bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of Indomethacin and Salt Depletion on Renal Proton MR Imaging
Authors: Heyman S. N. , Mammen M.
Published: June 2015

Blockade of the synthesis of vasodilating prostaglandins with non-steroidal anti-inflammatory drugs (NSAID) renders the renal medulla susceptible to hypoxic injury with reduced renal function, especially in clinical conditions characterized by volume depletion. Alterations in renal hemodynamics and urine production may affect renal MR imaging under these circumstances.

We injected salt-depleted and control rats undergoing proton MR imaging with indomethacin 10 mg/kg. Indomethacin abolished the cortico-medullary T2-gradient and markedly diminished the overall renal signal in salt-depleted rats only. These changes, which progressed over a period of 40 min after indomethacin was injected, probably result from renal oligemia and decreased urine production, with an associated decrease in T2-values. We suggest that a history of consumption of non-steroidal anti-inflammatory drugs should be obtained and taken into account in the evaluation of renal proton MR imaging, especially in the presence of salt and volume depletion.
CT Analysis of Metastatic Neoplasms of the Kidney
Authors: Honda H. , Coffman C. E. , Berbaum K. S. , Barloon T. J. , Masuda K.
Published: June 2015

The CT findings in 32 patients with pathologically proven metastases to the kidney were compared to findings in 74 patients with renal cell carcinoma. Fourteen CT criteria were chosen to describe and characterize the lesions and 2 radiologists evaluated the CT images retrospectively according to these criteria. Renal metastases were characterized as small, multiple, bilateral, wedge-shaped, less exophytic, and located within the renal capsule. Renal cell carcinomas were single, unilateral, nonwedge-shaped, and exophytic, and easily transgressed the renal capsule. The sensitivity of CT to discriminate renal cell carcinoma from renal metastasis was 93.2% for renal cell carcinoma, and to discriminate renal metastasis from renal cell carcinoma was 75.0% for renal metastases by computer posterior probabilities. This study indicates that CT is useful for distinguishing these clinically important tumors. By using posterior probability, some unnecessary biopsies may be avoided.
Emergent Embolization for Control of Massive Hemorrhage from a Splanchnic Artery with a New Coaxial Catheter System
Authors: Okazaki M. , Higashihara H. , Koganemaru F. , Ono H. , Fujimitsu R. , Yamasaki S. , Toyoshima H. , Sato S. , Hoashi T. , Kimura T.
Published: June 2015

Emergent superselective embolization with a 3.0 F (1 mm) coaxial catheter and a steerable guidewire was performed in 27 patients with massive hemorrhage from a small-caliber splanchnic artery. Eight patients had intraperitoneal hemorrhage, 3 had hemobilia, 9 had gastric hemorrhage, and 7 had intestinal hemorrhage. Out of 27 patients, 7 had hemorrhage from a splanchnic artery pseudoaneurysm. Complete cessation of bleeding was obtained in all patients initially, but in 3 patients gastric hemorrhage recurred later. Otherwise, there was no rebleeding nor any major complication such as marked infarction of tissue or misplacement of embolic materials. This coaxial catheter system was highly reliable for achieving superselective catheterization in small-caliber arteries, minimizing the volume of infarcted tissue and allowing maximal preservation of splanchnic organic function. We conclude that this system represents a major advance in interventional radiology.
Phantom Studies of Triple Photon Absorptiometry and Bone Mineral Measurement at a Hip Prosthesis
Authors: Farrell T. J. , Webber C. E.
Published: June 2015

The feasibility of using triple photon absorptiometry (TPA) for the measurement of bone mineral mass about a hip prosthesis was examined. A theoretical expression describing the variance of TPA measurements was verified using a triple photon source and phantom materials which simulate the soft tissue-bone mineral-metal prosthesis system. The expression for the variance was used to determine an optimized set of photon energies. It was shown that a precision of 3% could be obtained for reasonable measurement times using this optimized set of energies, and that TPA should be a feasible approach for measurement of bone mineral about a hip prosthesis.
Combined Angioplasty with the Kensey Catheter and Balloon Angioplasty in Occlusive Arterial Disease: A Preliminary Report
Authors: Lukes P. , Wihed A. , Tidebrant G. , Risberg B. , Örtenwall P. , Seeman T.
Published: June 2015

The Kensey dynamic angioplasty catheter is an instrument for mechanical intravascular atherectomy using a rotating cam to recanalize occluded arteries. Twelve dynamic angioplasties were performed in 11 patients. The procedure was followed by an additional balloon dilatation in all cases. A technical success, i.e., a restored lumen, was recorded in 7 patients but only 4 had a functional improvement. No distal embolization or other serious complication occurred. This preliminary report shows that the therapeutic potential with this technique must be further investigated.
Granulocyte Adherence is Inhibited by Radiographic Contrast Media in Vitro
Authors: Rasmussen F. , Antonsen S. , Georgsen J.
Published: June 2015

Different amounts of diatrizoate, ioxaglate, iohexol, iodixanol, NaCl 1000 mOsm/kg, mannitol 1098 mOsm/kg, and meglumine (meglumine concentrations corresponding to the content in the diatrizoate solutions) were added to either whole blood or a suspension of granulocytes in autologous plasma, and the adherence to nylon fibers was determined. At high concentrations all the investigated contrast media (CM) inhibited granulocyte adherence. The degree of inhibition was significantly greater when the ionic CM diatrizoate and ioxaglate were used, as compared with the nonionic media. Meglumine solutions at high concentrations also inhibited adherence but significantly less than diatrizoate solutions containing the same amount of meglumine. Diatrizoate showed the greatest inhibitory effect on granulocyte adherence, and significant inhibition could be detected even with a 1.25% solution.
Granulocyte Adherence after Intravenous and Intraarterial Injection of Ioxaglate or Iohexol
Authors: Rasmussen F. , Antonsen S. , Georgsen J. , Lindequist S.
Published: June 2015

The effect of iohexol and ioxaglate on granulocyte adherence to nylon fibers was investigated with blood from 15 patients undergoing angiography, and from 24 patients undergoing excretory urography. Decreased adherence and increased numbers of granulocytes in the circulation were observed soon after injection of iohexol or ioxaglate in the aorta, or injection of ioxaglate i.v. Increased adherence and decreased numbers of granulocytes in the circulation were observed soon after injection of iohexol i.v. The differences were small soon after the injection of contrast media (CM). More pronounced decreased adherence and increased numbers of granulocytes were detected 2 and 5 hours after injection in the aorta for both CM.
Comparison of CT Findings in Non-Hodgkin Lymphoma and Squamous Cell Carcinoma of the Maxillary Sinus
Authors: Matsumoto S. , Shibuya H. , Tatera S. , Yamazaki E. , Suzuki S.
Published: June 2015

The findings at CT in 11 patients with primary non-Hodgkin lymphoma (NHL) of the maxillary sinus were compared with the CT findings in 21 patients with squamous cell carcinoma (SCC) of the maxillary sinus. In NHL, the segmental bone destruction was in alignment with the bony wall with a massive tumor infiltration into the neighboring structures. In contrast, all patients with SCC were characterized by a soft tissue mass with aggressive bone destruction. About half of the patients with NHL had cervical lymphadenopathy. Post-treatment recalcification of previous bone destruction was seen in 4 out of 5 NHL patients on follow-up CT. In the patients with SCC, only a few had metastatic lymphadenopathy, and no recalcification occurred after treatment. CT is therefore of importance in differentiating NHL from SCC of the maxillary sinus.
Plain Radiography, Renography, and 99mTc-DMSA Renal Scintigraphy before and after Extracorporeal Shock Wave Lithotripsy for Urolithiasis
Authors: Munck O. , Gerquari I. , Møller J. T. , Jensen L. I. , Thomsen H. S.
Published: June 2015

Eighteen patients were evaluated before and 5 weeks after the first treatment with extracorporeal shock wave lithotripsy (ESWL) using abdominal plain radiography, 131I-hippuran probe renography, and 99mTc-dimercaptosuccinic acid scintigraphy. In 6 patients no urolithiasis was present on the post ESWL plain radiograph, in 7 the size had decreased, and in 5 the stone mass was unchanged. The renograms were within normal range in the 6 patients who were cured by ESWL, whereas this was the case for only 4 of the 12 who still had renal calculi. In 2 patients pelvic stones had descended into the ureter after ESWL, and the renograms indicated obstruction. Another 3 patients had ureteral stones, whereas in the remaining 7 patients only pelvic stones were found on the plain radiographs. In no patient did the scintigrams reveal scars. It is concluded that abdominal plain radiography of the urinary tract and probe renography are complementary and sufficient in the monitoring of patients with urolithiasis post ESWL.
Anal Endosonographic Findings in Patients with Obstructed Defecation
Authors: Nielsen M. B. , Rasmussen O. Ø. , Pedersen J. F. , Christiansen J.
Published: June 2015

Anal endosonography, including measurements of anal sphincter size, was performed in 16 patients with obstructed defecation. The findings were compared with those at defecography and anal manometry. Patients with rectocele and intussusception had a normal endosonographic appearance. One patient with puborectalic spasm had normal sonography. There was no correlation between sphincter size and anal manometry. The external sphincter muscle was thicker and the cross-sectional area larger in patients with obstructed defecation than in healthy controls (p < 0.05). Two patients with sphincter spasm and impaired rectal emptying at defecography had clearly thickened internal sphincters which may be the cause of their defecatory disorder. Three patients with previous anal dilatation or hemorrhoidectomy had sphincteric defects. Anal endosonography may be considered in patients with obstructed defecation to identify patients with internal sphincter hypertrophy.
Reduced Risk of Ventricular Fibrillation by Balancing Sodium, Calcium, Potassium and Magnesium Added to Nonionic Contrast Media
Authors: Besjakov J. , Bååth L. , Øksendal A. N. , Almén T.
Published: June 2015

The effect of addition of calcium, potassium and magnesium to iohexol (350 mg I/ml) enriched with 30 mM sodium was investigated with regard to ventricular fibrillation (VF) in isolated rabbit hearts. Enriching iohexol containing 30 mM sodium with increasing amounts of calcium (0–1.2 mM) caused an increase in the frequency of VF. Increasing amounts of potassium (0–3.8 mM) to iohexol with 30 mM Na + 0.15 mM Ca + 0.1 mM Mg reduced the risk of VF. However, this protective effect of potassium on VF was reduced if magnesium was removed from the test solution. Furthermore, increasing amounts of magnesium (0–1.2 mM) to iohexol with 30 mM Na + 0.15 mM Ca + 0.4 mM K led to an increased frequency of VF. Iohexol with 30 mM Na + 0.3 mM Ca + 0.9 mM K + 0.3 mM Mg caused no VF. It is of interest to add multiple cations to sodium-containing nonionic media to improve cardiac contractility following coronary perfusion. The present study indicates that it is possible to enrich iohexol 350 mg I/ml + 30 mM Na with calcium, potassium and magnesium in small amounts, and balanced with respect to each ion, without changing the risk of VF.
Application of a Mixed Imaging Sequence for MR Imaging Characterization of Human Breast Disease
Authors: Merchant T. E. , Thelissen G. R. P. , de Graaf P. W. , Nieuwenhuizen C. W. E. A. , Kievit H. C. E. , Den Otter W.
Published: June 2015

Single slice MR images were obtained from 9 normal breasts, 17 breasts with benign tumors, and 11 breasts with malignant tumors using an interleaved (mixed) spin echo (SE) inversion-recovery (IR) imaging sequence. SE and IR MR images were synthesized with variable repetition, echo and inversion times from the mixed sequence data. These images were used to qualitatively evaluate the contrast possibilities available when imaging the breast with MR imaging. Proton T1 and T2 relaxation times were determined for normal breast tissues and malignant and benign breast tumors from pure T1 and T2 images calculated using the mixed sequence data. The mean T1 value in benign tumors of 1049.02 ± 40.31 was found to be significantly longer (p < 0.0001) than the mean value of malignant tumors (876.09 ± 27.83) and normal tissues (795.64 ± 21.12). The value of T2 in benign tumors (89.15 ± 8.33) was significantly longer (p < 0.01) than the value of T2 in normal tissues (62.82 ± 4.06). The mixed sequence can be applied to improve image contrast between malignant tumors, benign tumors, and normal tissues of the breast and can potentially differentiate between these tissues in vivo.
Lung Abscess
Authors: Ha H. K. , Kang M. W. , Park J. M. , Yang W. J. , Shinn K. S. , Bahk Y. W.
Published: June 2015

Lung abscess was successfully treated with percutaneous drainage in 5 of 6 patients. Complete abscess resolution occurred in 4 patients, partial resolution in one, and no response in one. The duration of drainage ranged from 7 to 18 days (mean 15.5 days) in successful cases. The failure of drainage in one neurologically impaired patient was attributed to persistent aspiration. In 2 patients, concurrent pleural empyema was also cured. CT provided the anatomic details necessary for choosing the puncture site and avoiding puncture of the lung parenchyma. Percutaneous catheter drainage is a safe and effective method for treating lung abscess.
Degenerative Changes of the Menisci of the Knee
Authors: Hodler J. , Haghighi P. , Trudell D. , Resnick D.
Published: June 2015

Increased meniscal MR signal attributable to meniscal degeneration is a common finding. The role of different MR sequences in the analysis of the extent and distribution of meniscal degeneration in middle-aged and elderly patients has not been thoroughly evaluated. We retrospectively studied the role of different MR sequences in 175 anatomic meniscal sections originating from 20 freshly frozen knees from 10 cadavers using MR-anatomic correlation. T1-weighted and proton-density spin-echo images as well as postprocessed meniscal windows based on T1-weighted spin-echo images proved to be the most reliable in this diagnosis (53.7%, 54.9%, and 53.1% correctly diagnosed meniscal sections, respectively). T2-weighted spin-echo images and gradient-echo images proved to be less reliable (37.1%) and 40.0% correctly diagnosed meniscal sections). While the T2-weighted spin-echo images commonly underestimated the extent of meniscal degeneration, gradient-echo images commonly overestimated the extent of such changes. These last two types of sequences should not be used alone in the description of meniscal degeneration.
Radiologic Anatomy — A Credit Course for First-Year Medical Students
Authors: Lanier L. , Kaude J. V.
Published: June 2015

Diagnostic radiology should assume a more prominent role in medical student education. We have developed a 4-year plan for radiologic education at the University of Florida. The initial step in this plan is a required credit course in radiologic anatomy given in the first semester. Designed to introduce students to various imaging modalities while teaching anatomic recognition, the course combines a lecture series with systematized self-study film packets and self-test packets. These are reinforced by a videotape series and other written materials. Examinations are in practical format utilizing radiographs on viewbox stations. The course provides a foundation for subsequent coursework in diagnostic radiology, including radiologic pathology and clinical radiology. These courses stress how to workup patients and how to use the radiologist as a consultant in patient care. The response to the radiologic anatomy course has been highly favorable.
Duplex Ultrasonographic Evaluation of Liver Transplants
Authors: Defrancq J. , Trotteur G. , Dondelinger R. F.
Published: June 2015

Two hundred and twenty-two duplex ultrasonographic examinations were performed on 36 liver transplants in 30 patients over a period of 5 years and 9 months. Positive sonographic findings were correlated with 13 angiographic examinations. Arterial complications included 4 thromboses, 5 stenoses, and one mycotic aneurysm. A false-negative result was obtained in 2 cases of stenosis and a false-positive result in one case of thrombosis. One portal vein thrombosis, 2 stenoses, and 2 cases of portal hypertension were diagnosed correctly. Sensitivity was 87%, specificity 95%, and accuracy 93%. Duplex Doppler was least effective in the diagnosis of hepatic artery stenosis. Five cases showed biliary complications of ischemic origin. Angiography is indicated when duplex Doppler is positive or doubtful, but also when the clinical condition is unclear.
Effect of Gd-DTPA and/or Magnetic Field and Radiofrequency Exposure on Sister Chromatid Exchange in Human Peripheral Lymphocytes
Authors: Yamazaki E. , Matsubara S. , Yamada I.
Published: June 2015

The effects of a magnetic field, radiofrequency, and gadolinium diethylenetriaminepentaacetic acid (Gd-DTPA) on the sister chromatid exchange (SCE) in human peripheral lymphocytes were investigated. Whole blood was taken from a nonsmoker and samples were exposed to magnetic force (1.5 T) alone, and to a magnetic force combined with radiofrequency waves (63.86 MHz, specific absorption rate, SAR, 0.4 W/kg). Gd-DTPA was then added to other blood samples in varying amounts and concentrations. After exposure to the conditions described above, these blood samples were cultured for 69 hours. Slides were made for an SCE evaluation. As the concentration of Gd-DTPA added to the blood increased, the SCE frequency also increased. However, the addition of Gd-DTPA at the clinical concentrations normally used did not affect the SCE frequency.
Reproducibility of Quantitative Arteriographic Assessment of Atherosclerosis in the Femoral Artery
Authors: Bergstrand L. , Erikson U. , Holme I. , Johansson J. , Olsson A. G. , Mølgaard J. , Nilsson S. , Stenport G. , Walldius G.
Published: June 2015

Results from computer-analysed angiograms in the Probucol Quantitative Regression Swedish Trial (PQRST) were analysed to determine the reproducibility of the method and any drift in the analysing system. The precision index (P(μ)) for 2 angiography series, made at 10 min intervals, of the femoral artery in 276 patients was 10.5 for lumen volume and 21.9 for roughness (edge irregularity). No difference in reproducibility was found between patients with and without symptoms of peripheral atherosclerosis or when looking at the reproducibility over years. A drift of 0.67% per year in the radiographic equipment (but not in the analysis system) was found, confirmed by use of phantoms. Computer-based analysis of femoral atherosclerosis is a reliable method for follow-up trials, giving high reproducibility even if the trial spans over several years and involves different centres. The use of phantoms is essential for checking the method over time.
Reversed Diastolic Blood Flow at Duplex Doppler
Authors: Saarinen O. , Salmela K. , Ahonen J. , Edgren J.
Published: June 2015

In 25 renal allografts out of 253 with graft dysfunction a reversed diastolic blood flow was observed at duplex ultrasonography during the first post-transplant month. Eleven grafts were lost and 14 survived. The cause of graft loss was arterial thrombosis (n = 1), venous thrombosis or obstruction (n = 4), steroid resistant acute rejection (n = 4) and acute tubular necrosis (ATN) (n = 2). The cause of graft dysfunction in the surviving grafts was ATN (n = 7) and acute allograft rejection (n = 7). Grafts with only peak-like or low velocity continuous diastolic flow reversal had a better prognosis (3 out of 15 were lost) than grafts with any other type of reversed flow pattern (8 out of 10 were lost). This difference was statistically significant (p < 0.01).
Mr Spectroscopy in Clinical Research
Authors: Henriksen O.
Published: June 2015

MR spectroscopy (MRS) offers unique possibilities for non-invasive evaluation of biochemistry in vivo. During recent years there has been a growing body of evidence from clinical research studies on human beings using31P and1H MRS. The results indicate that it is possible to evaluate phosphorous energy metabolism, loss of neurones, and lactate production in a large number of brain diseases. Furthermore,31P and1H MRS may be particularly clinically useful in evaluation of various disorders in skeletal muscle. In the heart31P MRS seems at the moment the most suitable for evaluation of global affections of the myocardium. In the liver31P MRS appears to be rather insensitive and non-specific, but absolute quantification of metabolite concentrations and using metabolic “stress models” may prove useful in the future. The clinical role of MRS in oncology is still unclear, but it may be useful for noninvasive follow-up of treatment.

Taken together, the evidence obtained so far certainly shows some trends for clinical applications of MRS. Methods are now available for the clinical research necessary for establishing routine clinical MRS examinations.
Mr Imaging of the Pancreas AT 0.3 T Using a Super-Paramagnetic Oral Contrast Medium
Authors: Wallengren N.-O. , Holtås S. , Andrén-Sandberg Å. , Bach-Gansmo T.
Published: June 2015

Twenty patients with carcinoma of the pancreas identified with ultrasonography and/or CT and confirmed by histology, were examined with MR before and after administration of an oral superparamagnetic contrast medium. Ten patients were examined after administration of the contrast medium through a duodenal tube. Ten patients drank the contrast medium mixed with a viscosity-increasing agent. Organ delineation and diagnostic information were improved in the postcontrast scans in both groups and the viscous contrast suspension yielded better delineation and diagnostic information than the aqueous suspension. The viscous contrast suspension also showed better tolerance, contrast distribution and less artifacts than the aqueous suspension.
Ultrasonographic Abdominal Screening of Atomic Bomb-Exposed Subjects
Authors: Russell W. J. , Higashi Y. , Fukuya T. , Hosoda Y. , Murakami J. , Kawashima A. , Murayama S. , Ohuchida T. , Mihara F. , Takagi M. , Fujita S.
Published: June 2015

Abdominal ultrasonographic screening for cancer was performed in 6001 Hiroshima and Nagasaki A-bomb exposed and comparison subjects, all members of the Adult Health Study of the Radiation Effects Research Foundation, formerly the Atomic Bomb Casualty Commission. This study yielded 20 cancers, including 7 hepatocellular, 3 gastric, 3 renal and 2 urinary bladder cancers; one cancer each of the ovary, pancreas, colon and ureter; and one cancer metastatic to the liver, whose primary was unknown. Seventeen of these 20 subjects manifested no symptoms or signs of their disease. A variety of additional tumors, unproven and probably benign, including uterine myomata, and other abnormalities were also detected. Abdominal ultrasonographic screening greatly assisted in the detection of cancers, most of which neither the patients nor their physicians were aware. In this screened fixed population sample the cancer detection rate was 0.33%, exceeding any such rates previously reported in the medical literature.
Dynamic Gadolinium-Enhanced Mr Imaging in Active and Inactive Immunoinflammatory Gonarthritis
Authors: Østergaard M. , Lorenzen I. , Henriksen O.
Published: June 2015

Dynamic T1-weighted FLASH MR imaging, obtained just after i.v. gadopentetate dimeglumine injection, and pre- and postcontrast T1-weighted spin-echo (T1-SE) MR imaging were performed to compare their information value with respect to inflammatory activity in immunoinflammatory gonarthritis. We examined 16 clinically active (CAG), 7 clinically inactive (CIG) and 4 healthy knees. The synovium of a preselected slice was outlined. Its area and relative signal intensity increase after gadopentetate dimeglumine on T1-SE and FLASH (at each time t) were calculated. The CAG knees showed a mean signal intensity increase on early dynamic FLASH images higher by far than the CIG knees, while no significant difference was found on spin-echo images obtained 5 to 15 min after contrast injection. The early signal enhancement probably reflects the perfusion and capillary permeability of the synovium. The area of synovium could differentiate between healthy and arthritic knees. Gadolinium-enhanced dynamic FLASH imaging may provide clinically useful information about the actual inflammatory activity of arthritic joints.
Low Grade Coal Worker's Pneumoconiosis
Authors: Gevenois P. A. , Pichot E. , Dargent F. , Dedeire S. , Vande Weyer R. , De Vuyst P.
Published: June 2015

We compared CT with chest radiography (CR) in the assessment of low grade coal worker's pneumoconiosis (CWP) in a population of 83 subjects. All subjects had a high-voltage p.a. CR, graded according to the ILO classification between 0/0 and 1/1, a conventional CT (CCT) using contiguous 1-cm-thick sections on the entire thorax and a set of 10 high-resolution CT (HRCT) images. CR and CT were separately read by consensus by 2 teams of 2 trained readers. CR were coded 0/0 in 9 subjects; 0/1 in 31; 1/0 in 28; 1/1 in 15. Among these groups of patients, micronodules were detected by CT in respectively 2 (22%), 14 (45%), 17 (61%) and 10 (67%) patients. In all groups, micronodules were more often detected by CT when the opacities detected on CR were scored as rounded (p, q) than irregular (s, t). Among the patients graded 0/0 or 0/1, CT showed micronodules in 40%. By contrast, among the patients graded 1/0 or 1/1, CT did not show micronodules in 37%, but revealed in numerous patients that opacities detected on CR were related to bronchiectasis and/or emphysema only. Comparative analysis of HRCT and CCT showed that both techniques are complementary and proved the usefulness of CCT in the detection or confirmation of low profusion of micronodules.
Frequency of Proximal Tubal Obstruction in Patients Undergoing Infertility Evaluation
Authors: Wadin K. , Lönnemark M. , Rasmussen C. , Magnusson A.
Published: June 2015

Fallopian tube recanalization is a technique for treatment of proximal tubal obstruction caused by debris. The true frequency of infertile women for whom this treatment is suitable is not well known. In this study all hysterosalpingograms (HSGs) performed over a 3-year period (1986–88) were reviewed. The HSGs were performed as part of an infertility evaluation program in 494 women, with a mean duration of infertility of 2.4 years. Bilateral proximal tubal obstruction was found in 3% and unilateral proximal obstruction in 2% of the cases. In women examined in the first 2 years (1986–87) (n = 328), the birth frequency after HSG was 25%. When HSG was performed with optimal technique the number of patients who were suitable for Fallopian tube recanalization was low.
Nonparasitic Splenic Cysts
Authors: Siniluoto T. M. J. , Päivänsalo M. J. , Lähde S. T. , Alavaikko M. J. , Lohela P. K. , Typpö A. B. T. , Suramo I. J. I.
Published: June 2015

Sixty-three patients with splenic cysts, multiple in 7 cases, were reviewed. Only 3 patients had a history of previous abdominal trauma. The cysts ranged in size from less than 1 cm to 15 cm. They were anechoic in 40 patients, hypoechoic in 16, isoechoic in 4, mixed in one, and in 2 cases the echogenicity could not be assessed due to thick marginal calcifications. The echogenic cysts were larger than the anechoic ones and frequently calcified, and the findings at surgery, fine-needle aspiration biopsy and follow-up suggested the echogenicity to be related to a fresh or previous episode of intracystic hemorrhage. Initially, surgical treatment was undertaken on 10 patients, electively in 9 cases and due to cyst rupture in one. At follow-up (n = 37), the size of the cyst had increased markedly over several years in only 2 patients, necessitating delayed surgery in one. Routine follow-up of asymptomatic splenic cysts was of no clinical value.
Discovertebral Junction of the Spine — A Cadaveric Study by Spin-Echo MR Imaging
Authors: Kakitsubata Y. , Nabeshima K. , Kakitsubata S. , Koono M. , Watanabe K.
Published: June 2015

To evaluate the MR appearance of the discovertebral junction (DVJ) of the spine, we examined 161 DVJs in 27 cadaveric spines using superconductive MR imaging. T1-, proton density-, and T2-weighted spin-echo imaging were used. With a small surface coil, higher resolution and more sharply defined contours of the DVJ were obtained than when using a head coil. Cortical bone had very low signal intensity in all sequences. Cartilaginous end-plate (CP) was of low to intermediate signal intensity on T1-weighted images, and of low signal intensity on proton density- and T2-weighted images. MR images were able to reveal the gross CP appearances, Schmorl's nodules, and adjacent bone marrow pathology. We conclude that MR imaging is valuable for assessing abnormalities of the DVJ.
A New Technique for Nonsurgical Repair of Peripheral Pseudoaneurysm
Authors: Jeans W. D. , Leven H. O.
Published: June 2015

Peripheral vascular lesions may be inaccessible to treatment using catheter techniques. Ultrasound imaging in combination with Doppler may identify such lesions and provide possibilities for image-guided compression, injection of embolizing material by direct puncture, or both.
Nonpalpable Breast Lesion
Authors: Vega A. , Arrizabalaga R. , Garijo F. , Guerra I.
Published: June 2015

One hundred and fifty-six patients with suspect nonpalpable breast lesion underwent stereotaxic core needle aspiration biopsy (SCNAB) with a single pass in an upright “add-on” stereotaxic device using a manual 1.6-mm needle (16 G), to determine whether the results were comparable to results of SCNAB with a multiple-pass technique. Of the 69 carcinomas, 51 (74%) were correctly diagnosed and definitive surgical therapy, without surgical biopsy, was performed in 42 of the 50 invasive carcinomas (84%) and in 9 of the 19 noninvasive carcinomas (47%). Ten noninvasive carcinomas and 4 invasive carcinomas, discovered by microcalcifications or distortion on the mammograms, form 78% of the false-negative results. There were no false-positive results. Vasovagal reactions occurred in 11% of the procedures. Although the results were acceptable in patients with invasive carcinoma, more than one needle pass is necessary for greater diagnostic accuracy of SCNAB, especially in patients with only microcalcifications or distortion on the mammogram.
Wooden Foreign Bodies in CT
Authors: Pyhtinen J. , Ilkko E. , Lähde S.
Published: June 2015

CT findings in 2 patients with a wooden foreign body in the orbital region soft tissue, and a series of CT measurements of wooden elements are presented. The wooden foreign bodies presented low HU numbers in CT and were initially interpreted as a gas collection. Different species of trees presented a large spectrum of densities, varying from the −550 HU of pine up to the +289 HU of ebony. The density of a spruce plank increased along with water-logging from −470 HU to −86 HU in 4 weeks, and peak enhancement up to 106 HU was found in the layer closest to the surface. It was concluded that a wooden foreign body in soft tissues may present CT patterns simulating materials as different as a gas bubble or a bone fragment.
Muscle Edema in MR Imaging of Neuromuscular Diseases
Authors: Schedel H. , Reimers C. D. , Vogl T. , Witt T. N.
Published: June 2015

Muscle edema has been described as a typical finding on MR images in acute neuromuscular disorders, predominantly in acute inflammatory myopathies, but also in neuro- and myopathies. The purpose of this study was to examine the frequency of muscle edema and the diagnostic usefulness of Gd-DTPA in neuromuscular diseases. 144 consecutive patients with various generalized neuromuscular diseases were examined by MR imaging. Areas of high signal intensity, relative to normal muscle, were seen in 36% of T2-weighted images, whereas the corresponding T1-weighted images showed normal or lower signal intensities. These edema-like abnormalities — Enlargement of the extracellular fluid space — Were found more often in inflammatory and metabolic myopathies, but were also seen in degenerative myopathies. Contrast-enhanced T1-weighted images in 25 patients were not more sensitive than plain T2-weighted images.
Pulmonary Sequestration
Authors: Trigaux J.-P. , Jamart J. , Van Beers B. , Goncette L. , Pringot J.
Published: June 2015

The purpose of this study was to determine the prevalence of enlargement of the azygos system in the case of lung sequestration and its potential usefulness in the differential diagnosis of lower lobe opacities. Seven consecutive adult cases of pulmonary sequestrations were retrospectively enrolled; 4 sequestrations were proved surgically and all 7 angiographically. A group of 50 consecutive patients with a normal chest CT were used as controls. Another group consisted of 25 consecutive patients identified on the basis of an opacity in a posterobasal location on chest CT. For the 3 groups, the maximum diameter of the azygos and hemiazygos veins was measured, the level of measurement located between the upper poles of the kidneys and the confluence of inferior pulmonary veins into the left atrium. The diameter of the azygos veins (mean 10.4±5.1 mm) and of the hemiazygos veins (mean 7.1±3.0 mm) in the sequestration group was significantly larger than the diameter of the azygos and hemiazygos veins in the control group (mean 5.7±2.5 mm, and 3.4±2.4 mm, respectively), as well as in the study group (mean 5.9±2.6 mm and 3.3±2.6 mm, respectively). Our results suggest that enlargement of the azygos system in association with a posterobasal chest opacity, although nonspecific, may be a useful additional CT sign of sequestration.
Magnetization Transfer Contrast on Gradient Echo MR Imaging of the Temporomandibular Joint
Authors: Niitsu M. , Hirohata H. , Yoshioka H. , Anno I. , Campeau N. G. , Itai Y.
Published: June 2015

Thirty-nine temporomandibular joints (TMJ) from 20 patients with suspected internal derangements were imaged by a 1.5 T MR imager. The on-resonance binomial magnetization transfer contrast (MTC) pulse was applied to gradient echo images with a dual receiver coil (9 s/section). With the use of an opening device, a series of sequential images were obtained at increments of mouth opening and closing. The tissue signal intensities with (Ms) and without (Mo) MTC were measured and subjective image analysis was performed. Compared with the standard images, MTC technique provided selective signal suppression of disks. The average of Ms/Mo ratio of the disks (0.56) was lower than that of the retrodiskal pad (0.79) and of the effusion (0.89). With MTC technique, fluid conspicuity was superior to standard image. However, no significant superiority was found in disk definition subjectively.
Hepatic Portal Venous Gas
Authors: Schulze C. G. , Blum U. , Haag K.
Published: June 2015

In a prospective investigation the sensitivity of conventional radiography, sonography, color Doppler flow imaging (CDFI) and CT in the detection of hepatic portal venous gas (HPVG) was compared in 7 patients with different diagnoses. For the identification of HPVG sonography, CDFI and CT have a higher sensitivity than conventional radiography. CT, however, was the most suitable method to identify the underlying cause of HPVG. Patients with iatrogenic HPVG as a result of diagnostic or therapeutic intervention had a good prognosis. In contrast, in all cases with a sudden appearance of HPVG and a noniatrogenic cause, exitus ensued within 1 week.
Intravascular Ultrasound of the Portal Vein — Normal Anatomy
Authors: Hannesson Pétur H. , Stridbeck Hans , Lundstedt Christer , Andrén-Sandberg Åke , Ihse Ingemar
Published: June 2015

The purpose of this study was to evaluate the appearance of the normal portal vein with intravascular ultrasound. The portal vein was studied in 10 patients with colorectal carcinoma without known liver or pancreatic disease. For the intravascular portovenous examination, a 2.0-mm, 20-MHz ultrasound catheter was used. The field of view was 30 mm. The wall of the portal vein appeared as a single hyperechoic layer 0.5 to 0.8 mm in thickness. Normal structures adjacent to the portal vein, such as the common bile duct, the hepatic artery or small lymph nodes, were clearly separated from the lumen of the portal vein by the wall of the vein together with some periportal fat. In most cases the parenchyma of the pancreas could be separated from the wall of the vein.
Intraobserver and Interobserver Variations in Sonographic Measurements of Kidney Size in Adult Volunteers
Authors: Emamian S. A. , Nielsen M. B. , Pedersen J. F.
Published: June 2015

Estimation of renal size by sonography can be performed by measuring renal length, volume, cortical volume or cortical thickness. Observer variation in these measurements is an important factor, especially when repeated measurements are compared. This study was performed to examine the magnitude of intraobserver and interobserver variations for each of the above-mentioned measurements, and to find the measurement with the lowest observer variation. Sonographic measurements were performed by 3 observers on 18 adult volunteers. The standard deviation of the difference (SDD) between any 2 pairs of measurements was used as the indicator of the magnitude of the observer variation. Renal length measurement showed the lowest observer variation with a relative SDD of 4 to 5%. Measurement of cortical thickness showed the poorest reproducibility with a relative SDD of 18 to 23%, while volumetric estimations had a relative SDD of 14 to 17%. Renal length measurement should be preferred to renal volume estimation, especially when comparing repeated measurements.
Flow Measurements with Digital Subtraction Densitometry in a Steady Flow Experimental Model
Authors: Mygind M. , Engell L. , Mygind T.
Published: June 2015

Computerized densitometry was applied on digital subtraction series for measuring flow rates, 600 to 2 000 ml/min, in model experiments, using contrast medium as indicator substance. A total of 962 measurements were performed, employing the Stewart-Hamilton dilution technique, as well as direct measurements of velocity of the indicator bolus between 2 measuring sites. Results with the dilution technique were closely correlated with true values, but slightly lower (mean 8%), presumably because of sedimentation of contrast medium. Measurements based on bolus velocity were most accurate when the bolus passage was defined by points near the gravity line of the area under the concentration curve. Use of more easily identified curve points, e.g. the time of curve maximum, tended to yield too high values due to flow laminarity with a high-velocity leading edge of the indicator. Variation in repeated measurements on any single image series was attributed to the low sampling rate.
A New Liposomal Contrast Medium for CT of the Liver
Authors: Leander P.
Published: June 2015

A new type of liposomal liver-specific contrast medium was studied in an experimental tumour model. Rabbits were inoculated with VX2-carcinoma directly into the liver at laparotomy. CT studies were carried out 14 days after inoculation. The liver-specific contrast medium consisted of a suspension of liposomes in a 100 mg I/ml iodixanol solution, with equal amounts of encapsulated and nonencapsulated iodixanol. It was administered at a dose of 200 mg I/kg. The contrast of normal liver tissue to tumorous tissue was significantly increased by contrast medium administration, the increase being largest 10 min after injection.
Immediate and LAte Adverse Reactions in Coronary Angiography
Authors: Fransson S.-G. , Stenport G. , Andersson M.
Published: June 2015

Purpose and Methods:

In 120 patients in a double-blind, randomized, parallel study, iodixanol (Visipaque), a nonionic dimer isotonic with blood, was compared with ioxaglate (Hexabrix), an ionic low-osmolar dimer, in coronary angiography regarding early and late adverse reactions. Haemodynamic and electrophysiologic parameters were also analyzed.

Results:

Visipaque resulted in significantly fewer early adverse contrast medium-related reactions (p<0.05). Visipaque also demonstrated significantly fewer effects on electrophysiologic parameters. Both contrast media reduced systolic and diastolic blood pressures at the 1st injection in the left coronary artery. Late adverse reactions were unusual with both contrast media and occurred only as urticaria with a frequency of 1.7%, which is lower than reported in i.v. studies. One serious adverse reaction, a myocardial infarction in a male patient with severe cardiovascular disease, occurred in the Visipaque group. This event was considered to be procedure- and disease-related rather than related to the type of contrast medium used.

Conclusion:

We found Visipaque safe for coronary angiography, causing fewer early adverse reactions than Hexabrix and also fewer effects on electrophysiologic parameters. Late adverse reactions seemed to be unusual with intra-arterial administration of contrast media.
Ultrasonographically Guided Fine-Needle Aspiration Biopsy of Intrathoracic Tumors
Authors: Knudsen D. Ulrik , Nielsen S. Møller , Hariri J. , Christensen J. , Kristensen S.
Published: June 2015

Purpose:

Evaluation of diagnostic accuracy and complication frequency at ultrasonographically guided fine-needle aspiration biopsy of intrathoracic tumors.

Material and Methods:

A total of 134 ultrasonographically guided percutaneous fine-needle aspiration biopsies were performed on 128 patients with intrathoracic tumors abutting on the pleura. A cytologic diagnosis was obtained in 119 patients (93%).

Results:

In 83 patients, cytologic malignancy was found; in 34, benignity; and in 2, cellular atypia. A total of 117 diagnoses were correct and 2 diagnoses were false-positive. A malignancy subtyping based on the cytologic aspirates was made in 80 patients. In 40 (93%) of 43 histologically proven subtypes, the subtyping was correct. The complication frequency in terms of pneumothorax was 3.7%.

Conclusion:

Ultrasonographically guided percutaneous fine-needle aspiration biopsy is a safe and reliable method of establishing the cytologic diagnosis of intrathoracic tumors.
Imaging of Tuberculosis
Authors: Brismar J. , Hugosson C. , Larsson S. G. , Lundstedt C. , Nyman R.
Published: June 2015

Purpose:

To show that intracranial tuberculosis (TB) often masquerades as brain tumour.

Material and Methods:

Forty-six patients with intracranial TB, who after CT at the local hospital were referred for surgery or radiotherapy of brain tumour, are presented. Sometimes the correct diagnosis was first established during surgery for tumour.

Results:

The differentiation between TB and gliomas, meningiomas, metastases, or lymphomas may be impossible from the clinical history and CT findings. Angiography, done in 25 of our cases, often helped by not showing the expected tumour vasculature. MR, performed in 9 patients, helped by demonstrating a layered capsule on T2-weighted images in 4 of the lesions (hypointense rim outside hyperintense rim); the centres of the lesions were of decreased, usually very mixed T2 signal intensity.

Conclusion:

Even in patients with findings typical of brain tumour, TB remains an important differential diagnosis.
Simplified Percutaneous Gastrostomy
Authors: Cwikiel W. , Walther B.
Published: June 2015

Purpose:

The aim of this study was to develop a simple radiological method for the creation of percutaneous gastrostomy.

Material and Methods:

Percutaneous gastrostomy was created in 15 patients. After a blunt dissection of the abdominal wall under local anesthesia, puncture of the stomach was performed. A 6-mm peel-off introducer sheath was used to place the permanent catheter. Immediate use of the catheter was allowed.

Results:

The procedure was successful in all cases and no procedural complications were seen.

Conclusion:

The method is simple, cost-saving, and may be recommended as an alternative to other methods.
Conventional Radiography and Bone Scintigraphy in the Prognostic Evaluation of Legg-Calvé-Perthes Disease
Authors: Kaniklides C. , Sahlstedt B. , Lönnerholm T. , Moberg A.
Published: June 2015

Purpose:

The role of conventional radiography and bone scintigraphy in predicting the outcome of Legg-Calvé-Perthes disease was investigated.

Material and Methods:

The 75 children reviewed (86 hips) were followed up to the primary healing of the disease. The findings at conventional radiography (obtained at presentation, at the time of maximum capital head involvement, and at the end of the healing process of the disease) were compared to early bone scintigraphy features.

Results and Conclusion:

Bone scintigraphy provided more accurate information concerning the extent of the necrotic process than initial radiographs. Moreover it could determine revascularization and consequently the stage of the disease. The method was, however, unable to predict the outcome of the disease in some of the cases, particularly if it was performed late after the onset of symptoms. Conventional radiography provided important information about other parameters such as “head-at-risk” signs which facilitated treatment selection. Of these signs not only lateral subluxation but also metaphyseal changes strongly predispose to severe deformity of the hip joint.
Postoperative MR Imaging and Ultrasonography of Surgically Repaired Achilles Tendon Ruptures
Authors: Karjalainen P. T. , Ahovuo J. , Pihlajamäki H. K. , Soila K. , Aronen H. J.
Published: June 2015

Purpose:

To evaluate and compare MR and US findings in an unselected group of patients with 1–3-year-old surgically repaired complete ruptures of the Achilles tendon.

Material and Methods:

Thirteen patients with complete Achilles tendon rupture underwent clinical, MR and US examinations. The average time interval from rupture to postoperative imaging was 18 months.

Results:

The cross-sectional area of a postoperative tendon was 4.2 times that of the unaffected side. The shape of the operated tendon was more rounded than the unaffected side and it had irregular margins both in MR imaging and in US examination. In 4 of 13 cases an intratendinous area of intermediate to high signal intensity on proton density- and T2- weighted images was seen on MR. The size of this area varied from 4 to 18% of the cross-sectional tendon area. Two patients with the largest intratendinous area had poor clinical outcome. On US the tendon had mixed echogenicity in all cases and the tendon bands were thinner and shorter than normal. Comparison of dimension between MR and US revealed that in a.p. dimension the correlation was good (r=0.87, p=0.001), but in transversal width there was no significant correlation (r=0.58, p=0.06).

Conclusion:

The increased size and round irregular area of the operated Achilles tendon rupture was well detected by both MR and US, but intratendinous lesions were seen only by MR.