bluuebunny/crossref_metadata_2025 huggingface dataset:
Sonographic measurement of thymic size in healthy neonates
Authors: Hasselbalch H. , Jeppesen D. L. , Ersbøll A. K. , Lisse I. M. , Nielsen M. B.
Published: January 2010

Purpose: To assess the variation in thymic size in healthy neonates by sonography and to study the possible correlation to clinical variables.

Material and Methods: A study was made of 149 healthy term infants, at less than one week of age. The size of the thymus was assessed by sonography as a volume estimate, the thymic index. This index was compared to sex, weight, length, gestational age, and level of perinatal asphyxia of the infant. T-cell subsets (percentages of CD4 and CD8 receptor-positive T-lymphocytes in peripheral blood) were determined in 83 of the infants and compared to the sonographic thymic index.

Results: The thymic index varied between 4 and 29, and was positively correlated to the weight of the infant (p=0.0003). There was no correlation to sex, length, gestational age or slight perinatal asphyxia. We found no correlation between the size of the thymus and the CD4 percentage, the CD8 percentage, or the CD4/CD8 ratio.

Conclusion: The size of the thymus in healthy neonates as measured by sonography is significantly correlated to the weight of the infant. For a given weight of an infant it is possible to predict the normal range of thymic size.
Lung nodule conspicuity using unsharp mask filters with storage-phosphor-based computed radiography
Authors: Li F. , Sone S. , Kiyono K.
Published: January 2010

Purpose: To compare the performance of various types of unsharp mask filter applied in storage-phosphor-based computed radiography (SR), and to improve the detection of faint nodules of the lung cancer type.

Material and Methods: A total of 120 SR radiographs were obtained by means of an anthropomorphous chest phantom and a combination of 3 types of small simulated nodule (5-mm sphere-shaped, and 5-mm and 10-mm hemisphere-shaped) placed on the phantom's surface. Eight combinations of nodule site were selected from 16 predetermined chosen sites, and 5 types of parameter were used for unsharp mask filtering. Eight observers evaluated the images, and the detectability of the lung nodules was evaluated from the images by a ROC analysis.

Results: The visibility of the 10-mm hemispherical nodules was nearly equivalent at each site when 5 types of unsharp mask filter were used. The detection of the 5-mm nodules with mid-frequency suppressing and very-low-frequency enhancing filters was better than with a conventional (department standard) mid-frequency enhancing filter.

Conclusion: Mid-frequency suppressing versions of the filter helped to demonstrate faint nodular opacity, which is often shown by early bronchogenic carcinoma. This filter could replace conventional filters in the detection of lung nodules.
Mr imaging of primary non-Hodgkin's breast lymphoma
Authors: Mussurakis S. , Carleton P. J. , Turnbull L. W.
Published: January 2010

In this report we describe the MR imaging findings, including dynamic data, in a patient with primary non-Hodgkin's lymphoma of the breast. The precontrast T1-weighted sequence showed several hypointense, ill-defined, non-spiculated masses. In the T2-weighted images the masses showed a hyperintense halo. In the dynamic and postcontrast sequences all lesions enhanced markedly, and a further large mass was discovered. In comparison to mammography and sonography, only MR imaging identified the multicentric extent of the tumour. Differentiation from invasive cancer, based on either MR or conventional imaging features, was not possible.
Sonomorphology of the gallbladder in critically ill patients
Authors: Helbich T. H. , Mallek R. , Madl C. , Wunderbaldinger P. , Breitenseher M. , Tscholakoff D. , Mostbeck G. H.
Published: January 2010

Purpose: The aim of the study was to assess the value of a scoring system for the diagnosis of acalculous cholecystitis (AC) on ultrasound (US) follow-up examinations and to discuss the merits of a scoring system compared to clinical outcome and pathohistologic findings.

Material and Methods: In this prospective study, 21 patients at the intensive care unit (ICU) of a medical department were examined by follow-up US. Sonographic parameters of the gallbladder (GB) were obtained (longitudinal and transversal diameter, wall thickening, contents, and pericholecystic fluid) and scored (2 points: distension of GB, thickening of GB wall; 1 point: striated thickening of GB wall, sludge, and pericholecystic fluid; range (0-8)). The US findings were correlated with clinical findings and histology at cholecystectomy or autopsy.

Results: Of a total of 77 follow-up examinations in these 21 patients, US demonstrated GB distension in 19 patients, wall thickening in 18, sludge in 15, striated thickening of the GB wall in 13, and pericholecystic fluid in 12 patients. Of these, 41 (53%) examinations were scored ≥ 6, and 36 (47%) examinations ≤ 5. None of the patients with a maximum score during follow-up of ≤ 5 (n=8) had pathohistologic proof of AC or died due to GB complications. Patients with maximum scores of ≥ 6: had pathohistologic proof of AC (n=4); survived with normalization of GB morphology (n=4); had a normal GB at autopsy (n=1); or were lost for pathohistologic proof at autopsy (n=2).

Conclusion: Our results indicate that regular, short-term follow-up allows early diagnosis and immediate therapy for AC. The scoring system could be helpful in differentiating between patients with an abnormal GB without AC (score ≤ 5) and those with an abnormal GB (score ≥ 6) with a suspicion of AC. In the latter group, more aggressive diagnostic and therapeutic procedures may be indicated.
Radiography and bone scintigraphy in bone marrow transplant multiple myeloma patients
Authors: Ågren B. , Löqvist B. , Björkstrand B. , Rudberg U. , Aspelin P.
Published: January 2010

Purpose: To compare conventional radiography and bone scintigraphy in relation to clinical outcome in bone marrow transplant multiple myeloma patients.

Material and Methods: A total of 70 radiographies and 70 bone scintigraphies were compared in 35 patients.

Results: The skull, the extremities, the iliac and pubic bones were better assessed with radiography. For new vertebral lesions and for lesions in the ribs and sternum, bone scintigraphy proved superior. For the sacrum, the methods were equal. When bone scintigraphy was used as a complement to radiography, 4% more pathological sites were found. No patient had both a normal radiography and a pathological bone scintigraphy, but 5 patients had both a normal bone scintigraphy and a pathological radiography. The results of the radiological examinations did not always correlate with the clinician's grading of the patient's disease. The radiological examinations had no prognostic value for the 7 patients examined on several occasions.

Conclusion: The ability of conventional radiography and bone scintigraphy to disclose myeloma lesions varies, depending on location and size of the lesions. Radiography should remain the primary examination modality also for bone marrow transplant multiple myeloma patients. Bone scintigrapy can serve as a complement for investigating unexplained pain, e.g. caused by lesions in vertebrae or ribs.
Hemodialysis-related arthropathy
Authors: Karakida O. , Aoki J. , Kanno Y. , Watanabe T. , Tamura K. , Seo G. Suk , Sone S.
Published: January 2010

Purpose: A prospective examination of hemodialysis-related arthropathy by MR imaging with SE and GRE sequences was undertaken to verify whether the low signal intensity on T2-weighted SE images is caused by a paramagnetic susceptibility effect derived from amyloid or from hemosiderin.

Material and Methods: Twenty-seven joints (19 hip joints, 6 discovertebral joints of 5 lumbosacral spines and 1 cervical spine, 2 shoulder joints) in 14 patients undergoing long-term hemodialysis (duration 10-22 years, mean 17) were examined with SE T1-weighted, T2-weighted and GRE T2*-weighted sequences.

Results: The signal intensity of the intraarticular and periarticular masses of the involved joints was basically isointense to the muscle in all 3 pulse sequences. No significantly low signal area was found on GRE T2*-weighted images.

Conclusion: The low signal areas in the hemodialysis-related arthropathy on SE T2-weighted images are not caused by a paramagnetic susceptibility effect, but probably by the hypocellular and fibrous nature of amyloid-containing tissues. Therefore the GRE sequence can be helpful for differentiating hemodialysis-related amyloid arthropathy from chronic hemarthrosis or juxta-articular brown tumor.
ROC-study of a teleradiology workstation versus film readings
Authors: Størmer J. , Bolle S. R. , Sund T. , Weller G. E. R. , Gitlin J. N.
Published: January 2010

Purpose: We have used receiver operating characteristic (ROC) analysis to compare screen assessment of digitized radiographic films transmitted by a teleradiology system, with evaluation of the original radiographs on film.

Material and Methods: The material contained 120 cases (about 50% with selected pathology) that were difficult to diagnose. Four radiologists each evaluated half of the cases on film, and half on computer screen. The screen display was 1024×836 pixels with 8 bits/pixel.

Results: We found the accuracy and sensitivity of the teleradiology system to be clearly inferior to film evaluation.

Conclusion: Improvement is needed both in the teleradiology system, and in the training of radiologists to work on the electronic workstation.
Time-resolved white light transillumination for optical imaging
Authors: Jarlman O. , Berg R. , Andersson-Engels S. , Svanberg S. , Pettersson H.
Published: January 2010

Purpose: To describe a new breast-imaging method with the potential of multi-spectral optical transillumination based on a time-resolved technique.

Material and Methods: A breast phantom was irradiated with ultra-short laser pulses of white light generated by self-phase modulation of an incident high-power laser pulse in water. Time-resolved detection of the transmitted light was performed. Contrast resolution was studied using different absorbers located inside the breast phantom.

Results and Conclusion: The results showed that simultaneous, multi-spectral transillumination is possible. The technique can also be used for measurements of optical properties in tissue.
Digital fluoroscopy before and after laser uvulopalatopharyngoplasty in obstructive sleep apnea
Authors: Tsushima Y. , Antila J. , Laurikainen E. , Svedström E. , Polo O. , Kormano M.
Published: January 2010

Purpose: to study the changes in pharyngeal behavior after laser uvulopalatopharyngoplasty (LUPPP).

Material and Methods: the dynamic changes in the upper airway size were evaluated with digital fluoroscopy in 24 patients with obstructive sleep apnea (OSA) before and after LUPPP and in 16 normal controls, while they were awake and breathing normally. Cephalometric measurements were also made. the patients were classified into the categories of good and poor responders by means of a static-charge-sensitive bed.

Results: Following LUPPP, collapsibility at the velopharyngeal level was within the normal range in 15 of 17 good responders, but only in 2 of 7 poor responders (p=0.0086). the minimum airway size at the same level showed a similar trend. in 3 of 7 poor responders the hyoid bone was positioned more caudally than in the good responders (p=0.017).

Conclusion: Digital fluoroscopy provides information on the change in upper airway behavior after LUPPP.
Thymus size evaluated by sonography
Authors: Hasselbalch H. , Jeppesen D. L. , Ersbøll A. K. , Engelmann M. D. M. , Nielsen M. B.
Published: January 2010

Objective: to use sonography in a follow-up study aimed at assessing the size of the thymus in healthy infants, and to search for a possible relation to clinical variables, breast-feeding status, and illness.

Material and Methods: Forty-seven healthy infants were examined as neonates and re-examined at 4 months of age. Thirty-seven of the infants were also re-examined at 8,10, and 12 months of age. the thymus size was measured with the sonographic thymic index used as a volume estimate. the correlations between the thymic index and the sex, weight, length, illness, and breast-feeding status of the infants were analysed.

Results: at birth the median thymic index was 12 (range 4–29). at 4 months the median thymic index was 28 (range 12–83). the thymic index was positively correlated to the body length of the infant and to its breast-feeding status (p<0.0001). at 8 months the median thymic index was 29 (range 6–55) and most of the variation could be explained by the length of the infant (p=0.0018, r=0.50). at 10 months the median thymic value had decreased to 19 (range 9–49), and at 12 months to 17 (range 7–53). Infants exclusively breast-fed during the first 4 months of their lives had a larger thymic index at 10 months than formula-fed infants (p=0.0024). Infants with fever episodes from 10 to 12 months had a smaller thymic index at 12 months (p=0.0241).

Conclusion: the thymus size in healthy infants increases from birth to 4 and 8 months of age and then decreases. Most of the individual variation can be explained by breast-feeding status and body size, and to a lesser extent by illness. We propose statistical models by which the normal variation/distribution of the thymic size can be estimated in infants up to one year of age.
Cranial MR findings in Wilson's disease
Authors: Saatci I. , Topcu M. , Baltaoglu F. F. , Köse G. , Yalaz K. , Renda Y. , Besim A.
Published: January 2010

Purpose: to define various cranial Mr appearances in Wilson's disease (WD).

Material and Methods: MR examinations of 30 patients (9–44 years old) with WD were retrospectively reviewed. Six patients were asymptomatic siblings. Three other patients had isolated hepatic involvement, one with no symptoms. the remaining 21 patients had neurological involvement, 7 of whom had the mixed form of the disease. Nine patients had hepatic dysfunction, the 3 with isolated hepatic involvement and 6 of the 7 with the mixed form.

Results: All symptomatic patients (n=23) had abnormal MR examinations. Atrophy was present in the majority of them. the most frequently involved sites were putamen (18/21) and pons (18/21) in patients with neurological abnormality. the putaminal lesions showed a consistent pattern of symmetric, bilateral, concentric-laminar T2 hyperintensity. Putaminal lesions were lacking in only 3 patients with neurological involvement, all of whom were relatively old and had had the disease for a longer duration. Most of the patients with hepatic dysfunction (8/9) had increased T1 signal intensity in the basal ganglia, particularly in the globus pallidus. Pontine involvement always included the dorsal aspect of the pons, however, in some cases the central portion of pons was also affected but ventrolateral longitudinal fibers were spared. Midbrain (16/21), thalamic (10/21) and caudate nucleus lesions (9/21) were also encountered. in a few patients cortical and subcortical white matter lesions were present with a predilection to the frontal lobe, particularly the precentral region. in one patient, a hemorrhagic focus was identified within the white matter lesion.

Conclusion: on T2-weighted images, WD is suggested by: atrophy; putaminal lesions with a pattern of symmetric, bilateral, concentric-laminar T2 hyperintensity; and the involvement of the pars compacta of the substantia nigra, periaqueductal gray matter, the pontine tegmentum and the thalamus. the hepatic component of WD may cause increased T1 signal intensity in basal ganglia. in the adult age group, the basal ganglia lesions may be different from those in the pediatric group; the putaminal lesions may not be present; the globus pallidus and substantia nigra may show increased hypointensity on T2-weighted images. Cortical and subcortical lesions may also be present with a predilection to the frontal lobe.
CT and MR imaging in primary cerebral Non-Hodgkin's lymphoma
Authors: Lanfermann H. , Heindel W. , Schaper J. , Schröder R. , Hansmann M.-L. , Lehrke R. , Ernestus R.-I. , Lackner K.
Published: January 2010

Purpose: to determine the morphological appearance and topographical distribution of primary cerebral non-Hodgkin's lymphoma (NHL).

Material and Methods: CT and MR examinations of 68 patients with primary cerebral NHL were analyzed. the NHLs were classified by the Kiel classification and im-munohistological data, as centroblastic (25), immunoblastic (24), lymphoblastic (5), Burkitt (1), non-subclassifiable type B (11), and T-cell lymphoma (2).

Results: Centroblastic lymphomas tended to predominate in the parietal lobe (56.5%) and the corpus callosum (59.1%) while immunoblastic lymphomas were mainly distributed in the frontal lobe (52.8%). About 2/3 of all NHLs showed a multi-focal occurrence. Important for differential diagnosis, ventricular involvement was proved in 83.3% of these cases. in the remaining 26 patients with a solitary lymphoma, a periventricular location could be detected in only 8 cases. Central necroses were frequent in HIV-positive patients (7/11, 63.6%) but rare in the HIV-negative patients (9/57,15.8%). on T2-weighted SE MR images, 8/11 centroblastic lymphomas gave a signal that was isointense with, or lower than, that of the contralateral white matter, while 8/10 immunoblastic lymphomas gave a higher signal.

Conclusion: the radiological finding of multifocal brain lesions with ventricular involvement is relatively specific for primary cerebral NHL. However, subclassification on the basis of the CT or MR imaging results is not yet possible.
Brain penetration and neurological effects of gadobenate dimeglumine in the rat
Authors: Luzzani F. , Cipolla P. , Pélaprat M. L. , Robert F. , Gotti C. , Tirone P. , de Haen C.
Published: January 2010

Purpose: the study aimed at measuring the amount of the gadobenate ion that crosses an experimentally disrupted blood-brain barrier (BBB) in rats following i.v. administration of gadobenate dimeglumine (GD). the intention was also to compare this amount with the minimally effective intrathecal dose that alters the cerebral function.

Methods: Sprague Dawley rats with an osmotically disrupted BBB received 0.3 mmol/kg of (153Gd)GD, i.v. Radioactivity was measured in plasma and brain parenchyma. the effect on the cerebral function was evaluated by means of a standard motor coordination test (Rota-rod test).

Results: Brain levels of the gadobenate ion were approximately 60 nmol/g tissue after i.v. injection of GD. in rats with an intact BBB, the lowest dose of GD able to slightly impair motor coordination was 0.01 mmol/kg following intracisternal injection.

Conclusion: I.v. administration of GD to rats with a disrupted BBB results in brain levels of the gadobenate ion that are more than 20 times lower than those reached following intrathecal administration of the minimal effective dose, as determined by the Rota-rod test.
Variable tip angle slab selection pulses for carotid and cerebral time-of-flight MR angiography
Authors: Ikushima I. , Korogi Y. , Hirai T. , Takahashi M.
Published: January 2010

Objective: to determine the optimal parameters of variable tip angle slab selection (tilted optimized nonsaturating excitation, TONE) pulses in time-of-flight MR angiography, in order to produce the best visualization of vessels distal to the entry partition.

Material and Methods: the influences of the mean flip angle (MFA) and the profile tilt of the TONE pulse in three-dimensional (3D) time-of-flight MR angiography were evaluated with a mathematical modeling of the flow signal amplitude. We compared the calculated flow signals with the signals from flow-phantom models and with those from 6 normal volunteers. 3D gradient echo images (TR/TE/30/7) were acquired with a single variable of the MFA and the profile tilt. the flow velocity of the phantom was maintained at 15 cm/s. Regions of interest were measured on the source images. We also evaluated the visualization of the cerebral vessels on maximum intensity projection images obtained with and without TONE pulses in 5 other healthy volunteers.

Results: the changes of flow signals in the phantom and in the volunteers were in good accord with those of the signals mathematically predicted and plotted by a computer, as each parameter was varied. the peripheral saturation was weaker at smaller MFA than at larger MFA. A greater profile tilt produced a more pronounced TONE effect than a lower one. the visualization of the peripheral cerebral vessels was markedly improved by the addition of the TONE pulse.

Conclusion: Computer simulation is useful for examining the optimal TONE parameters. the TONE pulse markedly improves the visualization of the distal branches of the cerebral vessels.
Diabetic nephropathy
Authors: Soldo D. , Brkljacic B. , Bozikov V. , Drinkovic I. , Hauser M.
Published: January 2010

Background: the purposes of this study were: to compare conventional and duplex Doppler ultrasonography in the detection of renal changes in diabetes mellitus; to investigate whether a correlation was found with various clinical stages; and to assess whether increased renal vascular resistance in asymptomatic patients correlated with mild renal functional impairment.

Material and Methods: in 190 diabetic patients and 85 controls, conventional ultrasonography was used to assess renal length, parenchymal thickness, and cortical echo-genicity. Renal vascular resistance was estimated by duplex Doppler measurements of intrarenal arterial resistive indices. According to clinical stage, the patients were classified into 3 groups. Resistive indices were compared between controls and patient groups and correlated with age and renal function.

Results: in asymptomatic diabetic nephropathy, renal length and parenchymal thickness were significantly increased compared to that of controls, reflecting hyperfiltra-tion-induced nephromegaly. Differences between controls and patients with clinically manifest nephropathy were insignificant; only in advanced renal disease were both values significantly decreased. Cortical hyperechogenicity was noted only in very advanced disease. Resistive indices correlated well with renal function, and pathologic values (i. e. ≥ 0.70) were observed in 15% in the asymptomatic group and in 87% in the group with advanced nephropathy.

Conclusion: Renal changes in diabetic patients are detectable by conventional ultrasound only in very advanced stages of the disease. Pathologic resistive indices, however, may be detected in the earlier stages. Resistive indices correlate with serum cre-atinine levels and creatinine clearance rates. However, it remains unclear as to whether a diagnostic or prognostic benefit can be expected as compared to standard laboratory examinations.
Accessory lobe of the liver mimicking a mass in the left adrenal gland
Authors: Hashimoto M. , Oomachi K. , Watarai J.
Published: January 2010

An accessory lobe of the liver is a rare anomaly which we have diagnosed in a patient by CT. the lesion appeared as a soft-tissue-density mass with the same density as the liver and attached to the liver. Radionuclide liver scintigraphy helped to confirm the diagnosis. the object of this report is to draw attention to this rare entity since it can cause diagnostic confusion.
Ispaghula (vi-siblin) versus standard preparation for barium enema
Authors: Burchardt A. J. , Carstensen J. M. , Roikjer O. , Burcharth F.
Published: January 2010

Purpose: to compare 2 methods of colonic cleansing before double-contrast barium enema. A standard preparation of bisacodyl was compared with a preparation of dietary fibre (ispaghula).

Material and Methods: the patients referred for double-contrast barium enema were randomly allocated to one of the colonic cleansing regimens. the effectiveness and patient acceptance of the preparations were evaluated.

Results: There was a significantly poorer colon cleanness score in the ispaghula group (p=0.0001). Patient tolerance of the 2 regimens was not significantly different.

Conclusion: Ispaghula alone is not sufficient as a cleansing preparation for double-contrast barium enema.
Diverticulitis of the sigmoid colon
Authors: Stefánsson T. , Nyman R. , Nilsson S. , Ekbom A. , Påhlman L.
Published: January 2010

Purpose: to evaluate the use of laparoscopy, CT, colonic enema (CE), and laboratory tests (white blood cell count (WBC), sedimentation rate (SR), and C-reactive protein (CRP)) in diagnosing diverticulitis of the sigmoid colon.

Material and Methods: the diagnostic methods were prospectively evaluated in 88 patients, 30 of whom were referred for laparoscopy.

Results: Fifty-two patients were found to have sigmoid diverticulitis: 20 patients by laparoscopy, 21 by CT, and 11 by CE combined with one positive laboratory test. Laparoscopy proved to be superior to the other diagnostic methods in diagnosing diverticulitis of the sigmoid colon. CT had a high specificity (1.0; 95% CI: 0.92–1.0) but low sensitivity (0.69; 95% CI: 0.56–0.79) in detecting diverticulitis. CE had a higher sensitivity (0.82; 95% CI: 0.71–0.90) but a lower specificity (0.81; 95% CI: 0.67–0.91) than CT.

Conclusion: CT was the best method for diagnosing abdominal pathology outside the colon. CT can be recommended as the first examination in seriously ill patients where abscesses and other causes of the symptoms than diverticulitis must first be ruled out. Laparoscopy is probably the most accurate method in diagnosing diverticulitis.
Optimization of ascending phlebography of the leg for screening of deep vein thrombosis in thromboprophylactic trials
Authors: Kälebo P. , Anthmyr B.-A. , Eriksson B. I. , Zachrisson B. E.
Published: January 2010

Purpose: Comparison of 2 phlebographic techniques in achieving adequacy of deep venous filling.

Material and Methods: Sixty consecutive patients with a clinical suspicion of deep vein thrombosis (DVT) were examined by 2 different techniques, A according to GREITZ and B according to LEA THOMAS. All deep veins were scored according to a protocol as DVT, normal or inadequate. Venous evaluability and DVT rates were compared. Bilateral phlebograms according to the A-technique from 92 asymptomatic patients in a different trial were reviewed to allow comparison with the symptomatic subjects.

Results: the A-technique resulted in a significantly higher degree of overall evalu-able patients compared to the B-technique, 95% vs 47%. A vein-by-vein analysis showed that the A-technique was significantly better than the B-technique in filling the gastrocnemius muscular (82% vs 38%), anterior tibial (85% vs 43%), and deep femoral (28% vs 18%) veins. No significant difference was found in the other veins. the DVT rates were 42% and 40% respectively for the A- and B-techniques. About 94% of the phlebograms in the asymptomatic patients were adequate.

Conclusion: the A-technique resulted in better venous opacification and would seem to be a more suitable screening method for asymptomatic persons.
Technical aspects of catheter-related interventions in the liver of the rabbit
Authors: Kónya A. , Wright K. C. , Szwarc I. A. , Collins R. D.
Published: January 2010

Purpose: on the basis of 89 different vascular interventions performed in the livers of 39 rabbits, we attempted to establish the feasibility and technical limitations of these procedures.

Material and Methods: Forty-five selective hepatic artery catheterizations were carried out using 0.66-mm and 1.0-mm catheters, including superselective proper hepatic catheterizations (n=14) using a specially designed 0.66-mm introducer/catheter system. the portal system was investigated with both direct (n=5) and indirect (arterial) (n=4) portography. Hepatic vein catheterizations were performed in 22 cases.

Results: with the 0.66-mm system, spasm occurred in one of 11 cases in the proper hepatic artery, and no spasm was observed in the common hepatic and celiac arteries. Both arterial portography and hepatic venography were easily performed and were a precise and repeatable method.

Conclusion: the 0.66-mm system has proved to be advantageous over the 1.0-mm catheterization in avoiding arterial spasm. Direct portography as well as catheterization of the hepatic vein from a jugular approach are hazardous, leading to serious complications including the death of the animal.
A new catheter type for superselective angiography and embolization
Authors: Hoogewoud H.-M.
Published: January 2010

Purpose and Material: A new family of catheters was developed to overcome the shortcomings of conventional catheters and to avoid the use of coaxial catheters in superselective angiography and embolization. the new catheter is nylon, 1.67 mm (JF) long, and has a rigid proximal part (to ensure torque control and pushability) and a long 2-step flexible tip (to follow arterial tortuosities). It has a hydrophilic coating, and a long-lasting shape memory. This new catheter type was compared experimentally with conventional catheters.

Results: Clear advantages were found with the new catheters in pushability and trackability as they, more often than conventional catheters, permitted us to reach the periphery of an artery. Departmental experience with the new catheters currently amounts to over 500 arterial procedures.

Conclusion: the new catheters could frequently replace coaxial catheters, which would contribute towards reducing the costs of intravascular procedures.
Teleradiology by two different concepts
Authors: Kehler M. , Bengtsson P. O. , Freitag M. , Lindström B. , Medin J.
Published: January 2010

Two different teleradiology concepts are described. Their advantages, disadvantages and costs are discussed.
Intramuscular Myxoma and fibrous dysplasia of bone — Mazabraud's syndrome
Authors: Court-Payen M. , Jensen L. Ingemann , Bjerregaard B. , Lausten G. Schwarz , Skjoldbye B.
Published: January 2010

We present a case of Mazabraud's syndrome, a rare benign disease, with multiple intramuscular myxomas of the thoracic wall associated with fibrous dysplasia of bone. CT, MR imaging and ultrasonography (US) of the thorax showed 2 well circumscribed homogeneous intramuscular tumors. A US-guided needle biopsy with a large-core needle (2.0 mm) and a fine needle (0.8 mm) showed that the tumors were intramuscular myxomas with no sign of malignancy. 99mTc bone scintigraphy showed a markedly increased uptake in the right lower skull, and multiple smaller foci. CT of the skull revealed a right-sided unilateral bone thickening of the orbit and the ethmoidal cells, and right-sided exophthalmia. This case history suggests that patients with multiple intramuscular myxomas should be preoperatively examined for osseous lesions. A postoperative follow-up should also be performed to detect other soft-tissue myxomas not as yet clinically detectable, or rare osseous complications.
Frequency of unexpected multifocal metastasis in patients with acute spinal cord compression
Authors: Heldmann U. , Myschetzky P. S. , Thomsen H. S.
Published: January 2010

Purpose: the aim of the study was to estimate, in an acute care service, the frequency of multiple-level lesion involvement in patients with clinically suspected spinal cord compression or spinal blockage.

Material and Methods: Over a period of 17 months, 240 patients with symptoms of acute spinal cord compression underwent acute MR examination of the spine in a 0.1 T MR unit. the cervical spine was only added to the examination if there was clinical suspicion of cord compression above Thl.

Results: in 65 (27%) of the 240 patients, involvement of at least one level was found. of these patients, 32 (49%) showed involvement of more than one level. This high rate was surprising, since only 14 (44%) of the 32 multiple lesions had been clinically suspected. There was no correlation to age or original type of cancer.

Conclusion: MR accurately demonstrates the anatomy of the spine and spinal cord, showing the level and complexity of spinal lesions. Multiple lesions may be underestimated when the combination of myelography/radiculography and CT is used.
CT with the hepatocyte-specific contrast medium fp 736-04 in an experimental model of liver steatosis
Authors: Bergman A. , Sundin A. , Karpe F. , Magnusson A.
Published: January 2010

Purpose: to investigate whether liver uptake of the iodinated hepatocyte-specific lipid emulsion FP 736-04 is altered by fatty infiltration of the liver.

Material and Methods: Fatty infiltration of the liver was induced in female Sprague Dawley rats by an intraperitoneal injection of L-ethionine preceded by 15 h of food withdrawal. CT of the liver was performed before and 24 h after the administration of L-ethionine and, in addition at the latter time point, after an i.v. injection of 1.0 ml/kg b.w. of FP 736-04. A control group was subjected to the same CT examination protocol.

Results: Intraperitoneal administration of L-ethionine caused liver steatosis, as established by liver triglyceride analysis, leading to a significant decrease in the liver attenuation, from 69.2±2.4 to 27.8±12.0 HU. the uptake of FP 736-04 by the fatty liver was significantly reduced, yielding a maximum enhancement of 22.3±7.9 HU as compared to a value of 32.3±5.0 HU in the control group.

Conclusion: Enhancement by FP 736-04 was reduced in the steatotic liver compared with the normal liver. It remains to be established whether this degree of enhancement is sufficient for reliable lesion detection.
Percutaneous microwave coagulation therapy in liver tumors
Authors: Matsukawa T. , Yamashita Y. , Arakawa A. , Nishiharu T. , Urata J. , Murakami R. , Takahashi M. , Yoshimatsu S.
Published: January 2010

Purpose: Percutaneous microwave coagulation therapy (PMCT) is an interventional alternative for inoperable malignant liver tumors. in this paper, we report the results of our 3-year experience of PMCT in order to establish suitable indications for this treatment.

Material and Methods: We studied a total of 27 inoperable liver tumors in 24 patients. Histology of the tumors showed 20 hepatocellular carcinomas (HCCs) (13 well differentiated, 4 moderately differentiated, and 3 poorly differentiated) and 7 metastases. These tumors were treated by PMCT and were followed for 4–40 months (average 18 months). Under US guidance, the tumors were coagulated by microwaves emitted from an electrode. the changes of tumor size after PMCT were evaluated by CT. When the tumors disappeared or were reduced in size after treatment, PMCT was regarded as effective. Complications from PMCT were also evaluated. the patient survival rate was obtained by means of the Kaplan-Meier method.

Results: in tumors of 30 mm or less, treatment response was obtained in 70% of cases, while 55% of tumors larger than 30 mm responded. the tumor became smaller or disappeared in 85% of the well differentiated HCCs, and in 25% of the moderately differentiated HCCs, but none of the poorly differentiated HCCs responded. in metastatic tumors, PMCT was effective in 57% of cases, Slight pain (24%), fever (20%) and subcutaneous hematoma (8%) were experienced immediately after PMCT. in 2 poorly differentiated HCCs, needle tract seeding was observed. No case of liver dysfunction was seen after PMCT. the overall survival rate was 83.1% at 1 year and 68.7% at 2 years.

Conclusion: Good therapeutic results were achieved with PMCT in lesions of 30 mm or less, and in well differentiated HCCs.
Rim enhancement in colorectal metastases at CT during infusion hepatic arteriography
Authors: Irie T. , Tsushima Y. , Terahata S. , Hatsuse K. , Kusano S.
Published: January 2010

Purpose: to evaluate the morphologic substrate of the rim enhancement of colorec-tal metastases seen at CT during infusion hepatic arteriography (CTIHA).

Material and Methods: Eleven sector defects in the enhancing rim of 9 metastases at CTIHA were analyzed. the corresponding pathologic specimens were investigated for sector defects of liver parenchyma. We investigated whether there was a correlation between the central angle of the sector defects of rim enhancement at CTIHA and that of sector defects in the zone of liver parenchyma in histologic slices. the inner and outer diameters of the enhancing rim were also compared with the diameter of the metastases as seen at CT during arterial portography (CTAP).

Results: There was a significant correlation between the central angle of sector defects of rim enhancement at CTIHA and the angle of sector defects in the zone of liver parenchyma in histologic slices (p=0.008, Spearman's test). the diameter of the metastases measured at CTAP was larger than the inner diameter and smaller than the outer diameter of the enhancing rim in CTIHA, i.e. the margins of the nodules as seen in CTAP are located in liver parenchyma and not in tumor tissue.

Conclusion: the morphologic substrate of the rim enhancement of colorectal metastases seen at CTIHA is liver parenchyma.
Yield and complications in percutaneous renal biopsy
Authors: Nyman R. S. , Cappelen-Smith J. , Al Suhaibani H. , Alfurayh O. , Shakweer W. , Akhtar M.
Published: January 2010

Purpose: to compare the yield and complications of ultrasound-guided gun-biopsy and manual Tru-Cut techniques in percutaneous renal biopsy.

Material and Methods: A total of 448 biopies were reviewed. They comprised 124 manual and 131 gun-biopsies in native kidneys, and 111 manual and 82 gun-biopsies in transplant kidneys. the gun-biopsies were performed under real-time ultrasound (US) guidance. the manual technique used US mainly for marking the position of the kidney.

Results: There was a significantly higher diagnostic yield and fewer complications in the gun-biopsy group. A total of 8 major complications were found, all in the manual group.

Conclusion: Provided that the operator is experienced in US scanning, a switch from the manual technique to real-time US-guided gun-biopsy will result in the improvement of diagnostic accuracy together with a reduced risk of complications.
Effect of ultrasound contrast medium in color doppler and power doppler visualization of blood flow in canine kidneys
Authors: Abildgaard A. , Kløw N.-E. , Jakobsen J. Å. , Egge T. S. , Eriksen M.
Published: January 2010

Purpose: to examine the effect of an ultrasound contrast medium (UCM) in the visualization of parenchymal blood flow by means of color Doppler and power Doppler sonography.

Material and Methods: Nonenhanced and UCM-enhanced Doppler images of canine kidneys were obtained in a transversal plane during various states of flow reduction in the anterior branch of the renal artery. the UCM consisted of air-filled shell-stabilized microballoons (half-life approximately 2 min). the images were evaluated blindly by 4 observers who rated the amount of flow signal in the cortex and medulla, and categorized the flow state (normal, reduced or no flow) in the anterior part of the kidney.

Results: the UCM increased the area of Doppler signals in the cortex and outer medulla during normal or reduced blood flow. the border between nonperfused and normally perfused parenchyma was more distinct with the UCM. the categorization of the regional flow state was more correct with the UCM. Improvement with the UCM was greatest when the nonenhanced Doppler images had suboptimal intensity, but positive effects with the UCM were also seen in recordings with adequate precontrast intensity. Color blooming artifacts sometimes occurred on the side of the kidney facing away from the transducer.

Conclusion: the UCM improved the color Doppler and power Doppler visualization of the parenchymal blood flow in the canine kidney, and allowed a more correct categorization to be made of the regional blood flow state.
Percutaneous nephrostomy with real-time sonographic guidance
Authors: Gupta S. , Gulati M. , Shankar K. Uday , Rungta U. , Suri S.
Published: January 2010

Purpose: Percutaneous nephrostomy (PCN) is an effective method for achieving temporary drainage of the obstructed urinary system and is usually performed under fluoroscopic guidance alone or more commonly under combined sonographic and fluoroscopic guidance. We undertook a retrospective analysis of 273 PCNs performed solely under ultrasound (US) guidance with the aim of evaluating the technique and the safety and efficacy of the procedure.

Material and Methods: A total of 273 PCN procedures in 267 patients were performed under real-time US guidance using the Seldinger technique. the indications for PCNs comprised benign (n=215) and malignant (n=46) urinary obstruction, and urinary fistulae (n=6).

Results: PCN was successful in 269 of the 273 attempts (98.5%). Satisfactory catheter placement was achieved in 245 of the 269 procedures (91.1%) under US guidance. Fluoroscopic assistance for catheter repositioning was required in 24 PCNs owing to the unsatisfactory position of the catheter tip. Major complications occurred in 15 patients (5.6%). Catheter dislodgement and catheter blockage was seen in respectively 12.6% and 3.3% of procedures.

Conclusion: in most patients, PCN can be performed safely using real-time sonographic guidance.
The origin of the word stent
Authors: Hedin M.
Published: January 2010

In 1856, the English dentist Charles Stent developed a thermoplastic-like material for taking impressions of toothless mouths. This “Stent mass” was later used as a device or mould for keeping a skin graft in place; it was also used to provide support for anastomosis. A hundred years after the inventor's death in 1885, the word stent has been adopted all over the world in interventional radiology but today it is understood to mean percutaneous tubular structures that induce or maintain lumen patency

The true origin of the word stent is not found in many dictionaries. in most references, the wrong dentist is given credit for the discovery. Dictionaries also refer to the obsolete English and Scottish words stent and stint which mean, among other things, “to extend”. the true origin of the word is therefore somewhat unclear
Supratentorial primary intra-axial tumors in children
Authors: Higano S. , Takahashi S. , Kurihara N. , Ishii K. , Matsumoto K. , Shirane R. , Katakura R. , Singh L. N. , Yamada S.
Published: January 2010

Purpose: to evaluate the MR and CT features of pediatric supratentorial intra-axial tumors with respect to differential diagnosis and the role of each investigation modality

Material and Methods: MR and CT findings in 40 children with 12 types of pathologically proven histological tumors were reviewed

Results: the location of tumors might be one clue to differential diagnosis. in our material, cysts (60%), calcifications (45%), and intratumoral hemorrhages (27%) were found in the tumors. Characteristic features noted in some lesions included: peritumoral hemosiderin deposition in cavernous angiomas; intratumoral flow void in a choroid plexus carcinoma and in glioblastomas; and hemicerebral atrophy in germinomas. A comparison between malignant and benign tumors showed perifocal edema and a mass effect to be significantly more common in malignant lesions. Homogeneous enhancement suggested a benign tumor and an inhomogeneous pattern represented malignancy, while the lack of obvious enhancement did not always suggest benignity. Intratumoral calcium deposition was a not uncommon finding in malignant tumors

Conclusion: in most cases, the exact diagnosis should be made by histological examination but it is important for treatment planning that the appropriate depiction of tumor extension and tissue characterization be made by MR and CT
The perfusion fraction in volunteers and in patients with ischaemic stroke
Authors: Wirestam R. , Brockstedt S. , Lindgren A. , Geijer B. , Thomsen C. , Holtås S. , Ståhlberg F.
Published: January 2010

The fractional volume of capillary blood, i.e. the perfusion fraction f, was measured with the aid of an echo-planar imaging protocol originally designed for the measurement of water diffusion. in healthy volunteers, reasonable f values were obtained. in patients with cerebral ischaemic stroke, a marked decrease in the f value was seen in the infarcted region as compared with corresponding values in the contralateral hemisphere. We suggest that perfusion-fraction measurements may add to the diagnostic value of water-mobility examinations in patients with ischaemic disease
Abdominal CT features and survival in acquired immunodeficiency
Authors: Knollmann F. D. , Mäurer J. , Grünewald T. , Schedel H. , Vogl T. J. , Pohle H. D. , Felix R.
Published: January 2010

Purpose: HIV-infected patients show a high incidence of abdominal disease. This investigation was made to determine whether abdominal CT provided prognostically relevant information in these patients

Material and Methods: Images from 533 abdominal CT examinations in 339 HIV-infected patients were retrospectively reviewed for signs of abdominal disease, and correlated with clinical data and survival rates. the Kaplan-Meier analysis and rank testing of survival, and proportional hazards regression were used to define prognostic clinical and imaging findings

Results: of the 339 patients, 278 (82%) showed abnormal abdominal findings on CT. Median survival was 29 months. of the imaging findings, hepatic masses (n=11), pathologically enlarged lymph nodes (n=48), and ascites (n=7) were associated with poor survival, giving a median survival of respectively 13 months, 15 months, and less than 1 month. These three features showed no association with CD4+-T-lymphocyte count or CDC category. Main determinants of survival were a low CD4+-T-lymphocyte count, and certain abnormal CT findings. Splenomegaly (n=147), hepatomegaly (n=144), and lymphadenopathy (n=111) were the most common abdominal findings on CT but lacked prognostic relevance

Conclusion: Abdominal CT offered prognostic implications in HIV-infected patients and might serve in risk stratification in selected patients. CT features such as hepatic masses, grossly enlarged lymph nodes, or ascites indicate advanced immunosuppression
Morphometric measurement of abdominal organs
Authors: Groell R. , Machan L. , Schaffler G. J. , Uggowitzer M. , Peichel K. H.
Published: January 2010

Purpose: to determine interobserver variability in the morphometric measurement of abdominal organs with US and spiral CT, and to compare the results obtained with these two modalities

Material and Methods: US and spiral CT examinations of the abdomen were performed in 25 patients. in each patient, 13 defined distances were measured in the liver, spleen and both kidneys with US and spiral CT by two pairs of radiologists in a blinded manner. the interobserver variations of these measurements were evaluated for the US and CT examinations, and the data of both modalities were compared with one another

Results: the measurement of distances in the abdomen with US and spiral CT is subject to considerable interobserver variability in both modalities. the relative interobserver variations showed marked differences, according to which distance was measured. the average interobserver variations were higher in US than in CT. A direct comparison of US and spiral CT revealed that distances obtained with CT frequently exceeded those obtained with US

Conclusion: Morphometric measurements of abdominal organs with US and with spiral CT showed considerable differences. the follow-up examinations should therefore be performed with the same imaging modality as used in the original examination