bluuebunny/crossref_metadata_2025 huggingface dataset:
Width of the Medial Tibiotalar Joint
Authors: Fiirgaard B. , Iversen J. K. , de Carvalho A.
Published: January 2010

Purpose: To determine the extent to which the width of the space in the medial tibiotalar joint depends on plantar flexion.

Material and Methods: Thirty healthy volunteers were studied by means of a.p. roentgenograms of the left ankle both in a neutral position and in plantar flexion.

Results: The medial joint space showed significant widening (average 0.65 mm) between the neutral position and plantar flexion.

Conclusion: When ankle joint injuries are studied on radiographs, the position of the foot must be taken into consideration.
Dynamic Scintigraphy of Bone and Bone Marrow in Multiple Myeloma Patients with Bone-Marrow Transplants
Authors: Ågren B. , Rudberg U. , Aspelin P.
Published: January 2010

Purpose: To determine whether dynamic registration at bone and bone-marrow scintigraphy produces additional information compared to subsequent static registrations of bone-marrow transplants in multiple myeloma patients.

Material and Methods: In a prospective study, 8 dynamic bone and 6 dynamic bone-marrow scintigraphies were performed in 10 patients. The dynamic scintigraphies were compared with conventional radiography, MR images, and static scintigraphies of bone and bone marrow.

Results: No additional information was revealed by the dynamic registration method; on the contrary, 4 of the 8 known lesions were not discerned at dynamic registration. An incidental observation was that the time-activity curves of both radiopharmaceuticals had a specific pattern.

Conclusion: Dynamic registration at bone and bone-marrow scintigraphy was not useful for detecting disease in multiple myeloma lesions.
Dual-Energy X-Ray Absorptiometric Densitometry in Osteoarthritis of the Hip
Authors: Preidler K. W. , White L. S. , Tashkin J. , McDaniel C. O. , Brossmann J. , Andresen R. , Sartoris D.
Published: January 2010

Purpose: The aim of this study was to evaluate the influence of buttressing on bone densitometry measurements in the femoral neck, in Ward's triangle, and in the greater trochanter. In addition, we attempted to establish the length of the femoral axis (FAL) and the true length of the femoral neck (FNL) as potential correlates with osteoarthritis (OA) or with buttressing.

Material and Methods: Our study comprised 101 hips in 68 adult patients. Conventional radiographs of the hip joints were obtained in order to assess the presence and extent of OA by means of the 6-step grading system introduced in 1990 by Croft et al., and in order to measure the cortical thickness at the medial aspect of the femoral neck. In addition, FAL and FNL were measured. All patients underwent dual energy x-ray absorptiometry so that bone density could be assessed in the femoral neck, in Ward's triangle, and in the greater trochanter. The Spearman rank correlation was used to compare the measurements.

Results: Statistical analysis showed a significant positive correlation between cortical thickness and bone density in the femoral neck and in Ward's triangle. No correlation was found between cortical thickness and bone density in the greater trochanter, nor between cortical thickness and OA, FNL, and FAL, nor between OA and bone density, FNL, and FAL.

Conclusion: Buttressing influenced our bone density measurements in the femoral neck and in Ward's triangle. It did not affect the region of the greater trochanter which may therefore be the best region of interest for a long-term follow-up of bone density in patients with OA.
Blunt Pancreatic Trauma
Authors: Procacci C. , Graziani R. , Bicego E. , Mainardi P. , Bassi C. , Andreis I. A. Bergamo , Valdo M. , Guarise A. , Girelli M.
Published: January 2010

Purpose: To define the evolution patterns of blunt pancreatic trauma, and to point out the CT features most significant for the diagnosis.

Material and Methods: Ten cases of pancreatic trauma, observed over a period of about 10 years, were analyzed in retrospect. The cases were divided into 3 groups according to the time that had elapsed between trauma and first CT: early phase (within 72 h: n=3/10); late phase (after 10 days: n=3/10); and following pancreatic drainage (n=4/10).

Results: In the early phase, one case showed a blood collection surrounding the pancreatic head and duodenum, and displacing the mesenteric vessels to the left. In the 2 other cases it was possible to demonstrate a tear in the pancreas at the neck, perpendicular to the main pancreatic axis. In the late phase in all 3 cases, one cystic lesion was present at the site of the tear, either surrounding the gland or embedded - more or less deeply - within the parenchyma. One of the lesions subsided spontaneously; the 2 others required surgery. In the postoperative phase, an external fistula was demonstrated in 2 cases following percutaneous drainage of pancreatic cysts; the fistula was fed by a cystic lesion in the pancreatic neck. In the 2 other cases a pseudocyst developed.

Conclusion: Early demonstration of a parenchymal tear was difficult. At a later stage the diagnosis was easier owing to the demonstration of cystic lesions within the parenchyma at the site of the tear. The surgical drainage of this lesion does not usually lead to healing since an external fistula or a pseudocyst may develop.
Transjugular Intrahepatic Portosystemic Shunt (Tips)
Authors: Siegerstetter V. , Krause T. , Rössle M. , Haag K. , Ochs A. , Hauenstein K.-H. , Moser H. E.
Published: January 2010

Purpose: To compare the thrombogenicity and patency of the Palmaz stent and the Wallstent, and to evaluate the effect of periprocedural heparin therapy in cirrhotic patients with maintained coagulation capacity who receive a transjugular intrahepatic portosystemic shunt (TIPS).

Material and Methods: Twenty-four patients were randomized into 4 groups of 6 patients. Each received a Palmaz-stent or Wallstent TIPS with or without periprocedural heparin therapy. The groups receiving periprocedural heparin were given 24 U/ kg b.w. just before stent placement, followed by 24 h therapeutic i.v. heparin. After 24 hours, all patients received i.v. heparin for 1 week followed by subcutaneous treatment with low-molecular-weight heparin (0.3 ml/day) for another 4 weeks. Stent thrombogenicity was determined scintigraphically after i.v. injection of 120-290 mBq of 99mTc-labeled platelets at the time of stent placement and expressed as the stent/heart ratio. Shunt patency was assessed by duplex sonography and confirmed radiologically.

Results: The aggregation ratio was highest 90 min after stent implantation. Wall-stents showed a significantly higher ratio than Palmaz stents. Heparin reduced the ratio in patients with a Wallstent (-41%) but had no effect on Palmaz stents. Patients with a Wallstent without heparin had a higher rate of early shunt insufficiency (66.6%) than the other patients (0-16.6%). Primary assisted long-term patency was similar in the 4 groups.

Conclusion: Wallstents were more thrombogenic than Palmaz stents and gave a significantly higher risk of early shunt insufficiency in cirrhotic patients with maintained coagulation capacity. Periprocedural heparin was effective in the prevention of shunt insufficiency and is therefore indicated in such patients.
Optimal MR Protocol for Hepatic Hemangiomas
Authors: Kim T. K. , Choi B. I. , Han J. K. , Jang H.-J. , Han M. C.
Published: January 2010

Purpose: To compare conventional spin-echo (SE) sequences with T2-weighted turbo SE and serial gadolinium-enhanced T1-weighted FLASH sequences in the detection and characterization of hepatic hemangiomas, and to describe the enhancement characteristics of the lesions on dynamic MR imaging.

Material and Methods: Forty-two patients with 66 hemangiomas were studied at 1.0 T or 1.5 T by using conventional SE sequences (T1-weighted, T2-weighted, and heavily T2-weighted), T2-weighted turbo SE sequences, and breath-hold T1-weighted FLASH sequences acquired before, immediately after, and 1, 2, 3, 5, and 10 min after injection of a bolus of gadopentetate dimeglumine. Images were quantitatively analyzed for lesion-to-liver contrast-to-noise (C/N) ratios, and qualitatively analyzed for lesion conspicuity. The enhancement pattern and the rapidity of enhancement were analyzed in small (<15 mm), medium (15-39 mm), and large (>39 mm) hemangiomas.

Results: In T2-weighted images, T2-weighted turbo SE and heavily T2-weighted SE images had higher C/N ratios than T2-weighted SE images (p=0.003). Lesion conspicuity was not significantly different in these 3 sequences (p=0.307). In T1-weighted images, T1-weighted FLASH images had higher C/N (p<0.001) and also better lesion conspicuity (p<0.001) than T1-weighted SE images. Immediate uniform enhancement was seen in 43% of small hemangiomas (9 of 21 lesions), and persistent central hypo-intensity was seen in 73% of large hemangiomas (11 of 15 lesions). Rapid enhancement was seen in 62% of small hemangiomas (13 of 21 lesions) and in 31% of medium or large hemangiomas (14 of 45 lesions).

Conclusion: Further clinical study is needed for evaluating the differential diagnostic advantages of turbo SE T2-weighted imaging compared to the calculation of T2-values by means of a SE T2-weighted sequence. However, the results of the present study suggest that T2-weighted turbo SE imaging and precontrast and serial gadolinium-enhanced FLASH imaging have the potential to replace conventional SE imaging in the evaluation of hepatic hemangiomas.
Defaeco-Peritoneography in the Diagnosis of Rectal Intussusception and Rectal Prolapse
Authors: Bremmer S. , Udén R. , Mellgren A.
Published: January 2010

Purpose: The aim of the present study was to evaluate the use of defaeco-peritone-ography in diagnosing rectal intussusception as distinct from mucosal folds in the rectum, and rectal prolapse as distinct from mucosal prolapse.

Material and Methods: Fifty-seven patients with defaecation disorders were examined by means of defaeco-peritoneography.

Results: Twenty-three patients had rectal intussusception and 7 patients had rectal prolapse at defaeco-peritoneography. All these patients had a rectal peritoneocele in the serosal ring-pocket of the rectal intussusception or in the rectal prolapse. Twenty-seven patients had neither rectal intussusception nor rectal prolapse and none of these patients had a rectal peritoneocele.

Conclusion: The present study demonstrated that only patients with a rectal intussusception or rectal prolapse have a rectal peritoneocele. Defaeco-peritoneography therefore offers correct diagnosis of rectal intussusception as distinct from mucosal folds in the rectum, and of rectal prolapse as distinct from mucosal prolapse.
MR Evaluation of CSF Fistulae
Authors: Gupta V. , Goyal M. , Mishra N. , Gaikwad S. , Sharma A.
Published: January 2010

Purpose: To evaluate the role of MR imaging in the localisation of cerebrospinal fluid (CSF) fistulae.

Material and Methods: A total of 36 consecutive unselected patients with either clinically proven CSF leakage (n=26) or suspected CSF fistula (n=10) were prospectively evaluated by MR. All MR examinations included fast spin-echo T2-weighted images in the 3 orthogonal planes. Thin-section CT was performed following equivocal or negative MR examination. MR and CT findings were correlated with surgical results in 33 patients.

Results: CSF fistula was visualised as a dural-bone defect with hyperintense fluid signal continuous with that in the basal cisterns on T2-weighted images. MR was positive in 26 cases, in 24 of which the fistula was confirmed surgically. In 2 patients the CSF leakage was directly demonstrated on MR. MR sensitivity of 80% compared favourably with the reported 46-81% of CT cisternography (CTC). No significant difference in MR sensitivity in detecting CSF fistula was found between active and inactive leaks

Conclusion: MR is recommended as the first investigation for detecting a CSF fistula owing to its efficacy and to its freedom from the potential complications encountered with CTC.
MR Imaging of Experimental Subdural Bleeding
Authors: Orlin J. R. , Thuomas K.-Å. , Pontén U. , Bergström K. , Zwetnow N. N.
Published: January 2010

Purpose: To evaluate morphological and physiological changes during acute lethal subdural bleeding in 2 models of anaesthetized dogs.

Material and Methods: In model I, blood from the aorta was led into a collapsed subdural rubber balloon while in model II, the blood was directed into the subdural compartment over the left cerebral frontoparietal lobe. Eight vital physiological parameters were continuously registered. MR imaging visualized the compression and displacement of cerebral tissue, and assessed the dynamic changes in cerebral tissue water.

Results: In model I, tissue herniation and compression of cerebral ventricles led to death at a haematoma volume corresponding to 8% of the intracranial volume. In model II, the extravasated blood progressed infratentorially and into the spinal sac with a volume that was 3 times larger than that of the lethal haematoma. Tissue water increased almost linearly during bleeding in both models.

Conclusion: The high level of mortality after acute subdural haematoma is caused by a reduction in intracranial volume tolerance with a critical decrease in cerebral perfusion pressure, resulting in a fatal cerebral ischaemia.
Joint-space width in the axial view of the patello-femoral joint
Authors: Boegård T. , Rudling O. , Petersson I. F. , Sanfridsson J. , Saxne T. , Svensson B. , Jonsson K.
Published: January 2010

Purpose: to validate a bony landmark on the dorsal aspect of the patella for measurement of the interbone distance in the axial radiogram of the patello-femoral joint (PFJ); to assess the reproducibility of this radiogram and the minimal joint-space (MJS) width measurements in the medial and lateral compartments of the PFJ in this view; and to relate the MJS of the PFJ to MR-detected cartilage defects in the same joint

Material and Methods: Fifty-seven individuals with chronic knee pain (aged 41–58 years, mean 50 years) were examined with an axial view of the PFJ in the standing position. the MJS was measured with a mm-graded ruler. on the same day, an MR examination was performed with proton density- and T2-weighted turbo spin-echo sequences on a 1.0 T imager. We noted the cartilage defects in the PFJ in axial and sagittal MR images, and the shape of the sub-chondral cortex of the medial and lateral articular surfaces of the patella in sagittal MR images

Results and Conclusion: the bony landmark was found on all articular surfaces. the axial view of the PFJ and the MJS measurements were reproducible. an MJS of < 5 mm showed high specificity for MR-detected cartilage defects. Thus an MJS of 5 mm proved to be a limit in the diagnosis of joint-space narrowing in the PFJ in middle-aged individuals with chronic knee pain
Bone fragility induced by x-ray irradiation in relation to cortical bone-mineral content
Authors: Nyaruba M. M. , Yamamoto I. , Kimura H. , Morita R.
Published: January 2010

Purpose: A large single dose of irradiation to bone tissue causes bone fragility, and such bone will be susceptible to fracture even without trauma. the purpose of this study was to investigate the effects of fractional irradiation on the biomechanical properties of bone in the rat in relation to the cortical bone-mineral content (BMC), and to compare these effects with those brought about by single-dose irradiation

Material and Methods: Seventy-five veteran female Wistar rats were divided into 4 groups. Group 1 was the control group. the left tibiae of the remaining rats were exposed to irradiation. Group 2 received one single dose of X-rays at 10–60 Gy. Groups 3 and 4 received fractional irradiation up to different cumulative doses (10–60 Gy): group 3 received 2.5 Gy once a day; group 4 received 1.25 Gy twice a day. Twenty-four weeks after irradiation, the rats were killed and the BMC in each tibial diaphysis was determined by dual-energy X-ray absorptiometry (DXA). the bones were then loaded to failure in a three-point bending test

Results: the control group showed no difference (p<0.05) between left and right tibiae, neither in BMC nor in the maximum load at fracture. Single-dose irradiation caused a 16% ( p = 0.0366) decrease in the maximum load at 40 Gy, and a 19% ( p = 0.008) decrease at 60 Gy. the once-daily fractional dose of irradiation caused a 10% ( p = 0.0022) decrease in the maximum load of the irradiated tibiae at 60 Gy when compared to the intact contralateral tibiae. the twice-daily fractional dose of irradiation had no observable effect on the maximum load of the irradiated tibiae. Neither fractional irradiation modality had an effect on BMC

Conclusion: the study suggested that bone fragility induced by single fractional irradiation doses (given once daily up to high cumulative doses) was not associated with change in the cortical BMC. It also confirmed the preference for twice-daily fractional irradiation as compared to once-daily fractional irradiation and the total single dose
Conventional plain-film radiology, ultrasonography and CT in jejuno-ileal perforation
Authors: Grassi R. , Pinto A. , Rossi G. , Rotondo A.
Published: January 2010

Purpose: to evaluate conventional radiography, US and CT in identifying jejuno-ileal perforation

Material and Methods: We retrospectively reviewed the findings of conventional radiography, US and CT in 13 consecutive patients with surgically proven jejuno-ileal perforation

Results: the site of perforation was the ileum in 10 cases and the jejunum in 3 cases. Free gas was identified in 6 cases (46%) while indirect findings of perforation were found in 7 (54%). the jejunal perforations were diagnosed by indirect findings in all 3 cases. the ileal perforations were diagnosed by direct findings in 6 cases and indirect findings in 4 cases

Conclusion: Conventional radiology did not detect free gas in 7 (54%) of the 13 patients examined. in the absence of free gas, radiology showed indirect signs in all 7 patients, the most common being intraperitoneal free fluid in 5 (71%) of them. Jejunal perforations were more rare than ileal perforations and more difficult to identify by radiology. US was not useful for detecting free gas but it was useful for identifying intraperitoneal free fluid and intestinal paresis. Abdominal CT was useful when performed 6 h after the symptoms began
Enteroclysis-guided fine-needle aspiration cytology of focal small-bowel lesions
Authors: Verma V. , Nagi B. , Rajvanshi A. , Kochhar R. , Singh K.
Published: January 2010

Purpose: to study the role of enteroclysis-guided percutaneous fine-needle aspiration cytology (FNAC) of focal small-bowel lesions

Material and Methods: Twenty patients with non-palpable circumscribed small-bowel lesions found on enteroclysis underwent FNAC after confirmation of needle position under fluoroscopy

Results: Positive diagnosis was obtained in 18 (90%) of the patients. Thirteen patients with positive FNAC and one with inconclusive cytology underwent surgery. in all, the cytological diagnosis was confirmed by histopathology. No complications were seen

Conclusion: Enteroclysis-guided FNAC of focal small-bowel lesions is a safe and accurate diagnostic method
Spiral CT of the pancreas
Authors: Nishiharu T. , Yamashita Y. , Ogata I. , Sumi S. , Mitsuzaki K. , Takahashi M.
Published: January 2010

Purpose: to compare the value of a retrospective targeted high-resolution spiral CT to the standard reconstruction technique in the assessment of pancreatic diseases

Material and Methods: Spiral CT pancreatic images of a standard-size reconstruction protocol were compared prospectively with those of a retrospective targeted high-spatial-resolution reconstruction protocol in 30 patients. Prior to clinical evaluation, a phantom study was performed to evaluate the spatial resolution and signal-to-noise ratio of both protocols

Results: the high-resolution protocol achieved a good signal-to-noise ratio with acceptable spatial resolution. Phantom studies revealed increased image noise (+17%) with an increase in spatial resolution (+100%). in patients studied with the high-resolution protocol, the increase in noise was not significant but there was a marked improvement in the definition of small details

Conclusion: Images obtained with a targeted high-spatial-resolution reconstruction protocol showed superior lesion definition and vascular opacification compared with those obtained with a standard-size reconstruction protocol. This technique may have potential in the evaluation of small pancreatic abnormalities
Aneurysm clip MR artifacts
Authors: Burtscher I. M. , Owman T. , Romner B. , Ståhlberg F. , Holtås S.
Published: January 2010

Purpose: the aim of this study was to evaluate the extent to which titanium aneurysm clips could improve the quality of MR imaging compared with stainless steel clips, and to determine whether the clip artifacts could be reduced by controlling certain MR imaging parameters in frequently used pulse sequences

Material and Methods: the metal artifacts induced by 3 aneurysm clips were compared in 3 pulse sequences. the clips were: a Yasargil titanium aneurysm clip FT 752 T; a Yasargil standard aneurysm clip FE 752 K and, for comparison, a ferromagnetic Scoville aneurysm clip En-58J. the pulse sequences were: spin echo (SE); gradient echo (GE); and fast SE. an evaluation was made of 3 imaging parameters with regard to their influence on the size of the metal artifacts. the parameters were: bandwidth; echo time (TE); and echo-train length

Results: the titanium clip showed artifacts that were about 60% smaller than those from the stainless steel clip. the only parameter that influenced artifact size to any major degree was bandwidth in the SE sequences but not in the GE sequences. GE sequences induced larger artifacts than SE sequences and showed larger artifacts with longer TE

Conclusion: Titanium aneurysm clips reduced MR artifacts by approximately 60% compared to stainless steel clips. Artifacts were further reduced by using SE-based sequences with a high bandwidth or, if necessary, GE sequences with a low TE
Adrenoleukodystrophy - unusual CT and MR findings in two siblings
Authors: Sundgren P. C. , Blennow G. , Englund E. , Holtås S.
Published: January 2010

Purpose: to describe the unusual appearance of adrenoleukodystrophy (ALD) in MR imaging

Material and Methods: an analysis was made of MR findings, histopathology and clinical course in the cases of two brothers with ALD

Results: the older brother presented with frontal contrast-enhanced lesions, including a cyst. These were initially misinterpreted as a tumour at both radiology and pathology. the correct diagnosis was made after the discovery of very-long-chain fatty acids in the blood. the younger brother presented initially with involvement of various segments of the corticospinal tract

Conclusion: It is important that the radiologist be aware of the variants of ALD in MR imaging so as to avoid diagnostic mistakes
Iodine concentrations in the rat kidney measured by x-ray microanalysis
Authors: Ueda J. , Nygren A. , Sjöquist M. , Jacobsson E. , Ulfendahl H. R. , Araki Y.
Published: January 2010

Purpose: To measure the iodine concentrations in the proximal tubules and renal pelvis after i.v. injections of contrast media (CM) at 1600 mg I/kg b.w., using a micro-puncture technique and X-ray microanalysis

Material and Methods: The correlation between the viscosity of each CM and its iodine concentration was evaluated and the viscosity of the fluid in the proximal tubule and renal pelvis was estimated in rats

Results: After iotrolan injection, the iodine concentration in the proximal tubular fluid had increased to values about three times higher than those reached with diatrizoate, iohexol and ioxaglate. Similarly, iotrolan tended to produce a higher iodine concentration in the renal pelvis than did the other CM. the urine viscosity in the renal pelvis was much higher after the iotrolan injection than after the other CM injections

Conclusion: High urine viscosity after iotrolan injection can at least partly explain our previous findings of a prolonged increase in tubular hydrostatic pressure and a prolonged decrease in the single nephron glomerular filtration rate after administration of this CM
Multiplanar reconstruction in MR imaging of the knee
Authors: Wieslander S. B. , Rappeport E. D. , Lausten G. S. , Thomsen H. S.
Published: January 2010

Purpose: to compare standard MR sagittal and coronal imaging of the knee with the MR technique of finer sagittal imaging and subsequent reconstruction in any plane

Material and Methods: Forty-seven patients took part in the study. Two radiologists each made two independent interpretations in every case, based on images of: a) 4-mm sagittal and coronal slices; and b) 1.2-mm sagittal slices with subsequent reconstruction

Results: We found no significant difference in diagnostic efficacy between the two MR techniques. the reconstruction in any desired plane involved a potential reduction of 10 min in examination time but an increase of approximately 20 min in postprocessing time

Conclusion: the use of multiplanar reconstruction offered no additional diagnostic value and no saving of time
Fast spin-echo MR of the articular cartilage in the osteoarthrotic knee
Authors: Kawahara Y. , Uetani M. , Nakahara N. , Doiguchi Y. , Nishiguchi M. , Futagawa S. , Kinoshita Y. , Hayashi K.
Published: January 2010

Purpose: the objective was to assess the efficacy of fast spin-echo (FSE) imaging in the detection of articular cartilage abnormality in osteoarthrosis of the knee

Material and Methods: We studied 356 articular surfaces in 73 knees that had been examined by both MR imaging and arthroscopy. the MR images were obtained with FSE imaging (TR/TE 4200/100) on a 0.5 T unit. the surface abnormalities of the articular cartilage that were detected by MR imaging were compared with the arthroscopic findings

Results: the overall sensitivity and specificity of MR in detecting chondral abnormalities were 60.5% (158/261) and 93.7% (89/95) respectively. MR imaging was more sensitive to the higher grade lesions: 31.8% (34/107) in grade 1; 72.4% (71/98) in grade 2; 93.5% (43/46) in grade 3; and 100% (10/10) in grade 4. the MR and arthroscopic grades were the same in 46.9% (167/356), and differed by no more than 1 grade in 90.2% (321/356) and 2 grades in 99.2% (353/356). the correlation between arthroscopic and MR grading scores was highly significant with a correlation coefficient of 0.705 ( p<0.0001)

Conclusion: FSE sequence was less sensitive to mild cartilage abnormality but useful in detecting moderate to severe abnormality and in evaluating the degree of articular cartilage abnormality
Portal and splanchnic haemodynamics in patients with advanced post-hepatitic cirrhosis and in healthy adults
Authors: Dinç H. , Sari A. , Gümele H. Resit , Cihanyurdu N. , Baki A.
Published: January 2010

Purpose: to assess portal and splanchnic haemodynamics, and splanchnic vascular resistance in patients with advanced post-hepatitic cirrhosis and in healthy volunteers, by means of duplex Doppler ultrasound (US)

Material and Methods: the duplex Doppler US examination was performed in 16 patients with cirrhosis and in 24 healthy volunteers. We investigated vessel diameters, mean flow velocities, and mean blood flows in the portal vein, the superior mesenteric artery (SMA), and the splenic artery (SA), and measured the resistive index values of SMA and SA

Results: the mean portal venous blood flow in patients with cirrhosis (829 ± 264 ml/min) was not statistically different from those in the volunteers (734 ± 194 ml/min). the ratio of the SMA and SA blood flows (621 ml/min) to the portal venous blood flow (734 ml/min) was 0.85 in the control subjects. the mean portal venous blood flow (1261 ml/min) and the portal venous velocity (14.6 cm/s) were higher in the patients with recanalized para-umbilical veins than in the volunteers and in the patients without recanalized para-umbilical veins. the SMA and SA blood flows were significantly increased in patients with cirrhosis compared with volunteers. Splanchnic inflow (the sum of the SMA and SA blood flows) was higher than the portal blood flow in patients with cirrhosis except in the subjects with recanalized para-umbilical veins. SMA and SA resistive index values were significantly higher in these patients than in the volunteers

Conclusion: Splanchnic blood flow and splanchnic vascular impedance increased significantly in patients with advanced post-hepatitic cirrhosis. Splanchnic inflow must not exceed portal venous blood flow in patients with recanalized para-umbilical veins. Portal vein velocity and portal venous blood flow measurements alone are not useful parameters for discriminating patients with cirrhosis from healthy subjects
Electrolytic stent in the normal bile duct
Authors: Cwikiel W. , Harnek J. , Zoucas E. , Stenram U.
Published: January 2010

Purpose: to evaluate and compare changes in the bile-duct wall after the insertion of electrolytic and nonelectrolytic stents

Material and Methods: the electrolytic stents were composed of 3 different layers (iron, isolating polyethylene and tantalum) and were implanted surgically in the bile duct of 8 healthy pigs. the nonelectrolytic stents were also composed of 3 layers (2 layers of tantalum and an isolating layer of polyethylene) and were implanted surgically in the bile ducts of 9 healthy pigs. After an observation time of 8 weeks, the pigs were killed and the bile ducts were excised and sent for histopathological examination

Results: One pig was killed after the procedure owing to postoperative complications; all the other pigs survived without complications. Migration of the stent to the bowel occurred in 4 pigs. A slight inflammatory reaction was seen at histopathological examination in 6 pigs with the electrolytic stent and in 6 pigs with the nonelectrolytic stent. There was no difference in the specimens from pigs with electrolytic and nonelectrolytic stents

Conclusion: the electrolytic stents did not cause more changes in the normal bile-duct wall than the nonelectrolytic stents
Contrast enhancement in the craniopharyngioma cyst wall caused by irradiation
Authors: Eldevik O. P. , Gabrielsen T. O. , Altinok D.
Published: January 2010

Purpose: to report the occurrence, degree, frequency, and duration of contrast enhancement in the craniopharyngioma cyst wall as caused by irradiation

Material and Methods: Eight patients with cystic craniopharyngiomas had comparable CT or MR studies before and after either external irradiation of the cyst (n=5) or 32P instillation into the cyst (n=3)

Results: A minimal to marked increase in cyst-wall enhancement was seen at 66–157 days after 32P instillation in 3/3 cases and at 112–495 days after external irradiation in 3/5 cases. the increased enhancement was always associated with a variable interim increase in the thickness of the enhanced cyst wall

Conclusion: CT or MR imaging after the irradiation of cystic craniopharyngiomas usually demonstrated an increase in thickness and enhancement in the cyst wall. Such changes may be due to the irradiation alone and do not necessarily represent infection or increased neoplastic activity. the timing is uncertain as to the earliest possible development of such changes and their maximum duration, but they were seen as early as 66 days post-irradiation and as late as 495 days post-irradiation
Duplex ultrasound in the subclavian steal syndrome
Authors: Pãivänsalo M. , Heikkilä O. , Tikkakoski T. , Leinonen S. , Merikanto J. , Suramo I.
Published: January 2010

Purpose: the effect of subclavian steal on the contralateral vertebral flow and its possible effect on carotid flow were studied and the US results were compared to the angiographic findings

Material and Methods: the study consisted of the records of 74 patients with a duplex Doppler finding of subclavian steal syndrome. of these, 48 patients had had both angiography and US of the neck arteries and were selected for comparison. for a comparison of the US flow values, a control series of 48 was selected from our carotid archive and consisted of patients without subclavian steal who had also been examined with both US and angiography

Results: of the 48 patients, 44 had a subclavian steal syndrome at angiography, 31 on the left side and 13 on the right. of the 44, 21 patients had subclavian occlusion, and 23 stenosis. in 84% of the subclavian occlusions, US showed a complete systodiastolic steal and in 16% a partial systolic steal, while the corresponding findings for subclavian stenoses were 17% and 83%. of the 48 cases, 4 were not real subclavian steals: 2 had vertebral occlusion (1 with a 90% subclavian diameter stenosis) on the side of retrograde flow at US and a steal through the vertebral and collateral arteries to the spinal arteries; and 2 had a 70% diameter stenosis of the subclavian artery and to-and-fro flow in the vertebral artery at angiography. in the 21 cases of complete steals, the subclavian diameter stenosis was 97±8% at angiography, and in the 23 partial steals, it was 85±10%. There was a significant increase in contralateral vertebral and common carotid flow in the cases with retrograde vertebral flow compared to the vertebral and common carotid flow of the control subjects. the retrograde flow values, the ipsilateral vertebral lumen diameter, and the flow values in the common carotid arteries were higher in complete steals and subclavian occlusions than in partial steals

Conclusion: A complete vertebral steal at US correlated well with subclavian occlusion and a partial steal suggested stenosis of the subclavian artery. There were also flow changes in the contralateral vertebral artery and the common carotid arteries that compensated for the steal. Retrograde vertebral flow at US was sometimes associated with vertebral occlusion in subclavian stenosis without a true subclavian steal
Development of a huge varix following endovascular embolization for cerebellar arteriovenous malformation
Authors: Mineura K. , Sasajima H. , Itoh Y. , Kowada M. , Tomura N. , Goto K.
Published: January 2010

We report on the case of a huge varix that developed after the endovascular embolization of a cerebellar arteriovenous malformation (AVM) with a single drainer. A 21-year-old male presented with trigeminal neuralgia which was caused by the dilated drainer of the AVM. A varix was found at the basal vein of Rosenthal 2 months after an initial stage of embolization with polyvinyl alcohol particles; it diminished after the surgical extirpation of the AVM

The varix formation might have been facilitated by the stenosis in the vein of Galen and by the dynamic changes that followed the embolization

This rare complication should be kept in mind when embolization is performed for AVMs with impaired venous outlets
Reliability of doppler ultrasound in follow-up studies
Authors: Mikkonen R. H. M. , Kreula J. M. , Virkkunen P. J.
Published: January 2010

Purpose: to evaluate the reliability of repeat Doppler US measurements

Material and Methods: Nine radiologists conducted two sets of Doppler US measurements on a healthy volunteer, with a time interval of 9 months. Peak systolic velocity (PSV), resistance index (RI), and pulsatility index (PI) were measured 10 times in 4 arteries

Results: There was considerable intra- and inter-observer variation both at baseline and 9 months later. the PSV values from the carotid artery varied from 0.27 m/s to 1.95 m/s in February and from 0.22 m/s to 1.38 m/s in November. the RI values from the renal artery ranged from 0.44 to 0.71 in February and from 0.41 to 0.67 in November. the results of the 9-month follow-up varied markedly too. Best reproducibility was achieved by highly experienced radiologists both at baseline and 9 months later

Conclusion: the short-term and long-term reliability of Doppler US was poor when the measurements were performed by a heterogeneous group of radiologists. the RI and PI measurements were somewhat more reliable than the PSV measurements and are recommended for use in follow-up studies
Costs of plain-film radiography in a partially digitized radiology department
Authors: Alanen J. , Keski-Nisula L. , Laurila J. , Suramo I. , Standertskjöld-Nordenstam C.-G. , Brommels M.
Published: January 2010

Purpose: the aim of the study was to analyse the costs of computed radiography (CR) as part of a small picture archiving and communication system (mini-PACS), and to compare these costs with those of conventional analogue radiography using activity-based accounting (ABC)

Material and Methods: the study was conducted at the Central Hospital of Vaasa where in 1993 the Radiology Department acquired a mini-PACS with a CR reader, a chest CR unit, and a CT unit as digital image processing modalities. of altogether 34140 plain-film examinations, 3/4 were made with CR and stored mostly on film, and 1/4 were made with conventional analogue radiography. the costs and activities of these two modes were analysed by means of the ABC method which identifies and allocates indirect costs in radiological procedures

Results: the costs of CR imaging were 9% higher than those of conventional radiography. the costs of the chest CR unit were equal to those of conventional radiography. the difference was due to higher investment costs in digital image processing. the time gained from a reduction in the number of retakes did not shorten the time spent by patients in the examination room, and its effect on film costs was minimal

Conclusion: in planning the step-by-step transition of conventional film-based analogue radiography to fully digitized radiography, it should be noted that films are still used in the transition period and that this is associated with higher costs than in the previous system of conventional analogue plain-film imaging
Gd-dtpa as an alternative contrast agent in conventional and interventional radiology
Authors: Vehmas T. , Markkola A. T.
Published: January 2010

Purpose: Patients with contra-indications to iodine-based contrast media present problems in radiological examination. In this study, we evaluated Gd-DTPA as an alternative contrast agent in conventional and interventional radiology

Material and Methods: The undiluted contrast agent Gd-DTPA meglumine (469 mg/ml, Magnevist) was used in 10 examinations in 8 patients. A dosage of 20-45 ml was used in 5 conventional studies: endoscopic retrograde cholangiography, cystography, urethrocystography, and 2 retrograde pyelographies. A dosage of 10-120 ml was used in 5 interventions: 1 percutaneous nephrostomy, and 4 biliary tract drainages

Results: The image quality was adequate in all studies. No adverse pharmacological reactions occurred; however, there was renal extravasation of Gd-DTPA which did cause temporary pain in 1 patient at bilateral retrograde pyelography

Conclusion: Gd-DTPA may be used as an alternative contrast medium in selected conventional and interventional roentgenological studies when iodine is contra-indicated
Malignant glioma
Authors: Kadota T. , Nakagawa H. , Kuroda C.
Published: January 2010

Purpose: To investigate the clinical utility of 3D time-of-flight (Tof) MR angiography (MRA) in the evaluation of pathological vessels in patients with malignant glioma

Material and Methods: Sixteen patients with malignant glioma (12 with glioblastoma multiforme and 4 with anaplastic astrocytoma) were examined with 3D Tof MRA before and after the injection of gadopentetate dimeglumine. The 3D Tof MRA study was compared with conventional angiography in all patients

Results: The unenhanced 3D Tof MRAs successfully depicted the feeding arteries in 9 patients but failed to depict small feeding arteries in 2 patients in whom these arteries were shown by conventional angiography. The enhanced MRAs demonstrated draining veins from the lesions in 8 patients but failed to depict a draining vein in 1 patient that was shown by conventional angiography. The stereoscopic view projection effectively depicted displacements of the major cerebral arteries in 14 patients, and deep venous structures in 11 patients which almost accorded with the findings at conventional angiography

Conclusion: Our results indicate that 3D Tof MRA can provide an accurate visualization of pathological vascular structures and thus help establish a diagnosis in patients with malignant glioma
Increased accuracy in MR diagnosis of uveal melanoma by carbohydrate loading
Authors: Thuomas K.-Å. , Naeser P. , Wrigstad A.
Published: January 2010

Purpose: To evaluate patients with clinically diagnosed uveal melanoma

Material and Methods: Forty-eight consecutive patients were examined with spin-echo (SE) and fast spin-echo (FSE) MR sequences that utilized glucosefructose enhancement together with a subtraction technique on a 1.5 T unit

Results: Twenty-seven patients were enucleated and the eyes histologically examined for tumours (spindle cell, mixed cell, and epitheloid cell). The remaining patients were referred for other treatment. There were no significant differences in T2 although T2 was longer in the amelanotic lesions. Carbohydrate loading in combination with a subtraction technique gave: an increased signal intensity; a prolongation of T2; and an increased tumour size. The FSE sequences were as good as the SE sequences in the visualization of uveal malignant melanoma

Conclusion: MR imaging performed with carbohydrate loading registers metabolic changes induced in the tumour. This gives the method great validity in the diagnosis of uveal melanoma. The method is especially useful in amelanotic tumours that have longer relaxation times than melanotic tumours. The SE technique can be replaced with the FSE technique
Tumoral calcium pyrophosphate dihydrate deposition disease with bone destruction in the shoulder
Authors: Mizutani H. , Ohba S. , Mizutani M. , Sasaki S. , Ando K. , Matsushita Y. , Terazawa T. , Ohtsuka T. , Ijima S.
Published: January 2010

We report on specific CT and MR features in two cases of tumoral calcium pyrophosphate dihydrate deposition disease in the shoulder with unusually large tumors. CT revealed features that were specific to the disease. MR was useful for detecting the extent of the mass and for obtaining information on adjacent soft-tissue and bone-marrow changes
Ultrasonography of invasive lobular breast carcinoma
Authors: Rissanen T. , Tikkakoski T. , Autio A.-L. , Apaja-Sarkkinen M.
Published: January 2010

Purpose: To review the US findings in invasive lobular breast carcinoma which is often difficult to diagnose clinically and mammographically

Material and Methods: The mammographic and US findings in 63 cases of pure invasive lobular carcinoma diagnosed at our institution in 1990-1996 were reviewed retrospectively. The US findings were classified as positive, negative or indeterminate for malignancy

Results: Forty-nine of the 63 lobular carcinomas (78%, 95% CI 65.5-87.3%) were US-positive, and 51 (81%, CI 95% 69.1-89.8%) were mammography-positive. The US visibility of the carcinomas was affected by their palpability and mammographic appearance, and the radiographic density of the breasts. Indeterminate US findings (architectural distortion with acoustic shadowing) were visualized in 4 of the 10 cases that had asymmetric densities at mammography

Conclusion: The sensitivity of US for lobular carcinoma was not statistically different from that of mammography. The methods were complementary, especially with regard to evaluating dense breasts and lesions which were difficult to assess clinically and mammographically
Ultrasonography as a guidance method in the evaluation of mammographically detected nonpalpable breast lesions of suspected malignancy
Authors: Rissanen T. , Pamilo M. , Suramo I.
Published: January 2010

Purpose: To evaluate the role of ultrasonography (US) as a method of guidance for fine-needle aspiration biopsy or preoperative wire localization in the demonstration of nonpalpable mammographically detected breast lesions

Material and Methods: A total of 168 nonpalpable mammographically detected breast lesions were examined by means of high-resolution real-time US

Results: US depicted: 55% of all the lesions (92/168); 88% of the circumscribed densities (45/51); 80% of the stellate densities (35/44); 47% of the asymmetric densities (7/15); and 9% of the microcalcifications (5/58)

Conclusion: US was useful in guiding needle biopsy or wire localization in most of the circumscribed and stellate breast lesions, even in fatty breasts. However, with the equipment that is currently available, US was of no value in localizing microcalcifications
MR imaging in a desmoid tumor of the posterior mediastinum with extension into the abdominal cavity
Authors: Çiftçi E. , Erden I. , Koral K. , Akyar S.
Published: January 2010

We report on a rare case of desmoid tumor in a 40-year-old man with low back pain and cough. There was no history of previous surgery or trauma. MR imaging revealed a posterior mediastinal mass extending into the abdominal cavity
Diagnosis of acute left-sided colonic diverticulitis by three radiological modalities
Authors: Eggesbø H. B. , Jacobsen T. , Kolmannskog E. , Bay D. , Nygaard K.
Published: January 2010

Purpose: To compare the findings at US, CT and contrast enema (CE) with the clinical, biochemical, and surgical findings in patients with suspected acute left-sided colonic diverticulitis (ALCD)

Material and Methods: The study comprised 32 consecutive patients hospitalized with clinically diagnosed ALCD. During the first 3 days of hospitalization, they were examined by US and CT of the pelvis and abdomen, and CE

Results: of the 32 patients, 21 had ALCD according to the combined radiological, clinical, biochemical and surgical findings. Findings compatible with ALCD were verified by radiological examination alone in 12 patients (4 patients at US, 10 at CT, and 6 at CE). In 9 patients, only diverticula or tethering was found at either CE or CT, and the diagnoses were then supported by clinical and biochemical findings and clinical follow-up. The most common clinical symptoms and signs associated with ALCD were left lower quadrant pain, left-sided tenderness, and fever. Most patients showed elevations of the white blood-cell count, erythrocyte sedimentation rate, and C-reactive protein, but there was no statistical difference in the stages of severity of ALCD, or between ALCD and other abdominal disorders

Conclusion: Radiological examination is valuable in confirming the diagnosis of ALCD. CT was the radiological modality that best demonstrated ALCD and revealed complications (e.g. pericolic abscesses) during the course of the illness
CT in spontaneous adrenal gland rupture
Authors: Usamentiaga E. , Ortiz A. , Bustamante M. , Pereda T. , Pagola M. A.
Published: January 2010

Purpose: To report on an exceptional case of spontaneous, idiopathic, unilateral adrenal gland rupture that caused massive retroperitoneal hemorrhage

Methods and Results: US and CT were performed in a patient who presented with acute abdominal pain. Urgent adrenalectomy was required to prevent the blood loss from continuing. The CT findings were correlated with the histological findings

Conclusion: CT proved to be an accurate imaging modality by which to diagnose adrenal hemorrhage. The absence of irregular tissue enhancement showed that neoplasia was not the underlying cause of the hematoma