bluuebunny/crossref_metadata_2025 huggingface dataset:
Chemoembolization for Hepatocellular Carcinoma via the Inferior Pancreaticoduodenal Artery in Patients with Celiac Artery Stenosis
Authors: Okazaki M. , Higashihara H. , Ono H. , Koganemaru F. , Fujimitsu R. , Mizuma Y. , Nakamura T. , Sato S. , Kimura S. , Kodama S.
Published: June 2015

Twenty-one patients with hepatocellular carcinoma (HCC) accompanied by extensive celiac artery stenosis or obstruction were treated by chemoembolization via the inferior pancreaticoduodenal artery (IPDA). The tip of the catheter was placed in the arteries in front of the confluence with the proper hepatic artery in 12 patients (group A: the proximal portion of the IPDA in 10, and common hepatic artery in 2), and in the proper hepatic artery or branches of it (group B) in 9 using a coaxial catheter system. Transient hyperamylasemia was observed in 10 of the 12 patients in group A and in 3 of the 9 patients in group B after chemoembolization. Splenic infarction developed in 8 patients in group A and in none in group B. Intrapancreatic fluid collection was present in 2 patients in group A following chemoembolization. No fatal complications were encountered. The 1-, 2-, and 3-year survival rates of the 10 patients in group A treated by only chemoembolization were 90, 57, and 23%, respectively (mean survival 780 days). The 1- and 2-year survival rates of 9 patients in group B were 85.8 and 85.8% (mean 879 days), respectively. Considering the severity of complications and the survival rates in groups A and B, chemoembolization by superselective catheterization into the hepatic artery via the IPDA is the treatment of choice. However, chemoembolization from the arteries in front of the confluence with the proper hepatic artery seems to be acceptable in cases of hypervascular HCC which fail to be superselectively catheterized.
Normal Age-Related Alterations on Chest Radiography
Authors: Mihara F. , Fukuya T. , Nakata H. , Mizuno S. , Russell W. J. , Hosoda Y.
Published: June 2015

To ascertain serial changes on chest radiography attributable to aging, 16 parameters and 4 pulmonary parenchymal manifestations were assessed at 2 intervals; namely, 18.5 and 10 years after initial radiography in healthy men (n = 51) and women (n = 149) (age range 41–82 years). The transverse cardiac diameter, cardiothoracic ratio, and aortic arch transverse diameter increased significantly in both sexes from the initial to the final examinations. Although several other factors changed significantly, these changes were relatively small and the individual variations large. Initially, 13% and finally, 27% of the subjects exhibited at least one of the selected pulmonary manifestations.
Simple Mathematical Relations between the Acetabular Anteversion and Sector Angles
Authors: Anda S. , Amdal I. K.
Published: June 2015

Acetabular anteversion is an important parameter of the hip joint. It is measured at CT of the hip, as are the more recently introduced acetabular sector angles. These angles give information on the anterior and posterior support from the acetabulum to the femoral head. Some simple mathematical relationships between these angles are presented.
In Vivo Fluorescence Microscopy of Microcirculation in the Renal Cortex of Mice
Authors: Högström B. , Rooth P. , Sunnegårdh O. , Hietala S.-O.
Published: June 2015

An experimental model using in vivo fluorescence microscopy for studies of renal cortical blood flow was tested in 40 mice. The model was suitable for testing a wide variety of hypotheses concerning alterations in renal cortical blood flow, including the possibility of inhomogeneous capillary blood flow distribution in response to i.v. infusions. The experimental model was tested for the effects of i.v. infusion of mannitol (0.3 mol/l). Effects of anesthesia and mechanical kidney fixation on renal cortical blood flow were studied. Neuroleptic analgesia was less hazardous to the animals than pentobarbital. Due to artifacts from respiratory and peristaltic motion, it was not possible to use neuroleptic analgesia without mechanical kidney fixation. A rating scale was designed for evaluating the capillary blood flow. The correlation between repeated ratings by the same observer was 0.806 and between 2 different observers 0.59.
Res Scintigraphy in Polycythemia Vera and Secondary or Relative Polycythemia
Authors: Rudberg U. , Skårberg K.-O.
Published: June 2015

Scintigraphy of the reticuloendothelial system (RES) was performed in 19 patients with polycythemia vera (PCV) and in 18 with secondary or relative polycythemia (PS). Bone marrow extension was found in all patients with PCV and in 11 of 18 patients with PS. The patients with PCV had a higher degree of extension than those with PS. Increased pelvic bone marrow activity was found in 16 of 19 PCV patients, but in none with PS. Splenomegaly was found in 9 patients with PCV, and in none with PS. It is concluded that RES scintigraphy in the majority of patients may differentiate between PCV and PS using the parameters pelvic bone marrow activity, bone marrow extension and splenic size.
Effect of Low-Osmolality Contrast Media on Red Cell Filterability
Authors: Imai H. , Hiruma H. , Kumazaki T. , Uyesaka N.
Published: June 2015

The effects of low-osmolality contrast media (CM) on red blood cell (RBC) filterability were investigated using a recently developed nickel mesh filtration method. The conventional hypertonic CM iothalamate, low-osmolality iohexol, and the recently synthesized iomeprol were studied. Among them, the osmolality of iomeprol was the lowest. The impact of CM osmolality, viscosity, and iodine content on the RBC filterability was analyzed. Under equal iodine content or viscosity condition, the filterability order of RBCs suspended in CM was iomeprol > iohexol ≫ iothalamate, because of the osmolality of CM. Iomeprol caused small echinocytic changes but these had a negligible influence on RBC filterability. In conclusion, the osmotic effect of CM on RBC filterability is more predominant than the other CM effects, and iomeprol is the preferred CM for RBC filterability.
Iodixanol in Abdominal Digital Subtraction Angiography
Authors: Singh K. , Sundgren R. , Bolstad B. , Björk L. , Lie M.
Published: June 2015

The safety, tolerability and efficacy of iodixanol 270 mg I/ml were compared to those of iohexol 300 mg I/ml in a double-blind, randomized, parallel abdominal intra-arterial DSA phase III trial. Fifty-nine patients were included in the trial; 39 patients received iodixanol and 20 received iohexol. The mean volume of iodixanol administered was 235.8 ml (0.93 g I/kg b.w.) while the mean volume of iohexol was 254.7 ml (1.10 g I/kg b.w.). No differences in diagnostic information and radiographic density were apparent in spite of the difference in the concentration of iodine. No serious adverse events occurred. Four patients (10%) in the iodixanol group and 2 (10%) in the iohexol group experienced adverse events. Eight percent of the injections of iodixanol promoted discomfort, compared to 12%) of the injections of iohexol. An increase in S-urea and S-creatinine was seen with both agents the first day after injection, but appeared to be less pronounced with iodixanol than with iohexol. Other serum tests revealed no changes of clinical importance. Both iodixanol and iohexol were found to be effective, safe and well tolerated contrast media for abdominal intra-arterial DSA.
Progressive Brain Compression
Authors: Thuomas K.-Å. , Vlajkovic S. , Ganz J. C. , Nilsson P. , Bergström K. , Pontén U. , Zwetnow N. N.
Published: June 2015

Continuous recording of vital physiological variables and sequential MR imaging were performed simultaneously during continuous expansion of an epidural rubber balloon over the left hemisphere in anaesthetised dogs. Balloon expansion led to a progressive and slightly nonlinear rise in intracranial CSF pressures and a fall in local perfusion pressures. Changes in systemic arterial pressure, pulse rate, and respiration rate usually appeared at a balloon volume of 4% to 5% of the intracranial volume (reaction volume), together with a marked transtentorial pressure gradient and MR imaging changes consistent with tentorial herniation. Respiratory arrest occurred at a balloon volume of approximately 10% of the intracranial volume (apnoea volume), which was associated with occlusion of the cisterna magna, consistent with some degree of foramen magnum herniation. Increase in tissue water was observed beginning at approximately the reaction volume, presumably due to ischaemic oedema, due to the fall in perfusion pressures.
Yttrium-90 Glass Microspheres Injected VIA the Portal Vein
Authors: Yan Z. P. , Lin G. , Zhao H. Y. , Dong Y. H.
Published: June 2015

Nondegradable glass microspheres (35 μ) were injected into the portal vein for toxicity test in 15 rabbits. In 10 animals the microspheres were loaded with 90Y, giving liver absorbed doses between 24.6 and 437.4 Gy, and in 5 with 89Y (control group). The total amount of microspheres injected in each animal varied between 35 and 140 mg. The rabbits in the experimental group tolerated the effect of radioembolization in a dose 4 times higher than the upper limit of the clinical dose (100 Gy). After injection of 90Y glass microspheres into the portal vein of rats with diethylnitrosamine (DEN)-induced hepatic carcinoma, the microspheres, in addition to the liver parenchyma, accumulated in central and peripheral parts of the cancer nodules, causing necrosis. The internal radiation therapy of 90Y glass microspheres delivered via the portal vein may be an effective nonsurgical method for the treatment of liver cancer, especially in small nodules.
Digital Luminescence Radiography Using a Chest Phantom
Authors: Lyttkens K. , Kehler M. , Andersson B. , Carlsen S. , Ebbesen A. , Hochbergs P. , Strömbäck A.
Published: June 2015

With the introduction of picture and archiving communicating systems an alternative image display for the wards might be a personal computer (PC). The intention with this study was to evaluate the diagnostic image quality of the monitor of a PC compared to that of a workstation. Eighty-five digital radiographs of a chest phantom with simulated tumors in the mediastinum and right lung were saved on optical discs. The examinations were reviewed by 4 radiologists on a monitor at a workstation and at a PC, and receiver operating characteristic (ROC) curves were constructed. No significant difference was found between performance of the PC and the workstation.
Reactive Mediastinal Lympadenopathy in Bronchiectasis Assessed by CT
Authors: Thomas R. D. , Blaquiere R. M.
Published: June 2015

Mediastinal lymphadenopathy is commonly detected on CT. It is a non-specific finding, but because of its significance in the treatment in lung carcinoma it is important to know with which other disease states it is associated. We present a series of 42 patients in whom CT of the chest was used to confirm a clinical diagnosis of bronchiectasis. The size, number and distribution of mediastinal lymph nodes is documented. Lymph nodes were visible in 81% of patients. Nodes larger than 10 mm, the recognised maximum size for normal nodes in the U. K., were detected in 29%. In the absence of other recognised causes of lymphadenopathy in these patients, these findings confirm “reactive” mediastinal lymph node enlargement in bronchiectasis.
Carpet-Layer's Knee
Authors: Myllymäki T. , Tikkakoski T. , Typpö T. , Kivimäki J. , Suramo I.
Published: June 2015

In order to reveal abnormalities in the soft tissue of the anterior part of the knee, caused by protracted mechanical stress, we performed ultrasound studies of both knees of 95 male workers in the carpet-laying and parquet floor trade (group 1). Seventy-three painters (group 2) served as controls. In group 1, an anechoic fluid collection was detected in 10 knees, localized in the superficial infrapatellar bursa and in one patient in the prepatellar bursa, whereas there were no cases of fluid accumulation in the controls. A hypoechoic, oval subcutaneous thickening in the anterior wall of the superficial infrapatellar bursa was detected in 35 (18.4%) and 4 (2.7%) knees, respectively. Prepatellar subcutaneous thickening was detected in 45 knees (23.7%) in group 1, but in only 2 knees (1.4%) in group 2. Two knees in group 1 had thickened and inhomogeneous patellar tendons, while one in group 2 had a thickened and 2 both thickened and hypoechoic patellar tendons. We conclude that ultrasonography is a useful method for the detection of bursitis and soft tissue changes in carpet-layers. Detection of a fluid collection in a bursa does not necessarily denote bursitis of clinical importance, but does signify irritation due to work stress. Patellar tendon pathology is rare among carpet-layers and is probably unrelated to the occupation.
Vertical Field MR Imaging of Upper Thorax and Spine in Small Children
Authors: Brockstedt S. , Malmgren N. , Malmgren L. , Ivarsson M.-L. , Larsson E.-M. , Holtås S. , Ståhlberg F.
Published: June 2015

To improve image quality in a vertical field MR imaging unit, operating at low field strength (0.3 T), we have designed a half-elliptical coil for use in the upper thoracic region of small children. Our intention was also to shorten the examination time, which until now has been long, because several scans with different coils have been necessary to cover the thoracic region. The experimental coil is designed so that a child's shoulders fit into the central region. The coil consists of 2 serially connected cable-loops, mounted on a foam rubber vest. The coil performance was tested in a phantom and improvements relative to standard coils were demonstrated in in vivo studies. The results indicate that by using the half-elliptical coil, the signal-to-noise (S/N) ratio can be improved by a factor of 2 to 3 in the thoracic region of a child.
Contrast Radiography in Small Bowel Obstruction
Authors: Sandikcioglu T. G. , Torp-Madsen S. , Pedersen I. Krogh , Raaschou K. , Mygind T. , Thomsen H. S.
Published: June 2015

Thirty-six adult patients clinically suspected of small bowel obstruction underwent small bowel contrast radiography with either barium sulfate or a nonionic low-osmolar contrast medium after randomization. Films were taken after 2, 4, and 8 hours and later when needed. No difference as regards visualization and diagnostic quality was found between the 2 media. It is concluded that a nonionic low-osmolar contrast medium is an alternative to barium sulfate for small bowel contrast radiography where small bowel obstruction is suspected.
Cardiac Effects of Coronary Arteriography with Electrolyte Addition to Iohexol
Authors: Pedersen H. K. , Jacobsen E. A. , Refsum H. , Kløw N. E.
Published: June 2015

Electrolyte addition to nonionic contrast media has been suggested to further reduce the incidence of ventricular fibrillation during coronary arteriography. The present study was designed to investigate the effects of adding 30 mM NaCl, 0.9 mM KCl, 0.15 mM CaCl2 and 0.1 mM MgCl2 to iohexol on cardiac electrophysiology and hemodynamics (iohexol + electrolytes = IPE). Contrast media were injected into the left main coronary artery in 9 open-chest, anesthetized dogs before and after induction of acute ischemic heart failure. IPE increased left ventricular inotropy (LV dP/dtmax) with no initial decrease, even during heart failure. During heart failure IPE induced the same hemodynamic effects as iohexol without electrolyte addition. IPE slightly lengthened epicardial monophasic action potential duration before heart failure. We conclude that IPE appears to be well tolerated hemodynamically. The electrophysiologic differences between IPE and iohexol are small when the injection time is not longer than 5 s.
Three-Dimensional Display of Liver, Spleen, Hepatoma, and Blood Vessels by MR Imaging and Computer Graphics
Authors: Kashiwagi T. , Murakami T. , Azuma M. , Tamaki J. , Ishibashi K. , Kishida Y. , Takei Y. , Kawano S. , Fusamoto H. , Kamada T. , Nakamura H. , Kozuka T.
Published: June 2015

The technique of generating 3-D images from CT and MR data has made progress. Manipulation of the images has become simpler, the processing time shorter, and the quality better. Clinical application of this technique has been performed for images of brain (5, 7, 8) and bone (1, 2, 6), but only a few studies have been done of abdominal organs (3, 4).
Assessment AT CT of the Rheumatoid Shoulder with Surgical Correlation
Authors: Albertsen M. , Egund N. , Jonsson E. , Lidgren L.
Published: June 2015

Eleven shoulders in 10 patients with rheumatoid arthritis were examined by conventional radiography and CT prior to cup hemiarthroplasty of the humeral head and the results were compared with the surgical findings. There was good agreement between preoperative CT and surgical findings. Humeral head cavities and erosions, with cortical boundaries, could be seen more accurately at CT than at conventional radiography. The HU of their contents corresponded to those of soft tissue, being granulomatous in nature at surgery. In 8 humeral heads CT disclosed large areas of fatty degeneration of bone marrow with HU between − 10 HU and − 76 HU that were not visible on the conventional radiographs. These “fatty cysts” had no cortical boundaries, unlike inflammatory granulomas, but both lesions may influence the surgical approach to hemiarthroplasty.
Renal Effects of Nonionic Contrast Media after Cardioangiography
Authors: Jakobsen J. Å. , Berg K. J. , Brodahl U. , Laake B. , Moxness A.
Published: June 2015

A prospective double-blind randomized cardioangiographic study with iopentol and iohexol was performed in 60 patients. Glomerular filtration rate (GFR) was assessed by serum values of creatinine and β2-microglobulin (β2-MG), estimated creatinine clearance (CCr) according to Cockroft & Gault's formula, and 24 hour CCr. The urinary excretion of albumin, β2-MG, and of the renal tubular enzymes alkaline phosphatase (ALP) and N-acetyl-β-glucosaminidase (NAG) was also measured. Contrary to what has been found after i.v. injections, GFR was reduced by both nonionic contrast media. Serum creatinine (S-Cr) was increased by more than 25% in 6 patients, 3 in each group. CCr was more sensitive than S-Cr and S-β2-MG, but this method is less precise because of risk of urine sampling errors. Estimated CCr gave no additional information to S-Cr. The urinary excretion of NAG and ALP was increased. No clinically significant differences between iopentol and iohexol were detected. No correlation was found between the changes in tubular function parameters and changes in GFR. Twenty patients were on calcium channel blockers before the investigation, but this had no protective effect on the renal function parameters.
Scintigraphic Diagnosis of Thyroid Cancer
Authors: Oommen R. , Walter N. M. , Tulasi N. R.
Published: June 2015

Scintigraphy is part of the routine examination of thyroid disease, yet there are few published reports on its utility and pitfalls. Out of 2 025 consecutive thyroid examinations after excluding 230 cases of proven thyroid malignancies, 403 patients who underwent surgery were studied for histopathologic correlation. There were 232 with cold nodules, 143 with multinodular goiters (MNG) and 28 with uniformly increased uptake suggestive of toxic goiter. Malignancy was reported in 72 of the 232 cold nodules (31%). In solitary nodules, the examination was useful in selecting cases for surgery and, in cold lesions, for planning of surgery. In the majority of patients with MNG or thyrotoxicosis who were operated on, scintigraphy provided no additional information. MNG requires scintigraphy only in selected cases where there is strong suspicion of malignancy. Contrary to reports in the literature, papillary carcinoma was found to be associated with MNG in our patients.
Film-Screen Vs. Digital Radiography in Rheumatoid Arthritis of the Hand
Authors: Jónsson Á. , Borg A. , Hannesson P. , Herrlin K. , Jonsson K. , Sloth M. , Pettersson H.
Published: June 2015

In a prospective investigation the diagnostic accuracy of film-screen and digital radiography in rheumatoid arthritis of hands was compared. Seventy hands of 36 patients with established rheumatoid arthritis were included in the study. Each of 11 joints in every hand was evaluated regarding the following radiologic parameters: soft tissue swelling, joint space narrowing, erosions and periarticular osteopenia. The digital images were obtained with storage phosphor image plates and evaluated in 2 forms; as digital hard-copy on film and on a monitor of an interactive workstation. The digital images had a resolution of either 3.33 or 5.0 lp/mm. ROC curves were constructed and comparing the area under the curves no significant difference was found between the 3 different imaging forms in either resolution group for soft tissue swelling, joint space narrowing and erosions. The film-screen image evaluation of periarticular osteopenia was significantly better than the digital hard-copy one in the 3.33 lp/mm resolution group, but no significant difference was found in the 5.0 lp/mm group. These results support the view that currently available digital systems are capable of adequate diagnostic performance.
Radiographic Features of Limb Lengthening in Children
Authors: Minty I. , Maffulli N. , Hughes T. H. , Shaw D. G. , Fixsen J. A.
Published: June 2015

We report our experience in radiographic imaging in limb lengthening procedures using callotasis for limb lengthening discrepancy with the Orthofix dynamic monoaxial external fixator. Seventeen patients (average age at operation 10.8 years) completed 22 bone segments (7 femora, 11 tibiae, 4 ulnae) lengthening procedures. The average time for formation of good medullary bridging was over 6 months. The commonest radiographic abnormality was a periosteal reaction around the pin sites seen in 14 patients, while evidence of pin loosening was present in 10. All patients with pin loosening also showed periosteal reaction which pre-dated the loosening in 5 of 12 patients by an average of 47 days. Angulation was detected in 9 patients in the a.p. plane, and in 6 in the lateral plane. Six patients developed a ragged radiolucent region through the newly forming bone at an average of 95 days from the corticotomy but with uneventful healing.
MR Imaging of Multiple Myeloma in Tumour Mass Measurement at Diagnosis and during Treatment
Authors: Carlson K. , Åström G. , Nyman R. , Ahlström H. , Simonsson B.
Published: June 2015

The bone marrow of the spine, pelvis and proximal femora was examined with MR imaging at diagnosis in 30 cases of multiple myeloma (MM), and during treatment on 69 occasions. The MR pattern was normal, focal or diffuse and correlated to stage. A tumour mass index (TMI) was calculated by estimating the total myeloma mass visualised at MR imaging. The TMI correlated significantly with stage, lytic bone lesions, serum calcium, serum β-2-microglobulin and survival. No abnormalities were seen at MR investigation in 4 of 6 patients classified as stage II because of osteoporosis only. Therapy efficacy evaluation with MR imaging corresponded to clinical evaluation on 54 of the 69 occasions. MR examination of bone marrow in MM patients can be used for tumour mass assessment, both at diagnosis and during follow-up. Valuable information can be obtained when the tumour mass is difficult to estimate using clinical criteria, e.g. in non-secretory MM or when osteoporosis is the only variable indicating an increase in the tumour mass.
Acute and Late Adverse Reactions to Low-Osmolal Contrast Media
Authors: Mikkonen R. , Kontkanen T. , Kivisaari L.
Published: June 2015

A prospective study of acute and late reactions to low-osmolal contrast media was conducted in 4 875 patients. The contrast medium was injected intravenously in 4 417 patients and intraarterially in 458 for CT, urography or angiography. In the i.v. group only nonionic contrast media, iohexol or iopamidol, were used and in the intraarterial group both ionic and nonionic contrast media, ioxaglate and iohexol, were used. The patients completed 2-phase questionnaires, the rate of reply being 88%. In the i.v. group the incidence of acute reactions was 1.2% and that of late reactions was 4.7%. In the intraarterial group the incidence of acute reactions was 7.4% and the incidence of late reactions was 4.8%. Women and patients from under 40 to 60 years of age were the most susceptible to late reactions. The risk factors for late reactions are allergy, medicine allergy, previous adverse reaction to contrast medium and other diseases including diabetes mellitus, heart-, liver- and kidney diseases.
Contrast-Enhanced MR Imaging of the Breast in Patients with Breast Implants after Cancer Surgery
Authors: Boné B. , Aspelin P. , Isberg B. , Perbeck L. , Veress B.
Published: June 2015

The purpose of the study was to determine the value of contrast-enhanced MR imaging in the assessment of local recurrence in breast cancer patients who underwent mastectomy and breast reconstruction with an implant. Eighty-three patients have been evaluated by semidynamic contrast-enhanced MR imaging. The T1-weighted FLASH 3-D sequence was repeated twice postcontrast for evaluation of the entire breast bilaterally. The findings were compared to physical examination, mammography and histopathology. Recurrence verified by histopathology occurred in 14 of 83 patients (17%). Contrast-enhanced MR imaging was superior to palpation and mammography in revealing recurrences, especially when these were located close to the chest wall. MR was also more sensitive in detecting multiple foci of cancers. Our study revealed that MR imaging was influenced by size, type and composition of the tumor, as illustrated by the false-negative results. Therefore, the use of all 3 investigation methods is necessary for detecting recurrence at an early stage during the postoperative follow-up.
Vascular Mass Lesions and Hypervascular Tumors in the Head and Neck
Authors: Aspestrand F. , Kolbenstvedt A.
Published: June 2015

A retrospective analysis of the findings at contrast-enhanced CT, MR imaging and angiography in 24 patients with vascular mass lesions and 11 patients with hypervascular tumors in the head and neck region was undertaken. We attempted to find criteria at CT and MR imaging that could aid in differentiating between different lesion categories. Parameters such as contrast enhancement at CT, signal intensities at MR imaging, phleboliths and peritumoral hypervascularity were correlated to clinical presentation, biopsies and angiography. MR imaging was superior to CT and far better than angiography in delineating cavernous hemangiomas. Contrast-enhanced CT may better differentiate between cavernous and capillary hemangiomas than MR. MR imaging clearly differentiated cavernous hemangiomas from hypervascular tumors, but was, like CT, inadequate for distinguishing between capillary hemangiomas and hypervascular tumors. Lymphangiomas and cavernous hemangiomas had similar appearances at CT and MR imaging.
Congenital Urethral Polyp — A Rare Cause of Infravesical Obstruction
Authors: Rosenkilde M. , Leffers A.-M.
Published: June 2015

Urethral polyps are uncommon but may result in infravesical obstruction. A case diagnosed by voiding cystourethrogram and sonography is presented.
Early Roentgenological Grading of Femoral Shortening is Correlated to the Late Outcome after Femoral Neck Fractures
Authors: Hernefalk L. , Granström P. , Messner K.
Published: June 2015

Using orthoradiography, the distance between the centre of the femoral head and the intercondylar notch was assessed at regular intervals in 144 patients who were followed for a 2-year period after osteosynthesis of a femoral neck fracture. Late complications, such as segmental collapse and non-union, occurred in 27% of the patients. The degree of femoral shortening was significantly correlated to the incidence of late complications. At 1 month, femoral shortening of more than 5 mm was observed in 85% of patients who developed late complications, and in only 5% of patients without such complications. Thus, the observation of a shortening of more than 5 mm predicted a greater than 6-fold increase of the incidence of late complications. The prognostic accuracy of this observation 1 month after treatment was 92%.
Endoscopic Ultrasonography with Guided Fine Needle Aspiration Biopsy of a Mediastinal Mass Lesion
Authors: Pedersen B. H. , Vilmann P. , Milman N. , Folke K. , Hancke S.
Published: June 2015

A method of endoscopic ultrasonography (EUS) with guided needle aspiration biopsy for conclusive diagnosis of a mediastinal mass lesions is described. The technique might prove useful for diagnosis of solid mass lesions in the mediastinum including diagnosis of lymph nodes for preoperative staging of lung cancer.
Mammography and Ultrasound in the Diagnosis of Contralateral Breast Cancer
Authors: Rissanen Tarja J. , Mäkäräinen Hanna P. , Apaja-Sarkkinen Meeri A. , Lindholm Eija-Leena
Published: June 2015

Forty-nine (5%) of 956 women referred for follow-up imaging after breast cancer treatment had a malignancy in both breasts. The mammograms and ultrasonograms or US reports, and histologic slides or pathologic reports of 31 of these patients were reviewed. Mammography was more sensitive than clinical examination or US in detecting contralateral breast cancer, the sensitivity of mammography being 81%. Thirty-nine percent of the contralateral cancers were nonpalpable, and all were first detected at mammography. No cancers were depicted by US alone. US provided complementary information about palpable masses in 50% of the cases in which the mammographic finding was difficult to interpret. The mammographic appearance and the difficulties in detecting a contralateral cancer were similar to those known to be characteristic for first primaries. Distinguishing a new primary from a metastasis from the first breast cancer was not always possible by means of mammography or US.
Colo-Colonic Intussusception Caused by Lipoma
Authors: Wulff C. , Jespersen N.
Published: June 2015

Intussusception is primarily seen among children, most often as idiopathic ileocolic intussusception (1, 4), and only 5 to 16% of all intussusceptions are seen in adults (1, 8). In contrast to childhood invagination, in adults underlying pathologic processes are identified in 18 to 90% (1, 8).

This report presents 2 cases of colo-colonic intussusception caused by a colonic lipoma. The ultrasonic features of this benign tumour are rather characteristic. A definitive diagnosis can be provided by CT.
Echo-Planar MR Cerebral Blood Volume Mapping of Gliomas
Authors: Aronen H. J. , Glass J. , Pardo F. S. , Belliveau J. W. , Gruber M. L. , Buchbinder B. R. , Gazit I. E. , Linggood R. M. , Fischman A. J. , Rosen B. R. , Hochberg F. H.
Published: June 2015

Neovascularization is a common phenomenon in gliomas. MR imaging cerebral blood volume (CBV) mapping utilizes ultrafast echo-planar imaging and simultaneous use of gadolinium-based contrast material. To determine the utility of MR CBV mapping in the clinical evaluation of gliomas, we followed 15 patients with serial studies. This technique provided functional information that was not evident with conventional CT or MR imaging. Low-grade tumors demonstrated homogeneously low CBV, while high-grade tumors often showed areas of both high and low CBV The maximum tumor CBV/white matter ratio was compared between low- (n = 3) and high-grade gliomas (n=5) in patients without previous treatment and with histologic verification (n=8) and was significantly higher in high-grade gliomas (p<0.01). High CBV foci in nonenhancing tumor areas were present in 2 cases. The distinction between radiation necrosis and active tumor could be made correctly in 3 of 4 cases. The information provided by MR CBV mapping has the potential to be an adjunct in the clinical care of glioma patients.
Classification of Spontaneous Dural Arteriovenous Fistulas with Regard to Their Pathogenesis
Authors: Mironov A.
Published: June 2015

Purpose:

A classification of dural arteriovenous fistulas (DAVFs) according to their pathogenesis has not been established. The purpose of this study was to examine the hypothesis that the different angiomorphologies of DAVFs depend on the location of the venous recipient, and that a territorial classification of spontaneous DAVFs can be created based on their acquired development.

Material and Methods:

The clinical and radiographic findings of 96 patients with DAVFs were reviewed, especially with regard to their venous characteristics.

Results:

DAVFs were subdivided into 5 groups: Type 1 — DAVFs of the dural sinuses (n=39); Type 2 — DAVFs of the cavernous sinus (n=29); Type 3 — DAVFs of Galen's system (n=10); Type 4 — DAVFs of the venous plexus at the base of the skull (n=9); Type 5 — DAVFs of the parasinusal cortical veins (n=9). The documentation of a causal sinus thrombosis depends on the location of the DAVF: in 72% of the cases with type 1 DAVFs there was a thrombosis at the time of the investigation, but no thrombosis could be proved in cases with type 4 DAVFs.

Conclusion:

The morphological development of DAVFs seems to depend on the flow volume of the venous recipient. A pronounced development of pathological AV shunts takes place at the level of the large basal dural sinuses. A delayed development of pathological AV shunts with a low shunt volume occurs in a venous recipient with a low AV pressure gradient.
MR Imaging of 495 Consecutive Cases with Sensorineural Hearing Loss
Authors: Wu W. , Thuomas K.-Å.
Published: June 2015

Purpose:

To examine patients with sensorineural hearing loss (SNHL) with MR.

Material and Methods:

495 consecutive patients with SNHL and 120 age-matched healthy controls were examined. Spin-echo (SE) and fast spin-echo (FSE) images were used with 1.5 T equipment.

Results:

An intracranial abnormality was found in 211 (42.6%) of the patients with 95 (19.2%) along the acoustic pathway. Eleven of the 95 patients had sensory hearing loss while 84 had neural hearing loss with the retrocochlear auditory pathway affected by lesions. In 62 of the 84 patients, the internal acoustic canal and cerebellopontine angle were involved. Twenty-two patients had intra-axial lesions. The controls had no pathologic changes along the auditory pathway.

Conclusion:

MR imaging in a patient with SNHL must cover the entire acoustic pathway from the cochlea to the superior temporal gyrus, and all the components of the auditory pathway should be scrutinized. The FSE-technique can be used to detect the lesions causing SNHL. FSE-sequences can replace SE-sequences.
Adrenoleukodystrophy
Authors: Rosenkilde M. , Albrecht-Beste E. , Wagner A.
Published: June 2015

Purpose:

Adrenoleukodystrophy is a hereditary, usually X-linked recessive disorder, characterized by progressive demyelination of cerebral white matter and adrenal insufficiency.

Material and Methods and Results:

We report the case of a 14-year-old boy, presenting the typical changes in CT and MR with almost symmetrical changes in the white matter only, with no mass effect and a rim of enhancement. Adrenoleukodystrophy may resemble tumour but shows no mass effect.

Discussion and Conclusion:

We discuss the differential diagnoses and underline the importance of the characteristic appearance of this disease. Adrenoleukodystrophy is diagnosed by serum analysis.
Amber Chest Radiography and Patient Dose Measurements
Authors: Persliden J. , Fransson S.-G.
Published: June 2015

Purpose:

Improved chest imaging has been reported with the usage of AMBER (advanced multiple-beam equalization radiography) equipment but with a higher patient radiation dose compared with conventional chest radiography. Most studies, however, describe dose measurements from phantoms. This study presents a comparison of radiation dose measurements in 57 patients for p.a. projections from an AMBER unit with and without an extra Cu filtration and from a formerly used conventional Siemens chest stand.

Material and Methods:

Dose measurements were performed with thermoluminescence dosimetry. Entrance surface doses were recorded from 5 dosimeters, placed on the patient's back. Four were placed over the upper and lower lung fields, respectively, and 1 over the mediastinal area. The dose values were then compared with the values obtained from the conventional chest stand and from the measurements with the extra filtration on the AMBER system.

Results:

The mean entrance dose for the mediastinal area was 0.25 mSv (range 0.15–0.49). With the extra Cu filtration it was 0.16 mSv (0.07–0.29). For the lung fields the values were 0.19 mSv (0.07–0.44) and 0.10 mSv (0.02–0.31), respectively. For the conventional chest stand the entrance dose to the patient was 0.23 mSv.

Conclusion:

AMBER entrance surface doses for the p.a. projection without extra Cu filtration were comparable to the doses obtained with the formerly conventional Siemens chest stand and were well within European recommendations. With extra Cu filtration the AMBER entrance surface doses were reduced by a factor of almost 2.
Cine Phase Contrast Angiography of Normal and Diseased Peripheral Arteries
Authors: Krug B. , Kugel H. , Heindel W. , Schmidt R. , Krings F.
Published: June 2015

Cine phase contrast angiography (PCA) is a modified MR phase contrast sequence that acquires up to 22 coronal phase images per mean cardiac cycle. The ability of the sequence to visualise local haemodynamics was investigated in 7 normal volunteers and 9 patients with flow disturbances of the peripheral arteries using a 1.5 T imager. Functional flow information provided by coronal cine PCA was correlated with quantitative data obtained by MR flow measurements and vessel morphology confirmed by conventional angiograms. Due to the yet suboptimal image quality, an aortic dissection and 1 of 4 aneurysms could not be depicted morphologically. The temporal pattern of arterial perfusion in cine PCA corresponded with flow velocity versus time data provided by quantitative MR flow measurements. Accuracy and time resolution of cine PCA was thus sufficient to provide functional information on the severity of occlusive vascular disease.
UltrasonographicIn VitroExamination of Nonpalpable Breast Masses
Authors: Christensen J. , Nielsen S. Møller
Published: June 2015

Specimen radiology is necessary for ensuring successful surgical excision of nonpalpable, clinically occult breast masses discovered by mammography. However, occasionally nonpalpable lesions are only detected by sonography. A simple method of ultrasonographic in vitro identification of nonpalpable lesions invisible on specimen radiographs is presented.
Myocardial Cell Death in Reperfused and Nonreperfused Myocardial Infarctions
Authors: Nilsson S. , Wikström G. , Ericsson A. , Wikström M. , Øksendal A. , Waldenström A. , Hemmingsson A.
Published: June 2015

Purpose:

To investigate whether Dy-DTPA-BMA-enhanced MR imaging would permit identification of myocardial cell death, myocardial infarction was induced in 12 domestic pigs.

Material and Methods:

In 6 pigs with irreversible cell damage, Dy-DTPA-BMA (1.0 mmol/kg b.w.) was administered i.v. 70 min after coronary occlusion. In 6 other pigs, the infarctions were reperfused 80 min after the occlusion, followed by injection of Dy-DTPA-BMA after 30 min of reperfusion. In 4 additional pigs, the hearts were reperfused after 2 min of occlusion. All 16 pigs were sacrificed 10 min after the injection of Dy-DTPA-BMA. The hearts were excised and imaged with MR.

Results:

Reversibly injured myocardium could not be distinguished from adjacent nonischaemic myocardium after the administration of Dy-DTPA-BMA. Reperfused, infarcted myocardium demonstrated a high signal intensity in the proton-density- and T2-weighted sequences, despite a 5-fold higher Dy concentration compared with both nonreperfused infarcted and nonischaemic myocardium.

Conclusion:

This lack of susceptibility effect in infarcted myocardium, due to a homogeneous distribution of Dy, indicates the usefulness of Dy as a marker of tissue viability.
Traumatic Bilateral Carotid-Cavernous Fistulas Treated with Detachable Balloon
Authors: Kim J. K. , Seo J. J. , Kim Y. H. , Kang H. K. , Lee J. H.
Published: June 2015

A 29-year-old male developed ptosis and progressive pulsating protrusion of the right eye, accompanied by conjunctival injection and tinnitus following a bicycle accident. MR angiography revealed dilation of both superior ophthalmic veins and facial veins. Right internal carotid angiography demonstrated right carotid-cavernous fistula (CCF) at the C3 portion of the right internal carotid artery with abnormal venous drainage. After right carotid balloon occlusion test had been performed, a detachable balloon was introduced into the right CCF while preserving the lumen of the right internal carotid artery. A left CCF, which was detected after closure of the right CCF, was also closed with a detachable balloon. Follow-up carotid angiographies showed complete closure of both CCFs and no abnormal venous drainage. After 1 year no abnormal physical manifestations, or abnormal neurologic signs or symptoms were present.
Small Hepatocellular Carcinoma
Authors: Bartolozzi C. , Lencioni R. , Caramella D. , Palla A. , Bassi A. M. , Di Candio G.
Published: June 2015

Twenty-two patients with 37 small (3 cm or less) nodular lesions of hepatocellular carcinoma (HCC) were examined with ultrasonography (US), CT, MR imaging, digital subtraction angiography (DSA), and CT following intraarterial injection of Lipiodol (Lipiodol-CT). All patients subsequently underwent surgery, and the gold standard was provided by intraoperative US. The detection rate was 70% for US, 65% for CT, 62% for MR imaging, 73% for DSA, and 86% for Lipiodol-CT. A significant difference (p<0.05) was observed between the detection rate of Lipiodol-CT and the detection rates of all the other imaging modalities. The difference was even more manifest (p<0.02) when only lesions smaller than or equal to 1 cm were considered. It is concluded that Lipiodol-CT is the single most sensitive examination to detect small nodules of HCC. It should therefore be considered a mandatory step in the preoperative evaluation of patients with HCC considered to be surgical candidates after noninvasive imaging studies.
The Royal Princess Anna Vasa
Authors: Grzegorzewski M. , Boroń Z. , Laser W. , Florkowski A.
Published: June 2015

Radiological findings on the skeleton of the Royal Princess Anna Vasa are presented. Anna Vasa (1568–1625) was the sister of Sigismund Vasa, who reigned as Sigismund III, king of Sweden and Poland. She was born in Sweden but spent most of her life in Poland. Her skeleton was removed from the tomb in Toruń during restoration work at St. Mary's Church in April 1994. It was then subjected to anthropological and radiological examinations (conventional radiography and CT). The studies revealed a number of anatomical deviations and pathological abnormalities; e.g., basilar impression and congenital anomalies of the spine. These findings can explain many of the complaints troubling Anna Vasa during her lifetime. A fragmentary historical outline and biography of Anna Vasa and Sigismund III are also presented.
MR Imaging of Skeletal Muscle Hemangiomas
Authors: Jenner G. , Söderlund V. , Bauer H. F. C. , Brosjö O.
Published: June 2015

Purpose:

Our purpose was to evaluate how MR imaging depicts the vascular fibrofatty structure of hemangiomas.

Material and Methods:

MR images of 16 histologically proven skeletal muscle hemangiomas were reviewed retrospectively in a nonblinded manner. One patient was examined at 0.5 T, 9 at 1.0 T, and 6 at 1.5 T, and the imaging protocols varied.

Results:

All lesions were lobulated/tubular. Signal characteristics of fat were seen in 13 lesions as lace-like thin septa within or around the tumor. All 16 studies exhibited a hyperintense signal on T2-weighted spin-echo (SE) (n=15) or T1-weighted fast fat suppressed inversion recovery SE images (n=1). Postcontrast images showed marked signal enhancement in parts of the areas, both of high and low T2-weighted signal. Surgical staging based on MR images was correct in all lesions.

Conclusion:

MR images display the characteristic vascular fibrofatty structure of hemangiomas and may allow correct diagnosis.
MR Imaging of Liver Cirrhosis
Authors: Kita K. , Kita M. , Sato M. , Ooshima A. , Yamada R.
Published: June 2015

Purpose:

The objective of this study was to identify the factors affecting the visualization of regenerating nodules in cirrhotic liver by MR imaging.

Material and Methods:

MR images from patients with liver cirrhosis and normal subjects were studied, and signal intensity within the liver was measured and correlated with histologic findings. A reference phantom was also used as a standard.

Results:

The signal intensity of the liver on T2-weighted (T2WI) spin-echo (SE) images was significantly increased in patients with liver cirrhosis. Multiple ring-like or reticular high-intensity areas (RHAs) were demonstrated on T2WI SE images in 44 of 125 cirrhotic livers. Histologic examination in 44 cases revealed various degrees of inflammatory changes in fibrous septa surrounding regenerative nodules in all specimens, vascular dilation in fibrous septa in 4 specimens, and no hemosiderin deposition in some specimens. The results of linear discriminant analysis showed that inflammatory changes in fibrous septa were significantly more pronounced in cases with RHAs on MR.

Conclusion:

RHAs seen on T2WI SE images may correspond to fibrous septa with inflammation. The signal intensity of fibrous septa surrounding regenerative nodules on T2WI SE images may be increased in liver cirrhosis due to inflammation or vascular dilation, contributing to the visualization of regenerating nodules as relatively low-intensity regions on MR.
Radiographic Features of Lobar Agenesis of the Liver
Authors: Makanjuola D. , Al-Smayer S. , Al-Orainy I. , Al-Saleh M.
Published: June 2015

Purpose:

Our aim was to describe the radiographic features of lobar agenesis of the liver.

Material and Methods:

Six patients with lobar agenesis of the liver, 5 right- and one left-sided, are presented. CT was used to confirm diagnosis. Chest radiography, barium meals, and urograms were also analyzed.

Results:

In right-sided agenesis, the following were observed: a) hammock or U-shaped deformity of the stomach; b) colonic interposition of the diaphragm (Chilaiditi's syndrome); and c) reversal of the cranial orientation of the colonic hepatic flexure compared to the splenic flexure. The right kidney was higher in position than the left in both right- and left-sided lobar agenesis.

Conclusion:

Our radiographic findings can provide a multidisciplinary approach in the identification of this anatomic anomaly.
Proton MR Spectroscopy and MR Imaging in Acute and Chronic Multiple Sclerosis — Ringlike Appearances in Acute Plaques
Authors: Landtblom A.-M. , Sjöqvist L. , Söderfeldt B. , Nyland H. , Thuomas K.-Å.
Published: June 2015

Purpose:

We wanted to compare the metabolite status of brain lesions in different clinical subtypes of multiple sclerosis (MS). Two acute MS lesions with ringlike appearances were also investigated.

Material and Methods:

Twenty-three clinically stable MS patients, 2 patients with acute relapses, and 15 healthy individuals were examined by MR imaging and localized proton MRS.

Results:

No metabolite differences were seen in plaques of different subtypes. Decreased NAA/Cr and NAA/choline ratios as well as increased inositol/Cr ratios were observed in the plaques of the clinically stable or chronic active MS patients as compared with controls. The ring plaques had hyperintense cores with surrounding halos, separated from the cores by rings with low signal intensity in T2-weighted images. The core exhibited a prolonged T2 relaxation time. Proton spectra initially contained lactate.

Conclusion:

No differences between the metabolite status of nonacute plaques in different clinical subtypes could be detected. The ring plaques contained lactate signals indicating oedema, inflammation, and macrophage invasion, and may be transition forms between acute oedematous lesions and chronic demyelinated plaques.
The Introduction of Medical Radiology into Iceland
Authors: Brekkan Á.
Published: June 2015

Development of medical radiology in Iceland is described.