bluuebunny/crossref_metadata_2025 huggingface dataset:
Transcatheter Arterial Chemotherapy Using Doxorubicin, Iodized Oil and Gelfoam Embolization in Hepatocellular Carcinoma
Authors: Van Beers B. , Cauquil P. , Jamart J. , Pariente D. , Ajavon Y.
Published: June 2015

Computed tomography (CT) was performed in 54 patients with hepatocellular carcinoma three weeks after transcatheter arterial chemotherapy using iodized oil and doxorubicin with or without gelfoam embolization. Patients with iodized oil retention in the tumor greater than 50 per cent of tumor size survived longer than patients with retention of less than 50 per cent. Differences were also found within Okuda stages I and II, but they were significant only in Okuda stage I (p<0.0001). These results suggest a possible relationship between iodized oil retention and survival. In addition to Okuda stage, several factors affected iodized oil retention: tumor vascularity, tumor size, portal thrombosis and Gelfoam embolization. These factors may thus influence the prognosis after transcatheter arterial chemotherapy.
Computed Tomography for Localization of Intra-Abdominally Dislocated Intrauterine Devices
Authors: Hederström E. , Ahlgren M. , Salminen H.
Published: June 2015

CT with scanogram and selected scans was performed in 7 women aged 23 to 46 years where an extrauterine localization of intrauterine devices (IUD) had been considered present at ultrasonography in 6 patients and a questionable intrauterine position of the device in one. Abdominal radiography and hysterosalpingography gave conclusive evidence of extrauterine device dislocation in 5. CT provided good information about the relation of the IUD to adjacent organs and was thus helpful when planning for the mode of extraction. The gonadal radiation exposure at CT was not less than that given by the conventional radiologic methods but may be reduced with a slight change of technique. It is suggested that a CT examination should be the next step in the diagnostic follow-up when US fails or is equivocal in demonstrating an IUD.
Dependence of Ankle Joint Width on Plantar Flexion
Authors: Nielsen F. Farsø , de Carvalho A.
Published: June 2015

Joint space narrowing is the first roentgenologic sign of osteoarthrosis of the ankle. In this report the dependence of ankle joint width on plantar flexion was investigated. In 30 adult volunteers without ankle symptoms, standardized anteroposterior views of the left ankle joint in neutral position and in 25° plantar flexion were obtained. The average width of the joint space in neutral position was 2.7 mm in women, and 3.0 mm in men. A 25 per cent increment of the joint width following 25° plantar flexion was observed. Accurate standardized positioning of the ankle appears to be decisive for the estimation of ankle joint width.
Diagnosis of Deep Venous Thrombosis by Duplex Sonography
Authors: Mantoni M.
Published: June 2015

In a prospective study 90 patients with clinically suggested lower limb deep venous thrombosis (DVT) were examined with duplex ultrasonography (US) prior to venography. No attempts were made to examine the calf veins. Five ultrasound examinations were inconclusive. Thirty-four patients had DVT diagnosed at US with a sensitivity of 97 per cent and a specificity of 96 per cent. Compressibility of the vein as assessed by the real-time image was in the acute phase an easy and fast test for DVT, whereas the Doppler data failed to add to the diagnostic accuracy. Twenty-seven patients with DVT were followed during anticoagulant treatment, but only 16 regained fully compressible veins within the observation period of 3 to 6 months. Duplex sonography was useful in monitoring the changes in vein patency during anticoagulant treatment.
Renal Aneurysm and Arteriovenous Fistula
Authors: Savastano S. , Feltrin G. P. , Miotto D. , Chiesura-Corona M.
Published: June 2015

Embolization was performed in six patients with renal artery aneurysms (n = 2) and arteriovenous fistulas (AVF) (n = 5). The aneurysms were observed in one patient with fibromuscular dysplasia and in another with Ehlers-Danlos syndrome. All the AVFs were intraparenchymal and secondary to iatrogenic trauma. Elective embolization was performed in five patients with good clinical results at follow-up between 1 and 9 years. Because of rupture of the aneurysm emergency embolization was attempted without success in the patient with Ehlers-Danlos syndrome, and nephrectomy was carried out. A postembolization syndrome complicated three procedures in which Gelfoam and polyvinyl alcohol were used; in two of these cases unexpected reflux of the particulate material occurred, resulting in limited undesired ablation of the ipsilateral renal parenchyma. Embolization is the most reliable and effective treatment for intrarenal vascular abnormalities since it minimizes the parenchymal damage.
Blood-Brain Barrier Injury following Intracarotid Injection of Radiographic Contrast Media
Authors: Hayakawa K. , Yamashita K. , Mitsumori M. , Nakano Y.
Published: June 2015

Changes in signal intensity of the brain at magnetic resonance (MR) imaging before and after Gd-DTPA were used for in vivo quantification of injury to the blood-brain barrier (BBB). Immediately following intracarotid injection of 2 ml/kg of radiographic contrast medium (CM) 0.4 mmol/kg of Gd-DTPA was injected intravenously. MR imaging was performed with a 400/25 partial saturation pulse sequence. The maximum percentage changes (mean ± SD) in signal intensity of the brain after CM and Gd-DTPA were 1.6±1.6% with saline, 3.2 ± 2.0% with iotrolan, 4.3 ± 1.7% with iohexol, 6.6 ± 3.6% with ioxaglate and 8.2 ± 3.6% with diatrizoate. Not only the osmolality but also the ionicity and chemotoxicity seemed to influence Gd-DTPA leakage. A subtle BBB injury had a stronger tendency to occur in the basal ganglia than in the cerebral cortex. MR enhancement is proposed as a sensitive method for in vivo quantification of the BBB injury caused by intracarotid CM injection.
Iopentol Compared with Iohexol in Carotid Angiography
Authors: Nakstad P. H. , Skalpe I. O. , Bakke S. J. , Aanonsen N. O. , Ganes T.
Published: June 2015

A randomized double blind crossover test with iohexol and the new non-ionic contrast medium iopentol in 12 patients undergoing carotid angiography showed no difference in tolerability, EEG, ECG, neurologic status or image quality. Iopentol seems to be well suited for cerebral angiography.
Increased Rate of Left Predominance Associated with Adult Valvular Aortic Stenosis
Authors: Thorvinger B. , Lundin A. , Albrechtsson U.
Published: June 2015

The anatomy of the coronary arteries was outlined angiographically in 2 190 adult patients in order to determine the proportion of left predominance. Of 253 patients with valvular aortic stenosis 14.3 per cent were found to have left predominance, while the frequency of left predominance in the rest of the patients (1 937) was 8.5 per cent. Furthermore, this rate increases with the severity (gradient > 50 mmHg) of the aortic stenosis in the absence of aortic valve incompetence. These findings support the current concept of a relationship between adult aortic stenosis and congenital valvular malformation.
Entrapped Ovarian Cyst
Authors: Hederström E. , Forsberg L.
Published: June 2015

Recurrent abdominal pain in the left fossa often mimicking attacks of subileus is described in a woman aged 48 with extensive adhesions caused by multiple surgical procedures. Repeated examinations with conventional abdominal radiography and barium meals were negative with regard to mechanical intestinal obstruction. A cystic lesion varying in size from 2 to 8 cm in diameter was seen adjacent to the left ovary on repeat US examinations and also on CT. Pain episodes were sometimes correlated to increasing size of the lesion which was finally thought to be either a peritoneal inclusion cyst (fluid trapped between pelvic adhesions) or, as was finally confirmed at surgery, a true ovarian cyst (corpus luteum cyst) similarly trapped.
Coronary Angiography and Thallium-201 Single Photon Emission Computed Tomography in Multiple Vessel Coronary Artery Disease
Authors: Svane B. , Bone D. , Holmgren A.
Published: June 2015

Polar presentations of selective coronary angiography and myocardial 201T1 SPECT were compared in 141 patients with multiple vessel disease, 80 with 3-vessel disease, 34 with 2-vessel disease and 27 post-bypass patients. Perfusion defects were present in 125/141 patients (89%) and were located within the area supplied by 194/359 stenotic arteries (54%) and 9 non-stenotic arteries. The type and extent of disease was correctly indicated by 201T1 SPECT in 16/80 patients (20%) with 3-vessel disease, 5/34 patients (15%) with 2-vessel disease and 8/27 post-bypass patients (30%). Perfusion defects indicated the artery with the most severe lesion in 107/125 patients (86%). False negative isotope studies were present in 15 patients (11%).
Quantitative Evaluation of Hyaline Cartilage Disorders Using Flash Sequence
Authors: König H. , Aicher K. , Klose U. , Saal J.
Published: June 2015

In a prospective clinical study 24 normal volunteers and 106 patients with acute and chronic arthritis, osteoarthritis and post-traumatic alterations of the knee joints were examined. Using the parameters A and M 98 per cent of the pathologic cartilages and 74 per cent of the normal cartilages could be identified. In addition 78.5 per cent were correctly categorized in 5 cartilage classes. The A/M classification proved to be a fast and specific method for evaluation of cartilage disorders with special promise for follow-up examinations during therapy.
Gentamicin Nephropathy and Contrast Media
Authors: Thomsen H. S. , Skaarup P. , Larsen S. , Golman K. , Hemmingsen L.
Published: June 2015

Urine profiles were followed for 3 or 9 days after intravenous injection of diatrizoate, iohexol or saline in 30 rats, where a tubulointerstitial nephropathy was induced by gentamicin given over a 14-day period. Another 10 rats who had an injection of saline served as controls. Iohexol increased the excretion of lactate dehydrogenase significantly more than both saline and diatrizoate for the first 3 days, whereas diatrizoate had no effect. Both media caused significantly increased excretion of L-gamma-glutamyltransferase compared with saline, but iohexol significantly more than diatrizoate. Compared with saline S-creatinine was significantly increased following iohexol at 24 h, 3 and 9 days, and following diatrizoate only at 9 days. Among rats having gentamicin light microscopy revealed more severe changes in kidneys exposed to iohexol than to either diatrizoate or saline 3 days after their injection. Six days later no obvious differences were found between the 3 groups. In conclusion, iohexol induced more renal dysfunction than diatrizoate in this animal model of gentamicin induced nephropathy.
Isthmic Lumbar Spondylolisthesis with Sciatica
Authors: Annertz M. , Holtås S. , Cronqvist S. , Jönsson B. , Strömqvist B.
Published: June 2015

Seventeen patients with sciatica and isthmic lumbar spondylolisthesis were studied with magnetic resonance (MR) imaging. In 13, myelography was also performed: 5 had dural sac deformation and root sleeve shortening, 2 had deformation with unilateral root sleeve shortening, one had bilateral root sleeve shortening only, and one had sac deformation only. In 4, myelography was normal. On sagittal MR examinations the neural foramen had an altered shape bilaterally with the long axis horizontal in all cases. In addition to altered shape the following was found in the 33 foramina evaluated. I: normal nerve (n = 8); II: compressed nerve (n = 16); III: disappearance of fat, nerve not possible to identify (n = 9). In patients with unilateral sciatica, the degree of foraminal stenosis correlated well with the side of symptoms. Coronal views showed the course of the nerve and pedicular kinking. Eight patients underwent decompressive surgery which revealed nerve compression by hypertrophic fibrous tissue and pedicular kinking, which correlated well with the findings on MR. Since the site of nerve compression often was peripheral to the root sleeves, myelography did not give complete information.
Iopromide versus Diatrizoate
Authors: Skovgaard N. , Jensen E. R. , Jakobsen K. P.
Published: June 2015

One hundred patients were at random given an intravenous injection of equal amounts of either diatrizoate or iopromide. Subjective patient discomfort and objective parameters of adverse reactions were recorded. There were significantly fewer patients with adverse effects in the iopromide group, both as an overall estimate and especially for heat sensation, nausea and increase in heart rate. Iopromide is recommended for increased patient safety.
Spect Bone Scintigraphy in Assessment of Cranial Paget's Disease
Authors: Brixen K. , Hansen H. Hvid , Mosekilde L. , Halaburt H.
Published: June 2015

Single photon emission computed tomography (SPECT) bone scintigraphy was used in the assessment of Paget's disease in 3 patients with skull involvement. In comparison with conventional scintigraphy, SPECT improved the three-dimensional perception and made precise outlining of involved bones possible. The radionuclide uptake in lesions expressed as counts per pixel was 1.5 to 10 times that of normal bones. Routine use of SPECT in cranial Paget's disease for staging and monitoring the effect of treatment is proposed.
Size of Lumbar Disc Hernias Measured Using Computed Tomography and Related to Sciatic Symptoms
Authors: Fagerlund M. K. J. , Thelander U. , Friberg S.
Published: June 2015

The change in the relative size of lumbar disc hernias and its relation to sciatic symptoms was investigated in 30 consecutive patients after conservative treatment of CT verified lumbar disc herniations. CT and clinical examination were performed before the start of therapy (CT1), as well as 3 months (CT2) and 24 months (CT3) after institution of treatment. In each patient the size of the lumbar disc herniation in relation to the size of the spinal canal was measured on identical CT slices and expressed as an index. The disc herniation index decreased markedly from CT1 to CT2 (p < 0.001). Between CT2 and CT3 the reduction of the hernias was less pronounced and not significant for hernias located centrally but still significant for intermediate (p = 0.03) and lateral (p = 0.04) hernias. The degree of sciatic symptoms also decreased markedly between CT1 and CT2 (p = 0.001) while no further improvement occurred from CT2 to CT3. There was a significant positive correlation between the improvement from sciatic pain and the reduction in the size of the individual hernia (CT1–CT2 p = 0.02, CT2–CT3 p < 0.001). Thus, the disc herniation index provided a method to study the anatomic effect of conservative treatment as well as a method to evaluate sciatic symptoms in relation to anatomic changes.
Gallbladder Volume and Contraction Measured by Sum-of-Cylinders Method Compared with Ellipsoid and Area-Length Methods
Authors: Stolk M. F. J. , van Erpecum K. J. , van Berge Henegouwen G. P. , Kesselring O. F. H. W. , Hopman W. P. M.
Published: June 2015

Gallbladder volume, determined by ultrasonography (US) using the sum-of-cylinders (SOC) method, is tedious and time-consuming. We therefore examined whether ellipsoid (ELL) or area-length (A-L) methods, which are easier to perform, could reliably replace the SOC method. Fasting gallbladder volume and emptying were determined according to these 3 methods in 20 normal subjects and 20 gallstone patients. Excellent correlations were found but the ELL method yielded significantly larger mean volumes and the A-L method revealed significantly smaller volumes than the SOC method. Analysis of differences between methods revealed a considerable lack of consistency. Volumes according to the ELL method were 35 percent larger to 46 percent smaller for normal subjects and 34 percent larger to 41 percent smaller for gallstone patients than volumes according to the SOC method. Volumes according to the A-L method were 35 percent larger to 15 percent smaller for normal subjects and 51 percent larger to 17 percent smaller for gallstone patients. Maximal decrement of gallbladder volume in ml and in percentage according to the 3 different methods did not differ. Regardless of the method used, both fasting and minimal gallbladder volumes were significantly larger in gallstone patients than in normal subjects, whereas maximal decrement of gallbladder volume in ml and percentage was not different. The present study indicates that the SOC method remains the method of choice for US determination of gallbladder volume for scientific purposes.
Assessment of Bone Mineral Content in the Internal Bone Volume
Authors: Høiseth A. , Alho A. , Husby T.
Published: June 2015

A method for assessing values related to bone density and mass is described. Mean attenuation and pixel area are measured in pixels selected on the basis of CT units. The method is to a large extent computerized and not dependent on manual positioning or outlining of a region of interest. Because it is not dependent on a comparatively large volume of homogeneous bone it can be used to make assessments even in very heterogeneous bones including cortical bone. The method is adaptable for measurement in all parts of the skeleton and values related to both bone density (DRV) and bone mass (MRV) are derived. The measurements in the femoral condyles were shown to have a precision of approximately 0.25 to 0.30 Z-score units (standard deviation of the measurements expressed in Z-score units). The agreement between chemically analyzed calcium density (weight of calcium per volume) and DRV was little less than 0.50 Z-scores and 0.30 Z-scores for the chemically determined calcium mass and the MRV. The agreement with mechanical bone strength was 0.78 Z-scores for DRV and 0.64 for the MRV. Altering scan parameters or measuring approaches gave systematic differences in the measurements. There were, however, good linear correlations between the measurements which show that these different measuring approaches essentially gave identical measurements.
Dynamic Imaging of Pulmonary Ventilation
Authors: Kiuru A. , Svedström E. , Kuuluvainen I.
Published: June 2015

A new fluoroscopic imaging device consisting of an AT-micro-computer and a digital image memory unit has been used in experimental and clinical ventilation studies during a 2-year period. Digital images with 256 shades of gray were collected during one to 3 ventilation cycles at the rate of 6 to 25 images/s and stored on an optical laser disc. Both subtracted time interval difference (TID-) images and images relative, for example, to the mean image of the cycle (REL-images) were produced. The series of images could also be evaluated dynamically using animation sequences or analyzed using region of interest calculations. The method gave dynamic information with adequate spatial resolution and was easy to use in clinical practice. The radiation dose was kept low due to the high kilovoltage and heavy beam filtration technique. In experimental studies the software enabled flexible measurements of physiological pulmonary parameters.
Comparison of Iopromide versus Iohexol in Aortobifemoral Arteriography
Authors: Ohlsén H. , Albrechtsson U. , Billström Å. , Calissendorff B. , Gustavsson S. , Jensen R. , Johnsson K. , Nyberg P. , Strindberg L.
Published: June 2015

A double-blind randomized, clinical trial was conducted in 9 hospitals comparing the use of non-ionic contrast media (CM) iopromide 300 (Ultravist) and iohexol 300 (Omnipaque) during peripheral arteriography in a total of 446 patients. After premedication with morphine-scopolamine each patient was given two consecutive injections of 50 ml CM at a rate of 12 ml/s above the aortic bifurcation. Both CM were well tolerated. There were no differences between the two substances as far as general tolerance, pulse rate, blood pressure, sensation of heat or pain after CM injection were concerned.
Percutaneous Duodenostomy — Alternative Route for Enteral Nutrition
Authors: Cwikiel W.
Published: June 2015

Percutaneous translumbar duodenostomy for enteral feeding was performed in one patient with nutritional difficulties. No complication was encountered. The procedure can be an alternative to percutaneous gastrostomy and jejunostomy for enteral feeding in special situations.
Percutaneous Nephrolithotomy through an Intercostal Approach
Authors: Narasimham D. L. , Jacobsson B. , Vijayan P. , Bhuyan B. C. , Nyman U. , Holmquist B.
Published: June 2015

During a 5-year period percutaneous nephrolithotripsy through an intercostal space was performed in 56 of 231 procedures. Minimal thoracic complications were seen in 3 of 53 patients with 11th intercostal space tracts into a lower, middle, or upper pole calyx. A working sheath and a pyelostomy drainage catheter were used in all these cases. Hydro- and pneumothorax requiring treatment occurred in 2 of 3 patients with a 10th intercostal space approach into an upper pole calyx combined with improper use of the working sheath and/or the pyelostomy catheter. Review of the literature also indicates that an intercostal approach appears safe when performed via the 11th intercostal space into a lower or middle pole calyx. Thoracic complications occurred when punctures were made towards an upper pole calyx or above the 11th rib. The complications may be limited by identifying the posterior inferior lung border by fluoroscopy during puncture, and performing it under general anesthesia with controlled breath-holding. The use of a working sheath to seal the pleural opening during the procedure and an efficient pyelostomy drainage catheter to allow free drainage of urine and to tamponade the tract postoperatively are also recommended.
Clinical Value of Pet with 18F-Fluorodeoxyglucose and L-Methyl-11C-Methionine for Diagnosis of Recurrent Brain Tumor and Radiation Injury
Authors: Ogawa T. , Kanno I. , Shishido F. , Inugami A. , Higano S. , Fujita H. , Murakami M. , Uemura K. , Yasui N. , Mineura K. , Kowada M.
Published: June 2015

We studied 15 patients clinically suspected to have recurrent brain tumor or radiation injury, using positron emission tomography (PET) with 18F-fluorodeoxyglucose (18FDG) and L-methyl-11C-methionine (11C-Met). PET with 11C-Met (Met-PET) clearly delineated the extent of recurrent brain tumor as focal areas of increased accumulation of 11C-Met, and was useful for early detection of recurrent brain tumor. PET with 18FDG (FDG-PET) showed focal 18FDG-hypermetabolism in one patient with malignant transformation of low grade glioma, and demonstrated its usefulness for evaluation of malignant transformation. 18FDG-hypometabolism was observed in all patients with radiation injury, but was also found in one patient with recurrent malignant brain tumor. 11C-Met uptake in 3 patients with radiation injury was similar to that of the normal cortical tissue. FDG-PET can be used to initially exclude recurrent brain tumor which is seen as 18FDG-hypermetabolism. The combined use of Met-PET in addition to FDG-PET can improve the accuracy of differentiation of recurrent brain tumor with 18FDG-hypometabolism from radiation injury.
Evaluation of Heart Size and Pulmonary Vasculature
Authors: Manninen H. , Remes J. , Partanen K. , Tynkkynen P. , Mykkänen L. , Laakso M. , Soimakallio S. , Pyörälä K.
Published: June 2015

Inter- and intraobserver variation and diagnostic accuracy in estimation of heart size and pulmonary vasculature were evaluated for conventional film-screen technique and image intensifier photofluorography. Interpretation of 218 p.a. and lateral chest films by both imaging techniques was performed independently by 4 readers. Heart size relative to body surface area measured from the plain chest films was used as the reference in cardiac size determination. Overall diagnostic accuracies of conventional radiography and image intensifier photofluorography for cardiomegaly were close to each other, 0.70 vs 0.68, respectively. Specificity of film-screen radiography was better than that of photofluorography (0.92 vs 0.84, p <0.05). Interobserver agreement was poor both in assessment of the heart size and pulmonary vasculature (range of kappa coefficients 0.18–0.59) while the intraobserver consistency (kappa coefficients 0.60–0.85) was good to excellent. The results suggest a limited usefulness of visual assessment of heart size and pulmonary vasculature in chest roentgenographs.
Superparamagnetic Particles as Oral Contrast Medium in MR Imaging of Malignant Lymphoma
Authors: Lönnemark M. , Hemmingsson A. , Bach-Gansmo T. , Hagberg H. , Magnusson A. , Gundersen H. G. , Nyman R.
Published: June 2015

Non-biodegradable superparamagnetic particles, in plain and viscous aqueous suspensions, were used as an oral contrast medium in 34 patients with known or suspected malignant lymphoma. The contrast effect, the occurrence of artifacts, and the distribution were evaluated in the plain and the viscous aqueous suspensions, and the diagnostic information received from abdominal MR examinations performed without bowel contrast medium was compared with that of post-contrast examinations. Magnetic particles in the concentration of 0.5 g/l displayed a good contrast effect at 0.5 T, and helped in differentiating the intestine from adjacent tissues, resulting in increased diagnostic information in abdominal MR imaging. In the patients given the viscous aqueous suspension the occurrence of artifacts caused by the magnetic particles decreased considerably, and the distribution was homogeneous and improved compared with that in patients given the plain aqueous suspension.
Effect of Chemotherapy and Radiotherapy on Squamous Cell Carcinoma of the Esophagus
Authors: Samuelsson L. , Albertsson M. , Hambraeus G. , Thorvinger B.
Published: June 2015

In a series of 82 patients with epidermoid carcinoma of the esophagus, 68 were available for review of barium examinations and 44 for review of CT examinations showing the effect of preoperative treatment. After 3 courses of chemotherapy — Cisplatinum and 5-fluorouracil, and 24 Gy of presurgical irradiation — Over a total of 10.5 weeks, the patients were ready for surgery. The results of the presurgical radiographic examinations were compared with the findings of histopathologic studies after surgery. Where both the CT and the barium examination showed a complete response, none of the patients had remaining macroscopic cancer. When healing with stenosis was included, CT and barium studies in combination were necessary to exclude a residual macroscopic tumor. Therefore, a combination of barium esophagography and CT is recommended to estimate the preoperative effect of treatment.
CT Five Years after Myelographic Diagnosis of Lumbar Disk Herniation
Authors: Hurme M. , Katevuo K. , Nykvist F. , Aalto T. , Alaranta H. , Einola S.
Published: June 2015

Fifty-seven patients were examined with CT 5 years after primary myelography for disabling sciatica and suspected herniated lumbar disk. Forty were in an operated group, 22 with good and 18 with poor results evaluated by occupational handicap (21) 5 years after surgery. Seventeen patients had myelography indicating disk herniation, but were treated conservatively, 9 with good and 8 with poor result. Various spinal dimensions measured at CT did not correlate with outcome. Operated patients had narrower canals than others, and male canals were broader than those in females. Increased amount of scar tissue at L4 level correlated with poor result (p = 0.008). Operated patients with poor result had more advanced lateral stenosis than those treated conservatively (p < 0.001). Patients with good result after operation had more degeneration observed on CT of erector spinae muscle than those treated conservatively with good outcome. Only 9% of operated patients did not have muscle degeneration. A tendency for more frequent recurrent disk herniations could be seen for conservatively treated patients. The narrowing of the spinal canal 5 years after operation did not correlate with the 5-year outcome.
Primary Bone Tumors
Authors: Golfieri R. , Baddeley H. , Pringle J. S. , Leung A. W. L. , Greco A. , Souhami R. , Kemp H.
Published: June 2015

Eighty-three MR studies for primary bone tumors, performed with both spin echo and short time inversion recovery (STIR) sequences, were reviewed. Twenty-six patients underwent surgery within 10 days after MR imaging. Specimens were cut and directly compared with MR images. In the remainder, pathologic slides were compared in order to obtain a better understanding of MR pattern. All MR images were examined with a traditional morphologic approach and, upon comparison with surgical macroslides and with pathology samples, some MR distinctive patterns were identified: the bulky appearance of osteosarcoma surrounded by muscle edema, the multilobular high signal intensity (SI) chondroid lesions, the subtle infiltration of Ewing's sarcoma, rarely accompanied by muscle edema and prone to MR underestimation, the well defined “multiple shells” pattern of giant cell tumor, and the ill defined “storiform” appearance of malignant fibrous histocytoma are all typical MR features strictly corresponding to pathologic findings. The chondroid origin tumors may be identified based on the lobular high SI pattern whereas a benign fibrous lesion was the only one in this series to be distinguished relying on the SI. Peritumoral soft tissue edema was found by the STIR sequence only in malignant tumors (69%) of this series, and particularly in osteosarcoma (96%), chondrosarcoma (83%), and giant cell tumor (100%): this associate finding may further contribute to the diagnosis.
Laser Therapy and Insertion of Wallstents for Palliative Treatment of Esophageal Carcinoma
Authors: Lindberg C.-G. , Cwikiel W. , Ivancev K. , Lundstedt C. , Stridbeck H. , Tranberg K.-G.
Published: June 2015

A combination of endoscopic laser therapy (ELT) and insertion of Wallstents is a good alternative therapy for palliation of esophageal carcinoma and was performed in 12 patients. The method allows repeated laser therapy and, if necessary, supplementary insertion of stents to maintain the patients' ability to swallow during their remaining lifespan.
Identifying High-Risk Patients for Percutaneous Transluminal Angioplasty of Subclavian and Innominate Arteries
Authors: Sharma S. , Kaul U. , Rajani M.
Published: June 2015

We have performed percutaneous transluminal angioplasty for 7 subclavian (4 stenoses, 3 occlusions) and 2 innominate (both stenoses) artery obstructions in 7 patients by percutaneous femoral approach in all, and ipsilateral percutaneous brachial puncture in 2, patients. Initial success was obtained in 4 of the 6 stenoses (2 subclavian and both innominate) but in none of the 3 occlusions. Three of the 4 subclavian stenoses were located proximal to the vertebral artery origin and antegrade vertebral flow without subclavian steal was present in 2 of these lesions. Three patients had complications during the procedure. Two of them developed symptoms and signs of cerebral embolization. Both had shown antegrade vertebral flow and no evidence of subclavian steal in the initial angiogram. The third patient developed angina pectoris. The follow-up period ranged from 4 to 18 months (mean 10.8 months) and no re-stenosis was detected. Angioplasty appears suitable for management of a selected group of patients with nonocclusive lesions in whom subclavian steal phenomenon is evident in the initial diagnostic angiogram. The patients with antegrade vertebral flow are at a high risk of cerebral embolization during angioplasty.
Efficacy of Inverted Digital Luminescence Radiography in Evaluating Chest Neoplasms
Authors: Kehler M. , Albrechtsson U. , Andrésdóttir A. , Hochbergs P. , Lárusdóttir H. , Lundin A. , Lönntoft M.
Published: June 2015

Inverted (positive) digital chest radiographs of patients with lung tumors were compared with commonly used (negative) digital images, consisting of one simulated normal and one contrast enhanced image. The first part of the material consisted of 80 patients of whom 40 had tumors and 40 were normal. Five radiologists with different experience reviewed the examinations. From their answers, ROC curves were constructed. The second part of the material consisted of 100 chest phantom examinations with a simulated tumor in the mediastinum (45 examinations) and/or the left lung (46 examinations). In 31 exposures there was no abnormality. These were reviewed by 3 observers and performed as an ROC study as well. There was no statistical difference between the different types of images or between the observers in the 2 studies.
Patency after Iliac and Femoro-Popliteal Angioplasty
Authors: Thorvinger B. , Norgren L. , Albrechtsson U.
Published: June 2015

Twenty-five patients with clinical relapse after previous successful angioplasty of iliac or femoro-popliteal arteries were evaluated with repeat angiography. The angiographic patency was 80% despite the clinical symptoms. The discrepancy between the angiographic appearance and the clinical findings was explained by the progress of the general arteriosclerotic vascular disease. Such progression is more important regarding late prognosis than the result of the angioplasty per se.
Lithotripsy of Urinary Bladder Stones with a Mechanical Lithotriptor Inserted through a Narrow Introducer
Authors: Lindberg C.-G. , Henrikson H. , Lindstedt E. , Lundstedt C. , Stridbeck H.
Published: June 2015

Mechanical lithotripsy of urinary bladder stones was performed with the RotoLith lithotriptor in 8 pigs with implanted human stones or artificial stones after open cystotomy. The effect of the treatment on the urinary bladder was investigated macro- and microscopically immediately after the lithotripsy in 4 animals and 4 weeks after the lithotripsy in the other 4 animals. The stones were fragmented into very small pieces which would have been possible to pass with the urine. The histopathologic examination immediately after the procedure showed slight mucosal edema, patches of erosions in the mucosa, and minor submucosal bleeding. Microscopic examination of the bladders removed 4 weeks after lithotripsy showed slight chronic inflammation. The experimental results have encouraged us to plan to use this lithotripsy procedure in selected patients with bladder stones.
Relation between Lightscanning and the Histologic and Mammographic Appearance of Malignant Breast Tumors
Authors: Jarlman O. , Balldin G. , Andersson I. , Löfgren M. , Larsson A. S. , Linell F.
Published: June 2015

The relation between real-time transillumination (lightscanning) and the histologic appearance of 243 breast carcinomas was evaluated. Lightscanning mainly failed in identifying ductal and lobular carcinomas in situ. The result of lightscanning was also poor regarding small, invasive carcinomas. The absorption patterns in elastosis and scar tissue associated with carcinoma played no important role in the ability of lightscanning to identify a cancer. The relation between the lightscanning and mammographic appearance of 85 breast cancers from the same material was also evaluated. Lightscanning performed poorly in identifying tumors characterized by calcifications as compared to tumors with other mammographic appearances. However, the difference was not significant.
Diagnostic Accuracy of Lightscanning and Mammography in Women with Dense Breasts
Authors: Jarlman O. , Andersson I. , Balldin G. , Larsson S. A.
Published: June 2015

The diagnostic accuracy of lightscanning and mammography in 610 breasts with mammographically dense parenchymal patterns was investigated. Lightscanning identified 31 out of 36 cancers and mammography 32. Lightscanning and mammography were in agreement in 28 cases of cancer. One non-invasive lobular carcinoma was not identified by either modality. Four cancers were not correctly identified with lightscanning alone and 3 cancers with mammography alone. Of the 574 breasts without cancer, lightscanning falsely denoted 101 (18%) as possibly being cancerous (false-positives). The corresponding figure for mammography was 25 (4%). Thus, lightscanning, as performed in this study, has the same sensitivity as mammography in detecting cancer in mammographically dense breasts. However, its usefulness is limited by a low predictive value of a positive test (high rate of false-positives).
Spinal Gas Collection Demonstrated at CT
Authors: Hjarbæk J. , Kristensen P. W. , Hauge P.
Published: June 2015

In 234 consecutive CT examinations of the lumbar spine, gas collection was observed in 4 cases with disk herniation, and in 6 cases of disk protrusion. In 3 cases free gas was found in the epidural space, and one patient presented an intraspinal gas-filled “bleb”. Gas collection in intervertebral disk spaces and facet joints was found in a total of 60 patients. The CT findings and surgical results were compared to determine whether gas collection contributes to clinical symptoms. In most cases the presence of gas was not clinically important, but in one patient it presented as a spinal mass, causing pain and radiculopathy.
Digital Luminescence Radiography Using a Chest Phantom
Authors: Kehler M. , Albrechtsson U. , Arnadóttir E. , Ebbesen A. , Hochbergs P. , Lundin A. , Lyttkens K. , Kheddache K. , Månsson L. G. , Angelhed J.-E.
Published: June 2015

Ninety-eight digital radiographs of a chest phantom with simulated tumors in the mediastinum and left lung and a pneumothorax-simulation in the right hemithorax were compared with the corresponding examinations saved on optical disk and viewed on a 1 000-line monitor. The examinations were reviewed by 7 radiologists with different experience, and receiver operating characteristic (ROC) curves were constructed. There was no significant difference between the hard-copy and the monitor results. A significant interobserver difference was seen only with the low attenuating 6 mm “tumor” and then only between the observer with the highest and the one with the lowest scores.
CT in Pancreatic Involvement of Non-Hodgkin Lymphoma
Authors: Prayer L. , Schurawitzki H. , Mallek R. , Mostbeck G.
Published: June 2015

In an attempt to evaluate characteristic CT features of primary pancreatic involvement in non-Hodgkin lymphoma (NHL), scans of 10 patients were reviewed retrospectively and compared to 50 patients with histologically proved different neoplasms of the pancreas. Setting the correct diagnosis of NHL would be essential for planning of treatment and prognosis. CT findings of NHL were characteristic but not specific. Nevertheless, the presence of a homogeneous pancreatic mass with a diameter of 7 cm or more, infiltrating surrounding tissue accompanied by retroperitoneal and/or mesenteric lymphadenopathy strongly suggests NHL. CT-guided needle biopsy can help to establish the diagnosis of pancreatic NHL.
Extracorporeal Shockwave Lithotripsy for a Giant Calcified Gallbladder Stone
Authors: Herbetko J. , Burhenne H. J.
Published: June 2015

Extracorporeal shockwave lithotripsy to gallstones is an alternative treatment to surgery in the high-risk patient with acute cholecystitis. We describe the successful fragmentation of a giant gallbladder stone and the subsequent removal of fragments through a cholecystostomy tract. Even though the treatment required 22 days in hospital and multiple procedures, these were all considered low risk in this patient with severe chronic obstructive airway disease.
Thallium-Technetium Subtraction Scintigraphy of Enlarged Parathyroid Glands after Calcitonin Stimulation of Parathyroid Hormone Secretion
Authors: Bergenfelz A. , Tennvall J. , Ahrén B.
Published: June 2015

To improve the sensitivity of thallium-technetium subtraction scintigraphy for preoperative localization procedure of enlarged parathyroid glands in primary hyperparathyroidism, we administered calcitonin intramuscularly 4 hours before the scintigraphy in 14 consecutive patients. Injection of calcitonin reduced plasma levels of ionized calcium from 1.47 ± 0.10 mmol/l to 1.41 ± 0.09 mmol/l (p < 0.01). Concomitantly, serum levels of intact parathyroid hormone increased from 6.4 ± 2.5 pmol/l to 7.9 ± 2.6 pmol/l (p < 0.001). The scintigram after calcitonin injection visualized 11 adenomas (sensitivity 78%) compared to only 9 (sensitivity 64%) in conventional scintigrams. In addition, 5 of the adenomas were more distinctly imaged in the scintigram after calcitonin injection, whereas in only one patient was the conventional scintigram better. Thus, the calcitonin injection improved the scintigram in 7 cases and was inferior in only one case (p = 0.031). We conclude that stimulation of parathyroid hormone secretion with calcitonin results in a better preoperative localization of enlarged parathyroid glands in primary hyperparathyroidism.
Experimental Transjugular Portacaval Shunt
Authors: Cwikiel W. , Stridbeck H.
Published: June 2015

A transjugular portacaval intrahepatic stented shunt was created in 16 pigs without induced portal hypertension. A fine needle (OD 0.7 mm) was used for the transjugular puncture of the portal vein. The puncture was done directly from the inferior vena cava in 5 cases and from the right liver vein in 11 cases. The puncture tract was dilated and subsequently supported by a Strecker stent. The stented shunt was patent in all cases immediately after the stent placement, but was obstructed by fibrous tissue in 7 of 8 cases reexamined by angiography and autopsy after 4 weeks. Complications seem to be related to the choice of the puncture site, with fewer complications when the puncture was done via the right hepatic vein.
Mr Imaging of Pituitary Macroadenomas before and after Transsphenoidal Surgery
Authors: Hald J. K. , Nakstad P. H. , Kollevold T. , Bakke S. J. , Skalpe I. O.
Published: June 2015

MR findings before and after transsphenoidal surgery were evaluated in 6 cases. T1-weighted (TR/TE 600/20) sagittal and coronal images with 2 or 4 acquisitions were obtained, using 3-mm slice thickness and 0.3-mm interslice gaps. Of 18 MR examinations, 13 included coronal i.v. contrast medium enhanced images. Image quality, sinus cavernosus invasion, identification of normal pituitary tissue and tumor size were examined. All MR studies clearly demonstrated the macroadenomas whether 2 or 4 acquisitions were used, and whether i.v. contrast medium was administered or not. Surgically confirmed sinus cavernosus infiltration was seen in 4 patients. The pituitary stalk was identified separate from the tumor in 2 patients, and the gland in one. There was reduction in tumor size over time, indicating that final radiologic assessment after transsphenoidal surgery is best performed 4 to 6 months postoperatively. It should not be necessary to routinely include i.v. contrast medium injection in the postoperative evaluation of macroadenomas.
Hydatid Disease of the Spleen
Authors: von Sinner W. N. , Stridbeck H.
Published: June 2015

Seven patients with hydatid disease of the spleen were examined by radiography, ultrasound, CT, and in one case MR imaging. The observations were confirmed by patho-anatomic findings except in 2 patients where high indirect hemagglutination tests confirmed the diagnosis. In one patient primary, and in the others secondary, echinococcosis of the spleen was assumed to be present. Secondary hydatid disease of the spleen was caused by rupture of liver cysts with abdominal and pelvic dissemination. Ultrasound and CT findings of the cysts and cystic calcifications are described. In one patient MR imaging indicated prolapse of a splenic hydatid cyst into the left hemithorax, confirmed by patho-anatomic examination.
Bone Marrow Extension and Pelvic Bone Marrow Activity in Alcoholic Liver Disease
Authors: Rudberg U.
Published: June 2015

Red bone marrow extension and increased central bone marrow activity were found in 21 patients with alcoholic liver disease investigated with scintigraphy of the reticuloendothelial system. The patients had no concurrent disease known to alter red bone marrow distribution. The bone marrow extension and the increased pelvic bone marrow activity may be explained as being secondary to a decreased radiocolloid uptake in the liver and could thus be a sign of decreased reticuloendothelial capacity.
Intravascular Ultrasonographic Appearance of Angiographically Normal Arteries Related to Age and the Occurrence of Vascular Disease
Authors: Bolz K.-D. , Tveit K. , Nordby A. , Myhre H. O. , Gåserud K. , Østrem G. , Ommedal S. , Angelsen B. A. J.
Published: June 2015

In 22 individuals (mean age 52 years) the ultrasonographic images of arteries defined as normal by arteriography were studied and related to the age and medical history of the patients. The series was divided into 2 groups: patients with clinical manifestation of atherosclerosis and patients without a history of arterial disease. The study included 6 young patients (mean age 14 years) referred for angiographic documentation of abolished intracranial circulation. A typical 3-layered appearance of the arterial wall was found in young healthy individuals as well as in adult and elderly subjects. There was no difference in the ultrasonograhic appearance of muscular and elastic arteries. In patients with extensive obstructive atherosclerosis affecting other parts of the arterial tree, a segment of the iliac artery can have the same appearance as seen in young healthy individuals. There are indications that severe hypertension can result in a thickening of the middle low-echogenic layer of the arterial wall. In patients with chronic renal insufficiency, small calcifications in the middle layer were a typical finding.
Mr Relaxation Times and Fiber Type Predominance of the Psoas and Multifidus Muscle
Authors: Parkkola R. , Alanen A. , Kalimo H. , Lillsunde I. , Komu M. , Kormano M.
Published: June 2015

MR relaxation times, fiber composition, nonmyofiber space, water content, and fat content of human psoas and multifidus muscle samples of 10 male cadavers were studied in vitro. The T1 and T2 relaxation times of multifidus muscle were significantly longer than those of the psoas muscle. On average, type 1 fibers (slow fibers with a small cross-sectional diameter) predominated in both muscles. There was no correlation between the relative mass of type 1 or 2 fibers (fast fibers with a large cross-sectional diameter) or nonmyofiber space and the relaxation times. The quantity of fat in the muscle did not correlate with the relaxation times either.
Palliative Treatment of Hepatocellular Carcinoma with Transcatheter Arterial Embolization
Authors: Savastano S. , Feltrin G. P. , Neri D. , da Pian P. , Chiesura-Corona M. , Roman E. , Battaglia G. , Gerunda G. , Lise M. , Miotto D.
Published: June 2015

Thirty-three consecutive patients with previously untreated hepatocellular carcinoma (HCC) and 6 patients with recurrent HCC were treated with transcatheter arterial embolization (TAE). The patients were not eligible for surgical resection or percutaneous ethanol injection. TAE was performed with Lipiodol Ultra-Fluid, epidoxorubicin and Gelfoam, with a mean of 1.7 treatments per patient. CT was performed 15 days after TAE. The mean cumulative survival was 14.2 months in patients with previously untreated HCC. The survival of patients stages Okuda I and II did not differ significantly (p > 0.05); tumor size did not affect survival (p > 0.05). Two patients with recurrent HCC died 7.0 and 9.3 months after the diagnosis of tumor recurrence; the remaining 4 patients are still alive with a maximum follow-up of 22.5 months from the diagnosis of HCC recurrence. Ten complications occurred in 8 patients, and were controlled by medical therapy. Eleven patients died during the study; no death was related to TAE. The series was not randomized, but comparison with the natural history of HCC suggests that TAE is effective as palliative treatment of advanced or recurrent HCC.