underwent diuretic renography and duplex Doppler sonography before and after administration of furosemide.

Results: According to the half-time drainage patterns at diuretic renography, 13 kidneys were classified as nonobstructed and 15 as obstructed. At baseline, the mean RI values of nonobstructed and obstructed kidneys were not significantly different (0.66 and 0.64, respectively). Ten minutes after the injection of furosemide, the mean RI values of the nonobstructed and obstructed kidneys were 0.68 and 0.70, respectively. The increase in RI over the baseline 10 min after the diuretic injection was statistically significant ( p<0.00001) in the obstructed kidneys.

Conclusion: The baseline RI value of 0.70 is not a definite value for distinguishing obstructed from nonobstructed systems. An increase in RI of at least 10% over the baseline seems to be a more reliable criterion, especially when it is used in conjunction with diuretic renography.
Saline-Jet Aspiration Thrombectomy Catheter
Authors: Yamauchi T. , Furui S. , Okazaki M. , Higashihara H. , Matsui O. , Sakamoto T. , Tanaka T. , Kuribayashi S. , Takamiya M. , Sawada S.
Published: October 2009

Purpose: To evaluate hydraulic thrombectomy using a saline-jet aspiration thrombectomy catheter in the treatment of venous thrombosis.

Material and Methods: Ten patients underwent 12 hydraulic thrombectomy procedures using 2.7 or 4.0 mm catheters. The site of the thrombus was either central, peripheral or in portal veins. The age of the thrombi was between 2 and 60 days (mean 19.7 days). The efficacy of hydraulic thrombectomy was evaluated based on the aspirated thrombus ratio (ATR), i.e. the volume of the thrombus aspirated divided by the volume of the thrombus before thrombectomy. ATR was estimated by comparing the angiograms of the lesion before and after thrombectomy.

Results: Soft thrombi were usually rapidly removed. ATR was >2/3 in 3, 2/3-1/3 in 2, 1/3-0 in 4, and 0 in 1 patient. The activation time of the injector was 23–224 s (mean 102 s) and the volume of aspirated blood was 30–680 ml (mean 250 ml). Compensatory infusion of saline was performed for blood loss, and 400 ml of packed red blood cells was transfused in 1 patient. No complications of the hydraulic thrombectomy were observed. Thrombolysis or additional treatment were performed in 9 patients.

Conclusion: Hydraulic thrombectomy using this catheter can contribute to the treatment of venous thrombosis.
A Method to Evaluate the Performance of X-Ray Imaging Scintillators by Means of the Brightness-Sharpness Index (BSI)
Authors: Cavouras D. , Kandarakis I. , Prassopoulos P. , Kanellopoulos E. , Nomicos C. D. , Panayiotakis G. S.
Published: October 2009

Purpose: To propose an image quality index, the brightness-sharpness index (BSI), for assessing the quality of the image produced by phosphors of medical imaging detectors.

Material and Methods: BSI was evaluated by experimental X-ray luminescence and modulation transfer function measurements. BSI was determined for a number of test phosphor screens prepared from Gd2O2S:Tb, La2O2S:Tb, and Y2O2S:Tb phosphor materials. The screens covered a wide range of coating thicknesses from 50 to 150 mg/cm and measurements were performed for X-ray tube voltages between 50 and 120 kVp.

Results: Gd2O2S:Tb phosphor exhibited higher brightness and sharpness, as compared to the other phosphor materials, for all screens and X-ray tube voltages used. Best Gd2O2S:Tb performance was observed for thin screens and high tube voltages. La2O2S:Tb exhibited higher BSI values than Y2O2S:Tb for medium and high tube voltages.

Conclusion: Results showed that phosphor materials of high X-ray detection and X-ray-to-light conversion properties exhibit high BSI values indicating that BSI may provide a means of phosphor performance evaluation for imaging applications.
Epithelioid Hemangioendothelioma with Solitary Bone Location Associated to Multiple Lung and Liver Lesions
Authors: Dechambre S. D. , Coche E. E. , Roisin P. , van Eeckhout P. , D'Odemont J. P.
Published: October 2009

Progressive development of a lobulated osteolytic lesion of the left calcaneus was observed in a 28-year-old woman. The bone tumor was associated with multiple lung nodules and later with a few small nodular liver lesions. A histological and immunochemical diagnosis of epithelioid hemangioendothelioma was obtained by bone tumor resection and thoracoscopic lung biopsy. Imaging aspects are reported with emphasis on its multifocality.
Clearance of Iopromide during Haemodialysis with High- and Low-Flux Membranes
Authors: Matzkies F. , Tombach B. , Kisters K. , Schuhmann G. , Hohage H. , Schaefer R. M.
Published: October 2009

Purpose: The present clinical trial addressed the clearance of the contrast medium iopromide, a middle-sized molecule, during dialysis with high- and low-flux membranes.

Material and Methods: Twenty chronic haemodialysis patients without residual renal function were dialysed either with low-flux haemophan or high-flux polyamide directly after application of the contrast medium. Iodine concentrations were determined by radiofluorescence methods.

Results: Plasma concentrations of iodine before dialysis ranged between 1.1 and 3.9 mg/ml. The mean clearance rates for both membranes were comparable (110±1.4 ml/min high-flux and 108±1.9 ml/min low-flux), the sieving-coefficient was 0.83 for both membranes. After three hours of dialysis, 58% (high-flux) and 62% (low-flux) of iopromide was removed, half time of elimination was reached after 140±16 min (high-flux) and 122±11 min (low-flux).

Conclusion: Our results demonstrated that elimination of iopromide is not dependent on the pore size of the membrane during dialysis. Due to higher blood flow rate, we found a higher elimination rate and a reduced half-time of elimination than prior investigations.
Concentration of 123I-Metaiodobenzyl-Guanidine in Left and Right Liver Lobes
Authors: Jacobsson H. , Johansson L. , Kimiaei S. , Larsson S. A.
Published: October 2009

Purpose: Normal radioactivity in the liver is often shown to be higher in the left lobe than in the right lobe at clinical examination by single photon emission computed tomography (SPECT) with 123I-metaiodobenzylguanidine (123I-MIBG). Our objective was to determine whether this represents a pathological condition.

Material and Methods: The distribution of 123I-MIBG in the liver was retrospectively studied in clinical patients who had normal CT examinations of the liver and spleen. In the SPECT sections of 27 123I-MIBG examinations, we determined the activity ratios between the left and right lobes. The control group comprised 33 examinations with 111In-pentetreotide (OctreoScan) and 23 examinations with 99mTc-antigranulocyte antibody.

Results: The mean activity ratio between left and right lobes for 123I-MIBG was 1.24, and for 111In-pentetreotide 0.87. These figures differed significantly both from each other and from 1.00. The mean ratio for 99mTc-antibody at the early examinations was 0.99, and at the late examinations 0.95. These figures differed significantly from the values for 123I-MIBG and 111In-pentetreotide.

Conclusion: The increased concentration of 123I-MIBG in the left lobe of the liver compared to the right lobe is a normal finding. The reason for this cannot be explained. The difference in the way in which the left and right lobes deal with the three radiopharmaceuticals is a new finding and indicates a regional difference in liver function that has not been reported previously.
Interventional Neuroradiology
Authors: Nakstad P. H.
Published: October 2009

The purpose of this article is to provide an overview of all aspects concerning interventional neuroradiology of vascular central nervous diseases.

Today, interventional neuroradiology can help many patients that, even until a few years ago, did not have any possibility for a safe cure. Complex cerebral arteriovenous malformations and fistulas, inoperable aneurysms and intravascular thromboses are often treated with interventional neuroradiology alone, while in other cases a combination of neurosurgery and radiation may help in reaching a good outcome for the patients.

In the past few decades the efforts by neuroradiologists and collaborating clinicians to develop treatment strategies and methods for these and other high risk diseases represent a vast, fascinating field of modern medicine. The article therefore focusses on the state-of-the-art and describes presently used methods for diseases that can be treated with interventional neuroradiology.

Literature dealing with the historical development of interventional neuroradiology and important publications of recent scientific work are reviewed, providing the reader with an overview of the most pertinent material on each disease discussed.

Aspects of training and ethics are discussed and emphasis is focussed on the importance of recognizing these aspects as essential in any case of interventional radiological treatment.
MR Imaging of Experimentally Induced Intracranial Hemorrhage in Rabbits during the First 6 Hours
Authors: Gustafsson O. , Rossitti S. , Ericsson A. , Raininko R.
Published: October 2009

Purpose: To evaluate the MR appearance of intracranial, especially intraparenchymal, hemorrhage during the first 6 hours after bleeding with various pulse sequences in an animal model.

Material and Methods: Intracerebral hematomas and subarachnoid hemorrhage were created by injecting autologous blood in 9 rabbits. MR studies were performed using a 1.5 T scanner with pixel size and slice thickness comparable to those used in clinical practice before blood injection, immediately after injection, and at regular intervals during 6 hours. The images were compared with the hematoma sizes on formalin-fixed brain slices.

Results: In every animal, susceptibility-weighted gradient-echo (GRE) pulse sequences depicted the intraparenchymal hematomas and blood escape in the ventricles or subarachnoid space best as areas of sharply defined, strong hypointensity. The findings remained essentially unchanged during follow-up. The sizes corresponded well to the post-mortem findings. Gradient- and spin-echo (GRASE) imaging revealed some hypointensities, but these were smaller and less well defined. Spin-echo (SE) sequences (proton density-, T1- and T2-weighted) as well as a fluid-attenuated inversion recovery turbo spin-echo sequence (fast FLAIR) depicted the hemorrhage sites as mostly isointense to brain.

Conclusion: Susceptibility-weighted GRE imaging at 1.5 T is highly sensitive to both hyperacute hemorrhage in the brain parenchyma and to subarachnoid and intraventricular hemorrhage.
Ultrasonographic Evaluation of Invasive Lobular Carcinoma
Authors: Skaane P. , Skjørten F.
Published: October 2009

Purpose: To compare ultrasonographic (US) and mammographic findings and tumor size measurements of invasive lobular carcinoma (ILC).

Material and Methods: US diagnoses and mammographic findings were compared in 95 patients with pure ILC, including 46 palpable and 49 nonpalpable tumors. The diameters of tumors measured by mammography, US, and pathology were compared in 70 of the 95 patients using scatter plots and correlation analysis.

Results: Eighty-two (86.3%) of the ILCs were correctly diagnosed as malignant tumor, 5 (5.3%) were diagnosed as focal abnormality, and only 2 patients had normal findings on US. The most common mammographic findings were a spiculated mass (57%) and a focal asymmetric density (15%). US correctly diagnosed 8 of 12 patients with normal or equivocal mammographic findings. The correlation of tumor size assessment on imaging and pathology revealed that US measurements including the “halo” (r=0.69) was superior to that of mammography (r=0.59). ILCs larger than 30 mm were heavily underestimated by both methods.

Conclusion: Malignant tumor was diagnosed on US in most of the patients with ILC. US tumor measurement including the “halo” predicted tumor size most accurately. The correlation between imaging measurements and tumor diameter on histology was lower for ILCs than reported for populations of mixed carcinomas.
Contribution of Ultrasonography and Fine-Needle Aspiration Cytology to the Differential Diagnosis of Palpable Solid Breast Lesions
Authors: Reinikainen H. , Rissanen T. J. , Piippo U. K. , Päivänsalo M. J.
Published: October 2009

Purpose: To define the role of ultrasonography (US) and fine-needle aspiration biopsy (FNAB) relative to mammography in differentiating between benign and malignant palpable solid breast lesions, and to assess the contribution of FNAB cytology to the delay between referral and the definitive diagnosis of breast cancer.

Material and Methods: We retrospectively reviewed the mammograms and US images of 84 palpable breast lesions, 63 of them also blindly. The lesions were classified as benign, indeterminate or malignant by both modalities. The results were compared with histologic diagnoses. The cytologic reports of 57 lesions were reviewed and compared to the final diagnoses. The delay from referral until diagnosis was calculated for each case.

Results: Eighty-one of the 84 lesions (96%) were visible as a local abnormality at US. Fifty-two of the 53 cancers were seen as a tumor (n=51) or an architectural distortion (n=1). In the blinded analysis, the sensitivity of FNAB cytology was 92%, specificity 83%, and overall accuracy 88%. There were no false-negative malignancies in the three modalities combined. The delay until the date of the final diagnosis was shorter in the group with a cytologic diagnosis positive for malignancy.

Conclusion: Malignancy is unlikely if the US, mammographic and cytologic findings of a palpable breast lesion are all benign. Active and critical use of these three modalities could cut down the number of surgical biopsies of benign breast lesions and provide prompt surgical treatment for malignant lesions.
Sensitivity and Specificity of Planar Scintimammography with 99mTc-Sestamibi
Authors: Danielsson R. , Boné B. , Gad A. , Sylvan M. , Aspelin P.
Published: October 2009

Purpose: The aim of our prospective study was to determine the diagnostic accuracy of planar breast imaging with 99mTc-MIBI in detecting malignant disease.

Material and Methods: Ninety-six consecutive patients with 121 clinically-and/or mammographically-detected breast lesions underwent preoperative planar scintimammography. Ten minutes after injection of 700 MBq99mTc-MIBI, two lateral prone and one anterior supine projections with an acquisition time of 8 minutes each were obtained. Interpretation of scintimammographic results was made blindly and any focal accumulation of MIBI in the breasts was the criterion for an abnormal scintigram. All lesions were operated on and histologically verified.

Results: Histologically, 86 malignant and 35 benign lesions were found in 121 breast lesions. A sensitivity of 83.7% and a specificity of 74.2% for malignancy was achieved at planar scintimammography.

Conclusion: Scintimammography with 99mTc-MIBI is an imaging modality of modest usefulness in the investigation of breast lesions. The method has a low sensitivity in lesions smaller than 10 mm in diameter, which decreases the clinical use of the method.
Wrist and Finger Joint MR Imaging in Rheumatoid Arthritis
Authors: Klarlund M. , Østegaard M. , Gideon P. , Sørensen K. , Jensen K. E. , Lorenzen I.
Published: October 2009

Purpose: To elaborate the best MR imaging protocol for studies in rheumatoid arthritis (RA) and to evaluate the sensitivity and interobserver agreement with respect to detection of bone erosions (MR and radiography) and grading of synovial membrane hypertrophy (MR imaging only).

Material and Methods: MR imaging and conventional radiography of wrist and metacarpophalangeal (MCP) joints were performed in 41 RA patients and 3 healthy controls. The following pulse sequences were applied: T1-weighted spin-echo (T1-SE) with and without contrast enhancement, T2-SE, T2-turbo-SE, T1-2D-FLASH, T1-3D-FLASH, fat-saturated-T1-SE, STIR and 3D-DESS.

Results: Bone erosions were found by MR compared to radiography in 261 versus 85 bones of the wrist (ratio 3.1) and 59 versus 21 MCP joint quadrants (ratio 2.81). MR and radiography interobserver agreements were both approximately 90%. Likewise, MR scored synovial membrane hypertrophy in wrist and MCP joints with a high interobserver agreement. The most informative MR sequence appeared to be contrast-enhanced T1-SE MR, preferably with fat saturation. A STIR sequence or T2-weighted fat saturation sequence was useful in screening for joint disease.

Conclusion: The sensitivity of MR is superior to conventional radiography with respect to detection of bone erosions in wrist and MCP joints. The interobserver agreement for MR and radiography was similar. Thus, MR of wrist and finger joints may become a useful supplement to conventional radiography in the evaluation of RA patients in clinical trials and clinical practice.
Comparative Evaluation of Plain Films, Ultrasound and CT in the Diagnosis of Intestinal Obstruction
Authors: Suri S. , Gupta S. , Sudhakar P. J. , Venkataramu N. K. , Sood B. , Wig J. D.
Published: October 2009

Background: There are limited studies in the literature comparing plain radiography, US and CT in the evaluation of intestinal obstruction. We carried out this prospective study to compare the relative efficacies of these three imaging techniques in patients with intestinal obstruction.

Material and Methods: Thirty-two patients presenting with clinical suspicion of intestinal obstruction were subjected to plain radiography, US and CT and the findings were compared with reference to the presence or absence of obstruction, the level of obstruction and the cause of obstruction. The final diagnosis was obtained by surgery (n=25), or by contrast studies and/or clinical follow-up in those who were treated conservatively (n=7).

Results: Out of 32 patients, 30 had mechanical intestinal obstruction (22 had small bowel obstruction and 8 had large bowel obstruction). Of the remaining 2 patients, 1 had adynamic ileus and the other had a mesenteric cyst. CT had high sensitivity (93%), specificity (100%) and accuracy (94%) in diagnosing the presence of obstruction. The comparable sensitivity, specificity and accuracy were, respectively, 83%, 100% and 84% for US and 77%, 50% and 75% for plain radiography. The level of obstruction was correctly predicted in 93% on CT, in 70% on US and in 60% on plain films. CT was superior (87%) to both US (23%) and plain radiography (7%) in determining the aetiology of obstruction.

Conclusion: CT is a highly accurate method in the evaluation of intestinal obstruction especially for determining the level and cause of obstruction and should be the technique of choice when clinical or plain radiographic findings are equivocal.
Ferric Ammonium Citrate as a Positive Bowel Contrast Agent for MR Imaging of the Upper Abdomen
Authors: Kivelitz D. , Gehl H.-B. , Heuck A. , Krahe T. , Taupitz M. , Lodemann K.-P. , Hamm B.
Published: October 2009

Purpose: To evaluate the safety and diagnostic efficacy of two different doses of ferric ammonium citrate as a paramagnetic oral contrast agent for MR imaging of the upper abdomen.

Material and Methods: Ninety-nine adult patients referred for MR imaging for a known or suspected upper abdominal pathology were included in this randomized multicenter double-blind clinical trial. Imaging was performed with spin-echo (T1- and T2-weighted) and gradient-echo (T1-weighted) techniques before and after administration of either 1200 mg or 2400 mg of ferric ammonium citrate dissolved in 600 ml of water. Safety analysis included monitoring of vital signs, assessment of adverse events, and laboratory testing. Efficacy with regard to organ distension, contrast distribution, bowel enhancement and delineation of adjacent structures was graded qualitatively.

Results: No serious adverse events were reported for either of the two concentrations. A total of 31 minor side effects were noted, of which significantly more occurred in the higher dose group ( p<0.01). The diagnostic confidence in defining or excluding disease was graded as better after contrast administration for 48% of all images. Marked or moderate enhancement of the upper gastrointestinal tract was achieved at both doses in 69.5% of cases with no evident difference between the two doses. The higher dose tended to show better results in terms of the contrast assessment parameters.

Conclusion: Ferric ammonium citrate is a safe and effective oral contrast agent for MR imaging of the upper abdomen at two different dose levels. The higher dose showed a tendency toward better imaging results while the lower dose caused significantly fewer side effects. Therefore the 1200 mg dose can be recommended in view of the risk-to-benefit ratio.
Ultrasound-Guided Fine Needle Aspiration Biopsy of Gall Bladder Malignancies
Authors: Venkataramu N. K. , Sood B. P. , Gupta S. , Gulati M. , Khandelwal N. , Suri S.
Published: October 2009

Purpose: To establish the safety and efficacy of US-guided fine needle aspiration biopsy (FNAB) in gall bladder malignancies.

Material and Methods: 142 patients suspected to have gall bladder malignancies underwent FNAB under real-time US guidance. The most common sonographic appearances were a mass filling or replacing the gall bladder (n= 98), focal or diffuse wall thickening (n=25) and intraluminal polypoidal mass (n=19). FNAB was performed with a 0.7-mm spinal needle using a free-hand technique.

Results: On initial FNAB, 115 patients were diagnosed to have malignancy. In the remaining 27 patients, aspirates on first FNAB showed either inflammatory pathology (n=14) or the sample was suspicious of malignancy (n=7), or the aspirates were non-representative (n=6). Of these 27 patients, 13 underwent repeat FNAB because of the high suspicion of malignancy and 12 of them showed malignancy. The FNAB diagnosis of inflammatory disease of 7 patients was confirmed on subsequent surgery and 8 patients were lost to follow-up. Thus, a total of 127/142 were diagnosed to have gall bladder malignancy. Adenocarcinoma was the most common malignancy (89.76%). No procedure-related complications were encountered.

Conclusion: US-guided FNAB is a safe and accurate technique to diagnose gall bladder malignancy. Either a repeat FNAB or surgical biopsy is recommended when the suspicion of malignancy is high and the initial FNAB is negative.
CT of Liver Cysts in Patients with Autosomal Dominant Polycystic Kidney Disease
Authors: Gupta S. , Seith A. , Dhiman R. K. , Chawla Y. K. , Sud K. , Kohli H. S. , Sakhuja V. , Suri S.
Published: October 2009

Purpose: The purpose of this study was to illustrate the CT appearances of liver cysts in patients with autosomal dominant polycystic kidney disease (ADPKD).

Material and Methods: Contrast-enhanced CT images of 24 patients with ADPKD were retrospectively evaluated for the presence, number, size and distribution of liver cysts. An attempt was made to categorize these cysts into peribiliary cysts (located adjacent to larger portal triads or in the hepatic hilum) and intrahepatic cysts (within the liver parenchyma but not in contact with larger portal triads). When it was not possible to definitely categorize the cysts into either type, the cysts were labeled as indeterminate.

Results: Liver cysts were seen in 13 (54%) patients. Intrahepatic cysts were seen in 12 patients, and were mainly peripheral in location with sizes ranging from less than 10 mm to 8 cm. Peribiliary cysts were seen in all 13 patients and were usually less than 10 mm in size. These cysts were seen as discrete cysts (8 patients), a string of cysts (10 patients), or as a tubular structure paralleling the portal vessels, mimicking biliary dilatation (11 patients). Twelve patients also showed indeterminate cysts which defied definite categorization into either type; two common causes of confusion included large (more than 10 mm) discrete cysts in the hilar region and the presence of a vessel adjacent to peripheral cysts.

Conclusion: Liver cysts in patients with ADPKD show a wide variety of appearances on CT. Familiarity with these findings is essential to avoid confusion with other abnormalities.
Small Hepatocellular Carcinoma Supplied by the Right Renal Capsular Artery
Authors: Baba Y. , Miyazono N. , Inoue H. , Kanetsuki I. , Nishi H. , Nakajo M. , Tanabe G. , Aikoh T.
Published: October 2009

We present a case of hepatocellular carcinoma (HCC), which was fed only by the right renal capsular artery. Ten years earlier, this patient underwent surgery for a solitary HCC in segment IV. However, the hepatic artery was patent and did not participate in feeding the HCC. We consider the renal capsular artery as an essential extrahepatic parasitic feeding artery to HCC.
HRCT in Miliary Lung Disease
Authors: Voloudaki A. E. , Tritou I. N. , Magkanas E. G. , Chalkiadakis G. E. , Siafakas N. M. , Gourtsoyiannis N.
Published: October 2009

Purpose: To analyze high resolution CT (HRCT) features of a miliary pattern in different diseases.

Material and Methods: Eight HRCT studies with a miliary lung pattern were retrospectively reviewed with the diagnoses tuberculosis (n=3), Candida albicans (n=1), sarcoidosis (n=3), and metastatic adenocarcinoma (n=1).

Results: In all cases, HRCT showed diffusely disseminated nodules up to 3 mm. In 2 cases of tuberculosis and 1 of sarcoidosis, the lesions predominated in the upper/middle lung zones. In the case of metastatic adenocarcinoma the nodules were more sparse in the lung periphery while in 1 case of sarcoidosis, HRCT revealed a predominance of the lesions in the outer third of the lungs. Cyst-like lesions of 1–2 mm were observed in 2/3 cases of tuberculosis and in metastatic adenocarcinoma. Notably thickened interlobular septa and interlobar fissures were each seen in 2/3 cases of sarcoidosis. In general, a random relationship of miliary nodules to secondary lobular structures and bronchovascular bundles was observed, despite the co-existence of centrilobular, subpleural and paraseptal nodules.

Conclusion: HRCT features that potentially contribute in making a differential diagnosis are: a) A peripheral distribution of nodules, an increased number of thickened interlobular septae, and a notable thickening of interlobar fissures, all of which are indicative of sarcoidosis; and b) Multiple cyst-like lesions which should direct attention to tuberculous or metastatic origin. The predominance of miliary nodules in relation to cephalocaudal axis, their margin and size are not helpful features to the differential diagnosis of diseases presenting a miliary pattern.
Renal Masses — Evaluation by Amplitude Coded Colour Doppler Sonography and Multiphasic Contrast — Enhanced CT
Authors: Riccabona Michael , Szolar D. , Preidler K. , Uggowitzer M. , Kugler C. , Dörfler O. , Schreyer H. H.
Published: October 2009

Objective: To assess the efficacy of amplitude coded colour Doppler US (aCDS) in the evaluation of renal masses as shown by multiphasic contrast-enhanced CT.

Material and Methods: Eighty patients (155 kidneys) with suspicion of renal masses underwent aCDS and spiral CT. The findings were classified into normal kidneys, kidneys with tumours, kidneys with cysts, and those with “other findings” (i.e. bleeding, calcifications, inflammation, parenchymal hypertrophy). The aCDS findings were compared to CT results and to histological findings or clinical, laboratory and follow-up data.

Results: Eighteen renal cell carcinomas and 8 other tumours were found; 78 kidneys had cysts, 12 polycystic kidneys and 10 fibrotic kidneys were detected, 20 kidneys showed other findings. Diagnostic aCDS data were obtained in 129 kidneys (83.2%) showing pathology with an accuracy of 94%. CT adequately showed pathology in all patients with some diagnostic uncertainty in the evaluation of complicated cysts.

Conclusion: Though contrast-enhanced multiphasic spiral CT is the method of choice for evaluating renal masses, US including aCDS can provide valuable information, particularly in differentiating vascularized from non-vascularized lesions and in the evaluation of complicated renal cysts.
Supersymmetry of Generalized Linear Schrödinger Equations in (1+1) Dimensions
Authors: Schulze-Halberg Axel , Carballo Jimenez Juan M.
Published: October 2009

We review recent results on how to extend the supersymmetry SUSY normalism in Quantum Mechanics to linear generalizations of the time-dependent Schrödinger equation in (1+1) dimensions. The class of equations we consider contains many known cases, such as the Schrödinger equation for position-dependent mass. By evaluating intertwining relations, we obtain explicit formulas for the interrelations between the supersymmetric partner potentials and their corresponding solutions. We review reality conditions for the partner potentials and show how our SUSY formalism can be extended to the Fokker-Planck and thenonhomogeneous Burgers equation.
A legacy of tinnitus: multiple head and neck paragangliomas
Authors: Tan Tricia M.M , Hatfield Emma C.I , Thakker Rajesh V , Maher Eamonn R , Meeran Karim , Martin Niamh M , Turner Jeremy J
Published: October 2009

We describe the case of a patient who presented with a right-sided glomus jugulare tumor and bilateral glomus vagale tumors. These proved to be nonmalignant paragangliomas on histopathological analysis. Genetic analysis revealed a germline heterozygous missense mutation (Pro81Leu) in the succinate dehydrogenase subunit D ( SDHD) gene. We discuss the clinical presentations of the familial paraganglioma syndrome type 1, which is caused by mutations in SDHD, and the implications for the clinical diagnosis and care of such patients.
Treat and trick: A new way to increase false memory
Authors: Zhu Bi , Chen Chuansheng , F. Loftus Elizabeth , Lin Chongde , Dong Qi
Published: October 2009

This paper reports a new experimental manipulation that increased false memories 1 month after the manipulation. Mirroring the standard three‐stage misinformation paradigm (original event, misinformation, and test), subjects in the experimental group were first given a colour‐slide presentation of two stories (events), then given an accurate account (instead of misinformation) of the events in narrations, and finally tested for their memory of the original events. One month later, they underwent the standard misinformation paradigm with two new events. The comparison group was given the standard misinformation tasks at both time points. Results showed that the experimental group produced more false memories in the subsequent misinformation paradigm than did the comparison group. We focus on trust and credibility as possible mechanisms underlying this effect. Copyright © 2009 John Wiley & Sons, Ltd.
The accrual anomaly financial problem in the food supply chain
Authors: Trejo‐Pech Carlos J. , Weldon Richard N. , House Lisa A. , Gunderson Michael A.
Published: October 2009

This study introduces the accrual anomaly problem in the agribusiness literature. The authors document the accrual anomaly, introduced by Sloan (1996) for the complete U.S. market, in the food supply chain. A mimicked risk‐free trading strategy shorting high accrual agribusinesses and longing low accrual agribusinesses yield statistically significant annual abnormal returns of 5.9% during 1970–2004. Results for the food supply chain are different from results by Sloan and others. In particular, results for high accrual agribusiness are similar to results by Sloan for the complete U.S. market, but low accrual agribusinesses perform differently. The authors believe that this contrasting result is not industry specific, but rather a result supporting the idea that the fixation hypothesis by Sloan fails to explain the accrual anomaly problem. This is important because the fixation hypothesis is prevalent in the literature; a well‐articulated hypothesis on the accrual anomaly has not yet been offered. © 2009 Wiley Periodicals, Inc.
Demand for differentiated milk products: implications for price competition
Authors: Lopez Elena , Lopez Rigoberto A.
Published: October 2009

The authors apply the Berry, Levinsohn, and Pakes (1995) model to scan data from Boston supermarkets augmented with consumer characteristics data to analyze consumer choices and price competition in a differentiated fluid milk market. Milk characteristics include price, fat content, brand name, and the organic and/or lactose‐free nature of the product. Empirical results show that consumer valuation of fat decreases with income, but increases with the number of children. Low‐fat and specialty milks, such as organic and lactose‐free milks, are preferred by high‐income consumers with no children. Although all milks are price elastic at the individual brand level, the cross‐price elasticities are quite low and negligible for specialty milks. Based on calculated Lerner indexes, private label milks have the highest percent markups despite their lower prices, whereas specialty milks have the lowest markups despite their higher prices, which attests to a greater degree of market power for conventional and particularly for private label milk. [JEL Classification: D12, D40, L11, L81]. © 2009 Wiley Periodicals, Inc.
Service quality in agronomic inputs: does the hierarchical model apply?
Authors: Gunderson Michael A. , Gray Allan W. , Akridge Jay T.
Published: October 2009

Research regarding the quality of services is increasingly important as services account for more of the national economy. In agriculture many services are used, but are not systematically assessed in a manner similar to how products are assessed. This research aims to identify the compatibility of proposed service quality structures to the agriculture inputs sector. Results of a survey of Midwest row crop producers lend support to the hierarchical model of service quality structure. Input suppliers can use these results to structure their services more efficiently. [EconLit classification codes: M, Q]. © 2009 Wiley Periodicals, Inc.
Quality improvement through consumer sorting and disposal
Authors: Ferrier Peyton
Published: October 2009

Sorting allows consumers to capture the value of quality differences. As higher quality goods are removed, the value of the seller's remaining stock falls, lowering the price and profits. Bundling and other marketing mechanisms can discourage sorting and prevent the depreciation of the seller's stock. With comparative statics and simulations, the author shows that sellers can increase expected quality and profits by committing to discard a proportion of their resale stock after sorting occurs. In this manner, sorting acts similarly to agricultural grading. [EconLit Classification: Q1, Q11, Q13, L0, L1, D8, D82]. © 2009 Wiley Periodicals, Inc.
Would consumers value food‐away‐from‐home products with nutritional labels?
Authors: Drichoutis Andreas C. , Lazaridis Panagiotis , Nayga Rodolfo M.
Published: October 2009

The authors examine consumers' valuation for food‐away‐from‐home products with and without nutritional labels using experimental auctions. They presented subjects with three different nutritional information schemes: a European Union type label, a United States type label, and a traffic‐light colored information label. Furthermore, they examined the role of reference prices (i.e., the real market prices of the products) within the context of experimental auctions. Using well‐known products, our results indicate that subjects bid more for the products with nutritional labels. However, among products with nutritional information, subjects' willingness to pay values differ depending on the type of nutritional label on the product. In addition, the authors find evidence that inclusion of reference prices leads to higher bids. [JEL classifications: D12, C23]. © 2009 Wiley Periodicals, Inc.
Association study of SNAP25 and schizophrenia in Irish family and case–control samples
Authors: Fanous A.H. , Zhao Z. , van den Oord E.J.C.G. , Maher B.S. , Thiselton D.L. , Bergen S.E. , Wormley B. , Bigdeli T. , Amdur R.L. , O'Neill F.A. , Walsh D. , Kendler K.S. , Riley B.P.
Published: October 2009

SNAP25 occurs on chromosome 20p12.2, which has been linked to schizophrenia in some samples, and recently linked to latent classes of psychotic illness in our sample. SNAP25 is crucial to synaptic functioning, may be involved in axonal growth and dendritic sprouting, and its expression may be decreased in schizophrenia. We genotyped 18 haplotype‐tagging SNPs in SNAP25 in a sample of 270 Irish high‐density families. Single marker and haplotype analyses were performed in FBAT and PDT. We adjusted for multiple testing by computing q values. Association was followed up in an independent sample of 657 cases and 411 controls. We tested for allelic effects on the clinical phenotype by using the method of sequential addition and 5 factor‐derived scores of the OPCRIT. Nine of 18 SNPs had P values <0.05 in either FBAT or PDT for one or more definitions of illness. Several two‐marker haplotypes were also associated. Subjects inheriting the risk alleles of the most significantly associated two‐marker haplotype were likely to have higher levels of hallucinations and delusions. The most significantly associated marker, rs6039820, was observed to perturb 12 transcription‐factor binding sites in in silico analyses. An attempt to replicate association findings in the case–control sample resulted in no SNPs being significantly associated. We observed robust association in both single marker and haplotype‐based analyses between SNAP25 and schizophrenia in an Irish family sample. Although we failed to replicate this in an independent sample, this gene should be further tested in other samples. © 2009 Wiley‐Liss, Inc.