bluuebunny/crossref_metadata_2025 huggingface dataset:
Treatment of Liver Metastases by Arterial Injection of Adriamycin/Mitomycin C Lipiodol Suspension
Authors: Inoue H. , Kobayashi H. , Itoh Y. , Shinohara S.
Published: June 2015

Sixty-one patients with liver metastases were treated with hepatic arterial injection of Adriamycin/Mitomycin C oil suspension (ADMOS). The liver metastases originated from the gastrointestinal tract in 41 patients and from other organs in 20 patients. Sixty-nine liver tumors were analyzed in these 61 patients. Computed tomography (CT) after ADMOS injection (Lip-CT) gave more information in 19 cases (31%) than enhanced CT with a water-soluble contrast medium. With Lip-CT, Lipiodol tumor enhancement was observed in 64 of 69 lesions. The patterns of Lipiodol uptake in the tumors were classified into 4 types: Homogeneous accumulation (20%), heterogeneous accumulation (16%); accumulation with a central defect (57%); and no accumulation (7%). A tumor response was achieved in 41 of 69 lesions (59%). Anticancer effects were also shown as a decrease in serum CEA levels. The one year survival rate estimated by the Kaplan-Meier method was 43 per cent and the median survival time was 337 days. The results were better among patients who received multiple doses of ADMOS. Only minimal side effects were associated with ADMOS. The method is considered to be an excellent diagnostic and therapeutic procedure for liver metastases.
Small Bowel Barium Examination in Children
Authors: Bååth L. , Ekberg O. , Borulf S. , Lindhagen T. , Olsson R.
Published: June 2015

The indications for small bowel barium examination, the radiologic findings, and the clinical outcome were compared retrospectively in 331 children, aged 0 to 15 years. Sixty examinations (18%) were pathologic, which is in accordance with adult materials. The most common indications for referral were inflammatory bowel disease (48%) and small bowel obstruction (25%). The examinations were positive in 19 per cent and 17 per cent, respectively. Indications for referring patients with non-specific symptoms led to a low frequency of pathologic findings. A therapeutic or diagnostic procedure was performed in 38 of the 60 pathologic radiologic examinations (63%). In 18 patients (30%) a pathologic finding caused no change in therapy. No consistent difference in sensitivity, specificity or predictive values of a positive or negative result was found concerning enteroclysis or elective follow-through examination. For screening purposes of the small bowel in children follow-through examinations give adequate radiologic information and should be used instead of enteroclysis.
High Resolution Computed Tomography of Auditory Ossicles
Authors: Isono M. , Murata K. , Ohta F. , Yoshida A. , Ishida O.
Published: June 2015

Auditory ossicular sections were scanned at section thicknesses (mm)/section interspaces (mm) of 1.5/1.5 (61 patients), 1.0/1.0 (13 patients) or 1.5/1.0 (33 patients). At any type of section thickness/interspace, the malleal and incudal structures were observed with almost equal frequency. The region of the incudostapedial joint and each component part of the stapes were shown more frequently at a section interspace of 1.0 mm than at 1.5 mm. The visualization frequency of each auditory ossicular component on two or more serial sections was investigated. At a section thickness/section interspace of 1.5/1.5, the visualization rates were low except for large components such as the head of the malleus and the body of the incus, but at a slice interspace of 1.0 mm, they were high for most components of the auditory ossicles.
Vertebral Body Trabecular Density at the Thoracolumbar Junction Using Quantitative Computed Tomography
Authors: Singer K. P. , Breidahl P. D.
Published: June 2015

Quantitative computed tomography was used to assess vertebral trabecular density in 26 post-mortem spines from individuals aged between 14 and 80 years. All vertebrae from T10 to L1 were scanned transversely near the mid-vertebral level with calculations of trabecular density in HUs averaged and referenced to a mineral equivalent phantom. An age-related decline in trabecular density was recorded (r = 0.55, p < 0.0001). Density measures from the anterior aspect of the vertebral body were significantly greater than from postero-lateral regions. From T10 to L1, there was a significant decrease in trabecular density, whereas density measures multiplied by vertebral body cross-sectional area were constant. Predictions of vertebral compressive strength using quantitative computed tomography may become more accurate by increasing the sampling area per scan and including vertebral body cross-sectional area as part of the radiologic assessment.
Pericardial Effusion and Pericardial Compartments after Open Heart Surgery
Authors: Duvernoy O. , Larsson S. G. , Persson K. , Thurén J. , Wikström G.
Published: June 2015

Thirty-three patients with pericardial effusion after open heart surgery were investigated with computed tomography (CT). Twelve of the 33 patients also underwent echocardiography prior to pericardiocentesis. The effusions were typed according to the results of the CT investigation. Because of postoperative adhesions, typical patterns of localized pericardial effusions were found in 16 patients. The localized compartments were seen on the right and left side of the heart and around the aorta and the pulmonary artery. CT was therefore shown to be of value for selecting the approach for drainage with catheter pericardiocentesis.
Magnetic Resonance Imaging of Thoracic Hydatid Disease
Authors: von Sinner W. N. , Rifai A. , te Strake L. , Sieck J.
Published: June 2015

Two patients with thoracic manifestations of hydatid disease (HD) are discussed; one patient had recurrent HD of the chest wall and the other, intrapulmonary HD after rupture and intrathoracic extension of an infradiaphragmatic cyst. At magnetic resonance (MR) imaging the manifestations of HD in the thorax are similar to previously reported MR findings in HD in the liver. The presence of a low signal intensity rim on T2 weighted images representing the cyst wall was confirmed. On T1 weighted images cysts with heterogeneous low and intermediate signal intensity contents and a relatively high signal intensity wall were seen. ‘Folded parasitic membranes’ previously not described on MR were noted. Daughter cysts may have a low or high signal intensity depending on contents. Reactive changes in the lung may be quite marked compared with the liver, due to reaction to the parasite or simply because the lung is more easily compressed leading to secondary atelectasis.
Cine-Computed Tomographic Assessment of Regional Renal Blood Flow
Authors: Jaschke W. , Sievers R. S. , Lipton M. J. , Cogan M. G.
Published: June 2015

The new modality of cine-computed tomography was used to assess regional renal blood flow following hemorrhagic hypotension and administration of atrial natriuretic factor (ANF). As has also been established with other techniques, hypotension induced by hemorrhage caused cortical blood flow to fall from 5.3 (SD 0.8) to 2.1 (SD 1.1) ml min−1g−1 (p<0.005; n = 7) proportionally more than inner medullary blood flow which fell from 0.45 (SD 0.24), to 0.26 (SD 0.08) ml min−1g−1 (p<0.05) so that the ratio of the cortical to inner medullary blood flow decreased from 11.8 (SD 4.8) to 8.2 (SD 5.1) (p<0.01). In contrast, during natriuresis induced by ANF, cortical blood flow was unaltered (5.8, SD 1.1, vs 5.4, SD 0.9 ml min−1g−1; NS; n = 5) while inner medullary blood flow declined from 0.66 (SD 0.13) to 0.51 (SD 0.11) (p < 0.005) so the ratio of cortical to inner medullary blood flow increased from 8.8 (SD 1.3) to 10.9 (SD 1.7) (p<0.005). These results indicate that cine-CT appears to be an appropriate technique for demonstrating changes in distribution of intrarenal blood flow. Cine-CT may, therefore, be an attractive alternative for measuring regional renal blood flow.
Intra-Arterial DSA and Duplex-Doppler Ultrasonography in Detection of Vascularized Inguinal Lymp Node
Authors: Björk L. , Levén H.
Published: June 2015

Twenty-three patients with ischemic disease of the legs referred for routine preoperative angiography were examined with intra-arterial DSA and high resolution ultrasonography with duplex-Doppler to detect inguinal lymph nodes. None of the patients had evidence of malignant or lymphomatous disease and only 3 had skin ulceration on the foot. DSA detected nodes in 9 patients (39%). In 3 cases the nodes were highly vascularized. Ultrasonography detected lymph nodes in 16 patients (70%). In all but 2 nodes a high velocity arterial flow was recorded. It is concluded that DSA and particularly duplex-Doppler ultrasonography are sensitive methods to detect vascularized lymph nodes and that such nodes are found in many patients with no evidence of malignancy or infection.
Roentgen Stereophotogrammetric Analysis
Authors: Selvik G.
Published: June 2015

Soon after Roentgen's discovery, the ‘new’ rays were used to produce stereoscopic images or used for spatial reconstruction of positions of foreign bodies. However, no systematic use of roentgen stereo measurements seems to have occurred until the 1970's, although many attempts have been made before. Since 1972, a system for roentgen stereophotogrammetry has been in use at the University Hospital in Lund. The system has been named RSA, roentgen stereophotogrammetric analysis. It is a complete system, including instrumentation for implanting tantalum landmarks, devices for calibration of the stereo roentgen set-up, and comprehensive software. Using different calibration set-ups, any part of the body can be investigated under different conditions using standard roentgen equipment. The computer programs make it possible to calculate spatial landmark coordinates from measured film coordinates, and further to calculate growth, and volume changes or kinematic variables in well-defined and generally used terms. After the basic principles have been established, a survey of applications grouped according to anatomic regions follows. Special emphasis is laid on total hip and knee replacement, which besides complex craniofacial and spinal disorders, are the most rewarding fields of study.
Luxation of the Elbow Complicated by Proximal Radio-Ulnar Translocation
Authors: Eklöf O. , Nybonde T. , Karlsson G.
Published: June 2015

Luxation of the elbow complicated by proximal radio-ulnar translocation is a rare entity. The clue to diagosis is the reversed position of the bones of the proximal forearm. In the a.p. projection the radial head articulates with the trochlea and the ulna with the capitellum. This unexpected anatomic relationship is easily overlooked. Delayed reduction may result in permanent impairment of elbow motility. Our experience with three recent cases is presented.
Graded Stress Radiography in Acute Injury to the Lateral Ligaments of the Ankle
Authors: Rijke A. M. , Vierhout P. A.
Published: June 2015

The diagnostic accuracy of graded stress radiography in 26 patients with acute injury to the lateral ankle ligaments has been compared with findings at arthrography and surgery. Measuring talar tilt angles and anterior talar displacement over a range of pressures applied to the distal tibia using a commercially available stress device allows diagnostic distinction between isolated anterior talofibular ligament injury and a combined lesion that involves the calcaneofibular ligament. The results compare well with arthrographic and surgical findings.
Preoperative Localization of Endocrine Pancreatic Tumours by Intra-Arterial Dynamic Computed Tomography
Authors: Ahlström H. , Magnusson A. , Grama D. , Eriksson B. , Öberg K. , Lörelius L.-E.
Published: June 2015

Eleven patients with biochemically confirmed endocrine pancreatic tumours were examined with intra-arterial (i.a.) dynamic computed tomography (CT) and angiography preoperatively. Seven of the patients suffered from the multiple endocrine neoplasia type 1 (MEN-1) syndrome. All patients were operated upon and surgical palpation and ultrasound were the peroperative localization methods. Of the 33 tumours which were found at histopathologic analysis of the resected specimens in the 11 patients, 7 tumours in 7 patients were correctly localized by both i.a. dynamic CT and angiography. Six patients with MEN-1 syndrome had multiple tumours and this group of patients together had 28 tumours, of which 5 (18%) were localized preoperatively by both CT and angiography. I.a. dynamic CT, with the technique used by us, does not seem to improve the localization of endocrine pancreatic tumours, especially in the rare group of MEN-1 patients, as compared with angiography.
External Carotid Artery Embolization of Dural Arteriovenous Malformations Involving the Cavernous Sinus; Outcome and Role of Venous Thrombosis
Authors: Hirabuki N. , Mitomo M. , Miura T. , Hashimoto T. , Kawai R. , Kozuka T.
Published: June 2015

Nine patients with dural arteriovenous malformations (AVMs) in the region of the cavernous sinus were treated by means of external carotid artery (ECA) embolization using polyvinyl alcolhol. All AVMs received vascular supply from both the ECA and the internal carotid artery. Seven cases were clinically cured after embolization, while 2 cases with cortical venous drainage and high flow through the shunt were not completely cured. Venous thrombosis was observed in 5 cases before and in 9 after embolization. In 6 cases the drainage pattern changed owing to venous thrombosis. Complete thrombosis of the cavernous sinus was found on a follow-up angiography in 2 cases. Formation of venous thrombosis and occlusion of feeding arteries are crucial factors for success of ECA embolization. Dural AVMs with cortical venous drainage and high flow cannot be relieved by ECA embolization alone owing to difficulty in obtaining thrombosis of the veins.
Changes in Atheroma Volume Estimated from Digitized Femoral Arteriograms
Authors: Nilsson S. , Erikson U.
Published: June 2015

To evaluate the effects of treatment in patients with cardiovascular risk factors, valid and reproducible methods for assessing changes in atheroma volume are required. We postulated that these changes could be accurately estimated by repeat measurement of the lumen volume of the artery to be studied. With a computer-based technique, the lumen volume of a 20 cm segment of the femoral artery was measured in arteriograms from 107 patients with hypercholesterolemia. Films were digitized with use of a high-resolution scanner, cross-sectional areas were calculated with a slice thickness of 150 μm and the lumen volume was obtained by their integration. The validity of the method was demonstrated in model experiments. An automatic algorithm to correct for changes due to patient positioning was developed and validated in a model experiment. With repeat measurement 10 min and 11 to 13 months apart the coefficients of variation were 2.9 per cent (N = 107) and 6.1 per cent (N = 29), respectively.
Oral Superparamagnetic Particles for Magnetic Resonance Imaging
Authors: Lönnemark M. , Hemmingsson A. , Ericsson A. , Gundersen H. G. , Bach-Gansmo T.
Published: June 2015

As a potential gastrointestinal MR contrast medium magnetic particles have been evaluated in preclinical studies as well as in healthy volunteers. The main problem was to achieve an even distribution of the aqueous suspension of magnetic particles in the entire intestine. To improve the distribution of the contrast medium, a viscosity-increasing agent was added to the preparation. In the plain aqueous suspension the magnetic particles sedimented rapidly and caused artifacts, whereas no such sedimentation occurred in the viscous preparation. The contrast effect, as well as the presence of artifacts, increased with particle concentration. The general contrast effect was good in all 5 volunteers, and the contrast medium was well distributed in the small intestine, including the duodenum. There were no artifacts observed, and the contrast medium was well tolerated. The viscosity-increasing agent will thus be introduced in further clinical studies.
Chest Radiography in the Intensive Care Unit
Authors: Geijer M. , Jensen C. , Schlossman D.
Published: June 2015

Consecutive chest radiographs (n = 2 303) in 601 patients in the intensive care units (ICU) were analyzed with regard to main disease and indication. Two thirds of the patients were transferred for routine post-operative treatment, 14 per cent mainly for cardiopulmonary insufficiency. The remainder were referred because of various clinical conditions. The main indications for chest radiography were routine radiographic follow-up and/or control of the position of catheters, tubes, drainages etc. (50%). Obvious clinical indications appeared in only about 1/4 of the patients. When the patients were discharged from the ICU all chest radiographs were analyzed with regard to their predicted future value. Films considered not worth storing were removed and stored in a separate archive (57%). During a 15-month follow-up period none of the removed films were requested, indicating that a substantial number of films can be sorted out continuously. The possibility to reduce and to ‘clinically compress’ the amount of data in a future digital picture archive is emphasized.
Arterial Segmental Vasoconstriction in Hypercholesterolaemic Patients
Authors: Nilsson S. , Berglund I. , Christoffersson A. , Erikson U. , Högman N. , Johansson J. , Lörelius L. E. , Roberts R. G. , Walldius G.
Published: June 2015

Regular, wave-like constriction in medium-sized arteries, arterial segmental vasoconstriction (ASV), has been observed at arteriography and described by many authors. We found ASV in arteriograms of the superficial femoral artery in 13 of 107 hypercholesterolaemic patients, enrolled in the Probucol Quantitative Regression Swedish Trial (PQRST). The arteriograms were digitized and studied with a quantitative computer-assisted technique. The frequency of ASV was higher than has been reported earlier in clinical materials, possibly because of an increased vasoreactivity in hypercholesterolaemia, as recently observed experimentally. The ASV patients were, on average, younger, had lower blood pressure and less atherosclerosis, than the non-ASV patients. ASV was not found in any of the 19 patients in the material who either had symptoms of peripheral vascular disease or arteriographically verified arterial occlusions. No significant correlations with smoking habits or serum cholesterol levels were found. A computer-based index of ASV and measurement of ASV wavelength are discussed.
Ultrasonography and Doppler Duplex Compared with Angiography in Follow-up of Mesocaval Shunt Patency
Authors: Hederström E. , Forsberg L. , Ivancev K. , Lundstedt C. , Stridbeck H.
Published: June 2015

Thirty-four patients with portal hypertension of various etiologies were operated upon with an interposition mesocaval Goretex graft. During a period of 6 years 84 angiographic and ultrasonographic (US) examinations (53 B-mode, and 31 Doppler Duplex) were performed, with few exceptions within 3 days. Angiography served as the ‘gold standard’. Shunt patency was correctly interpreted as normal in B-mode US in 38 examinations. Shunt occlusion, definite or probable, was seen in 12 B-mode examinations, where angiography demonstrated occlusion in 6 and patency in the remaining 6 shunts. Shunt occlusion was not observed sonographically in one examination. US was technically inadequate on two occasions. Doppler Duplex showed shunt patency in all 31 examinations, which was correct according to angiography. Both B-mode US, in 6 out of 6 examinations, and Doppler Duplex, in 7 out of 9 examinations failed to reveal shunt stenosis. Five patients with abundant venous collaterals (in one case with aberrant vascular anatomy) were not possible to evaluate even after the introduction of Doppler Duplex, which otherwise facilitated the evaluation. We suggest that US including Doppler should be the primary modality for follow-up in patients with interposition mesocaval Goretex grafts.
Osseous Temporomandibular Joint Abnormalities in Rheumatic Disease
Authors: Larheim T. A. , Kolbenstvedt A.
Published: June 2015

Computed tomography (CT) of the temporomandibular joint (TMJ) was compared with hypocycloidal tomography in 30 joints of 15 adults with rheumatic disease. CT included 1.5 mm thick axial scans (at 1.0 mm intervals) with reformatted oblique sagittal and oblique coronal sections. Multisection (at 2.0 mm intervals) tomography included oblique sagittal and occasionally, oblique coronal sections. CT demonstrated bone abnormalities in 21 and tomography in 20 joints, indicating high agreement between the imaging modalities regarding number of abnormal TMJs. Bone structures were, however, better visualized by multiplanar CT due to superior contrast and spatial resolution particularly in the most lateral and medial parts of the joint, indicating superiority of CT for depicting subtle bony TMJ abnormalities in patients with rheumatic disease.
Superparamagnetic Particles as Gastrointestinal Contrast Agent in Magnetic Resonance Imaging of Lower Abdomen
Authors: Niemi P. , Katevuo K. , Kormano M. , Baksaas I. , Bach-Gansmo T. , Mäenpää J.
Published: June 2015

Negative gastrointestinal contrast enhancement can be achieved by oral administration of superparamagnetic particles. Their feasibility for the MR imaging of the female pelvis and lower abdomen was evaluated in studies on 32 follow-up patients with treated gynaecologic cancer. All the applied doses (0.2–1.0 mg particles/ml given in a volume of 600–800 ml) of contrast medium decreased the intraluminal signal. However, there was unpredictable individual variation in segmental distribution, and in some cases only a limited contrast effect was obtained. Image distortion was detected when the applied particle concentration exceeded 0.5 mg/ml, especially of the sagittal sections.
MR Imaging of Experimental Intramuscular Hemorrhage AT 0.02 T
Authors: Niemi P. , Paajanen H. , Kormano M. , Alanen A. , Määttänen H. , Dean P. B.
Published: June 2015

Intramuscular hemorrhage was induced by injecting autologous blood into the paraspinal muscle of 8 rabbits. In order to evaluate the time-dependent changes of hemorrhage observed on MRI, the animals were imaged at different stages of blood resolution at 0.02 tesla (T), and control examined with ultrasound using a 7.5 MHz linear transducer. Six inversion recovery sequences (TR= 1000 ms. TE = 30 ms, and TI = 18, 48, 148, 201, 302, and 398 ms) were used for the invivo calculation of T1 relaxation times. IR 1000 (398)/30 imaging was performed before and after the Gd-DOTA administration. The hemorrhage was evident on MR images throughout the study, especially on the T2 weighted (SE 1000/100) images. MRI showed the healing lesion longer than ultrasound. The T1 relaxation time increased during the time of resolution. Lesions on days 4 to 7 enhanced in intensity after the injection of Gd-DOTA.
Thallium-201 Single Photon Emission Computed Tomography in Patients with Symptoms of Heart Disease and Non-Significant Coronary Artery Lesions
Authors: Svane B. , Bone D.
Published: June 2015

Polar presentations of coronary angiograms and myocardial201T1 SPECT were compared in 44 patients without significant coronary artery disease (< 50% stenosis at angiography). Regions of reduced isotope activity (defects) were present in 18 patients (41%). Nine of these had angiographic and/or clinical evidence of non-coronary heart disease, such as documented or suspected myocardial infarction, dilated cardiomyopathy or other myocardial diseases. Such defects could be caused by impaired small vessel blood flow, abnormalities in cell membrane transport or relative differences in left ventricular wall thickness. In 9 patients defects were probably due to attenuation artifacts. Defects in patients with heart diseases were significantly larger than in those without obvious disease. The information content in coronary angiography and201T1 SPECT overlap but are not congruent. Coronary angiography describes morphology of large coronary vessels, whereas201T1 SPECT contains information of large and small vessel perfusion as well as membrane transport of201T1 ions.
Deep Vein Thrombosis of Lower Extremities
Authors: Gudmundsen T. E. , Vinje B. , Pedersen T.
Published: June 2015

In 150 patients with possible deep venous thrombosis in the lower extremities, the diagnostic accuracy of real time ultrasonography (US) with 3.5, 5.0 or 7.5 MHz transducers was assessed using venography as standard. In the area of the common femoral/popliteal vein, US was correct in 147 patients, giving an accuracy of 98 percent. There were no false negative studies, giving a sensitivity of 100 percent (60/60) and three false positive studies, giving a specificity of 97 percent (87/90). The results were almost the same using all the three frequencies. The simplicity and accuracy of US make it a useful diagnostic tool.
Variations in Gastrointestinal Melanoma Metastases
Authors: Plavsic B. , Robinson A. E.
Published: June 2015

In 10 patients with gastrointestinal metastases from cutaneous malignant melanoma, metastases to the stomach were found in 2, the small bowel in 9, and the large bowel in 3. Gastric metastases typically appeared as target lesions. However, the morphology of secondary melanoma deposits to the small and large intestine varied significantly, target lesions being only one possible manifestation. Less common appearances of gut metastases were found in 4 patients. One presented atypically with matted loops of distal ileum resulting in prolonged stasis of barium in the affected areas. In 3 patients, infiltrative and stenotic lesions were found in the distal ileum, terminal ileum and cecum. One stenotic lesion of the distal ileum was accompanied by multiple small polypoid lesions more proximally, and the cecal lesion was ulcerated. Six of the patients presented with polypoid and, occasionally, ulcerated and multiple secondary melanoma deposits. Possible causes for variations in morphology are discussed.
Renal Osteodystrophy
Authors: Trattnig S. , Hübsch P. , Traindl O. , Kainberger F. , Schwaighofer B. , Wolszczuk W.
Published: June 2015

The parathyroid hormone concentration in the blood measured by the ‘two-site radioimmunoassay’, which is specific for the biologically active parathyroid molecule (parathyrine), was compared with the radiological manifestations of secondary hyperparathyroidism (HPT) on magnification radiographs of the phalanges in patients undergoing maintenance hemodialysis and in patients with renal allografts. Sensitivity of radiology for the diagnosis of HPT proved to be high (88%), whereas specificity was low (30%). Statistical analysis showed that there was a good correlation between the parathyrine levels and the intensity of radiological changes in the phalanges in patients with renal allografts (coefficient of Krueger-Spearman = 0.65). In patients undergoing hemodialysis the correlation between laboratory parameters and radiological changes was poor.
Lumbar Disc Degeneration
Authors: Tervonen O. , Lähde S. , Rydberg J.
Published: June 2015

Computed tomography (CT) images of 59 discs in 30 patients suffering from low back pain were compared with CT/discography images of the same discs in order to assess the correlation between intradiscal damage and changes in annular configuration and density. The discs were graded in CT as not bulging, slight protrusion, advanced protrusion or disc herniation, and were checked for local areas of hypodensity. General degeneration and annular disruption in CT/discography were evaluated separately according to the Dallas Discogram Description, on a scale of non-existent, slight, moderate, or severe. Most discs with a slight protrusion in CT showed severe annular disruption in CT/discography. Discs with advanced protrusion showed in addition a severe general degeneration. Disc herniation was associated only with severe annular disruption. Local hypodensity proved to be a specific but insensitive sign of annular disruption. It is concluded that a bulging disc is a sign of intradiscal damage and should be noted even when there is no nerve entrapment present.
Computed Tomography after Modified Whipple Procedure with Pancreatic Duct Occlusion
Authors: Abildgaard A. , Kolmannskog F. , Mathisen Ø. , Bergan A.
Published: June 2015

Eighty-two CT examinations performed on 28 patients who had undergone a modified Whipple procedure including pancreatic duct occlusion were reviewed. Reduction of the antero-posterior diameter of the body and tail of the pancreatic remnant was observed on consecutive scans in 8 patients (29%). Decreasing liver attenuation was seen in 4 patients (14%) postoperatively, and pseudocysts in the pancreatic remnant in 6 (21%). In 10 examinations performed because of suspected intraabdominal abscess postoperatively, abscess was diagnosed in 2 patients. In 62 routine follow-up CT examinations, significant positive findings were diagnosed in 5 patients: tumor recurrence or metastases in 4, and a large pseuodocyst in one. CT is of value in the early postoperative phase to reveal postoperative complications and in the follow-up of patients with specific symptoms indicating tumor recurrence or metastases.
Iohexol for Contrast Enhancement of Bowel in Pediatric Abdominal CT
Authors: Smevik B. , Westvik J.
Published: June 2015

Abdominal CT scans from 160 examinations performed on pediatric patients using iohexol 2 percent as contrast medium for bowel enhancement were evaluated retrospectively. When diluted with a beverage of the child's choice, iohexol has a neutral taste and cannot be detected, and 139 out of 142 patients drank the full amount of dilute contrast offered to them. The enhancement of bowel in the area of interest was graded as good (58%), reasonable (23%), or poor (19%). The contrast medium was prepared from leftovers from our angiocardiography studies. We conclude that the use of water-soluble contrast medium in a low concentration is a safe and cost-effective way of facilitating ingestion of sufficient amounts of the medium in oncologic pediatric patients undergoing cytotoxic and/or radiation treatment.
Digital Luminescence Radiography in Interstitial Lung Disease
Authors: Kehler M. , Albrechtsson U. , Andrésdóttir A. , Brådvik I. , Hochbergs P. , Lárusdóttir H. , Lundin A.
Published: June 2015

The subtle changes often found in interstitial lung disease can be difficult to evaluate at conventional radiography. In order to define the information obtained with digital radiography, it is particularly important to find out to what extent interstitial lung disease can be observed with this technique. Ninety-one patients, 56 with interstitial lung disease and 35 with normal lungs, were examined both with a digital system and with conventional film-screen technique. The examinations were reviewed independently by 4 radiologists with different experience and receiver operating characteristics (ROC) curves were constructed. The 2 systems were equal in diagnostic performance with no statistic difference between the conventional radiographs, the 2 digital images reviewed together or the 2 digital images reviewed separately. There was a significant difference between the 2 observers with the highest and the one with the lowest score only in the review of digital unsharp mask images, but otherwise no differences statistically. A lower number of false negatives and a higher number of false positives were seen with the digital unsharp mask image, producing a higher sensitivity and lower specificity.
Hepatocellular Carcinoma in Extrahepatic Bile Ducts
Authors: Park C. M. , Cha I. H. , Chung K. B. , Suh W. H. , Lee C. H. , Choi S. Y. , Chae Y. S.
Published: June 2015

An elongated solid lesion observed on ultrasonography and CT in the biliary tree causing a smooth filling defect on cholangiography was observed in 2 patients. No tumor was observed in the liver parenchyma either on radiography or at operation. Histopathology showed hepatocellular carcinoma. After removal of the intraductal tumors, recurrence was observed in 2 and 6 months, respectively.
Effect of Superparamagnetic Particles in Agarose Gels
Authors: Ericsson A. , Lönnemark M. , Hemmingsson A. , Bach-Gansmo T.
Published: June 2015

The effect of different preparations of superparamagnetic particles, designed as potential MR contrast media for the gastrointestinal tract (oral magnetic particles, OMP, diameter of 3.5 μm, iron content 20% by weight) and for the reticuloendothelial system (intravenous magnetic particles, IMP, mean diameter of 0.3 μm, iron content 30% by weight), were evaluated in agarose gels in vitro, using a 0.5 T whole body MR system. The iron content ranged from 2.1 × 10−4 to 2.1 × 10−1 mg Fe/ml in both preparations. Both preparations reduced the signal intensities substantially over a range of concentrations in spin echo sequences. Generally, the signal intensity decreased monotonously with concentration, except for IMP at low concentrations, at which a minor signal intensity increase was observed on T1 and proton density weighted images. The reduction of the signal intensity was stronger in gradient echo and phase contrast sequences, as compared to corresponding spin echo sequences with similar timing. Both IMP and OMP had a pronounced T2 effect, the effect of IMP being stronger than that of OMP. IMP had a relatively smaller T1 effect, whereas T1 was almost unaffected by OMP. Susceptibility artifacts occurred at higher concentrations of both OMP and IMP, in all sequences used. Thus, OMP reduced the signal intensity, without causing significant artifacts, on both T1 and T2 weighted images over a relatively wide range of concentrations.
Arterial Phlebography of the Leg
Authors: Björk L.
Published: June 2015

On conventional ascending phlebography of the leg the deep femoral and pelvic veins are poorly visualized or not visualized at all. These veins are presumed to be the site of thrombosis and a source of pulmonary embolism in many instances. Diagnostic images of deep femoral and pelvic veins were obtained in 4 patients using injection of 30 ml of iopromide 300 mg I/ml into the iliac artery and DSA imaging of the venous phase of the angiogram.
Diagnostic Significance of Angiographically Observed Visceral Aneurysms with Regard to Polyarteritis Nodosa
Authors: Hekali P. , Kajander H. , Pajari R. , Stenman S. , Somer T.
Published: June 2015

During a 10-year period, intraparenchymal aneurysms were found in 38 of 748 patients at selective abdominal angiography with magnification technique. According to strict criteria, 17 patients were classified as suffering from necrotizing vasculitis of the polyarteritis nodosa group (PAN), 7 from severe arterial hypertension, and 3 from rheumatoid arthritis. The diagnoses of 5 patients remained to be confirmed, and each of the remaining 6 patients suffered from various other diseases. PAN was diagnosed histopathologically in 2 patients without angiographic aneurysms. Based on the 156 patients in whom the indication for angiography was suspicion of arteritis, the angiographic diagnosis of PAN had a sensitivity of 89 percent and a specificity of 90 percent, a positive predictive value of 55 percent and a negative predictive value of 98 percent. The mean number of both renal and hepatic aneurysms was higher in patients with PAN than in the other patients (p < 0.01 and p < 0.05, respectively). Five PAN patients had numerous and large aneurysms, whereas the aneurysms of the other 12 PAN patients did not differ from those of patients with other diseases. Patients with PAN had renal infarcts more often than the other patients (p < 0.05). Our findings suggest that visceral angiography is useful in establishing the diagnosis of PAN, but the angiographic finding of aneurysms is not pathognomonic.
Demonstration of Hepatic Veins by Computed Tomography Using Axial and Angulated Scanning
Authors: Tidebrant G. , Lukes P. , Tylén U. , Wihed A.
Published: June 2015

The main hepatic veins run obliquely into the inferior caval vein. They are often poorly demonstrated on conventional axial computed tomography (CT) performed with a vertical gantry. In order to determine whether CT with caudal tilting of the gantry could improve demonstration of the hepatic veins, 30 consecutive patients of whom 20 had focal lesions in the liver were examined with both a vertical and a 20° caudally tilted gantry. As a reference group, 10 patients were examined with a 20° cranially tilted gantry. In 14/30 (47%) of the non-enhanced examinations caudally angulated CT demonstrated the hepatic veins better than axial CT, while axial CT was the better technique in one patient. No additional tumors were detected with either technique, but the caudal angulation improved the anatomical location of tumors due to a better demonstration of their relation to hepatic veins. CT with cranial angulation did not in any patient improve the demonstration of veins when compared to axial CT. Angulated CT also included examination with contrast enhancement using bolus technique. In 20 out of 27 (74%) examinations with a caudally tilted gantry and contrast enhancement considered optimal for tumor detection, veins containing contrast medium were depicted for an anatomical description. Caudally angulated CT is a non-invasive technique which should be performed in patients in whom liver resection is considered.
Diagnostic Value of Resistive Index of Renal Transplants in the Early Postoperative Period
Authors: Saarinen O.
Published: June 2015

Duplex ultrasonography was used in the diagnosis of acute rejection in 150 renal transplant recipients during the early post-transplant period. In 85 patients (56%) the allograft implantation had a stable postoperative course (control group) while 34 patients (23%) had no initial graft function due to acute tubular necrosis (ATN). Acute rejection occurred in 31 grafts (21%). Doppler spectra were obtained from the intrarenal arterial branches. An average resistive index (RI) was calculated from the spectra. The RI values of the control group differed significantly from those in both ATN and rejection groups. However, there was no statistical difference between the RI values of the ATN and rejection groups. Using a cutoff point of RI ≥ 0.9 the sensitivity and specificity of the diagnosis of an acute rejection were 48.4 and 92.4 percent, respectively. All grafts with stable function had an RI < 0.9. Thus, resistive index shows a poor sensitivity and a less than 100 percent specificity in the diagnosis of rejection. However, an RI ≥ 0.9 is diagnostic of some kind of pathologic condition, including rejection and ATN.
Comparison of MR Imaging and CT in Pituitary Macroadenomas
Authors: Lundin P. , Bergström K. , Thuomas K. Å. , Lundberg P. O. , Muhr C.
Published: June 2015

The findings on mid-field MR imaging and CT were compared retrospectively in 65 patients with pituitary macroadenomas. The evaluation comprised tumour extension and delineation, invasiveness, relationship to adjacent structures, and internal tumoral changes. MR was superior to CT except in the demonstration of bone changes and tumour calcification. The superiority of MR was most pronounced regarding cavernous sinus invasion, tumour relationship to the carotid arteries and optic chiasm, and tumour haemorrhage. Extensive bone changes were visualized with both methods; erosions were often seen only with CT. It is concluded that MR is the preferable method for evaluation of pituitary macroadenomas. CT is useful as a supplementary modality when detailed information on bone anatomy is required, particularly if a transsphenoidal surgical approach is contemplated.
Renal Angiomyolipoma
Authors: Päivänsalo M. , Lähde S. , Hyvärinen S. , Kallioinen M. , Jalovaara P.
Published: June 2015

The findings at ultrasonography (US), CT, and angiography in 13 patients with renal angiomyolipomas were compared with histologically determined proportions of fatty, myogenic, and vascular components. The angiomyolipoma was composed mainly of fat in 4 cases, half of fat in 2, mainly of myogenic tissue in 4, and was hemorrhagic in 3. US showed high echogenicity in 10 patients, while CT demonstrated attenuation values of fat in 3 tumors with mainly fat tissue but gave non-specific findings in the other cases. The angiographic findings were considered specific for angiomyolipoma in 2 out of 11 cases (18%). Low fat content and hemorrhagic areas caused diagnostic difficulties at both US and CT. The diagnostic algorithm for renal angiomyolipoma is discussed.
Renal Effects of Iopentol and Iohexol after Intravenous Injection
Authors: Jakobsen J. Å. , Kolbenstvedt A. N. , Berg K. J.
Published: June 2015

Renal effects of the 2 non-ionic contrast media iopentol and iohexol were investigated and compared in a double-blind, randomized parallel study where 30 patients received iopentol, and 31 patients iohexol intravenously for abdominal CT. The dosage of contrast medium (350 mg I/ml) was 700 mg I/kg body weight. Only one patient (in the iohexol group) had an increase in serum creatinine of more than 50%. Iopentol and iohexol had no effects on the mean serum values of creatinine, urea, and β2-microglobulin (β2-MG) nor on creatinine clearance. The urinary excretion of albumin and β2-MG was also unchanged. The excretion of the proximal tubular enzymes alkaline phosphatase and N-acetyl-β-glucosaminidase was increased. No significant difference between iopentol and iohexol was found.
Influence of Renal Angiography in Living Potential Kidney Donors
Authors: Kjellevand T. O. , Kolmannskog F. , Pfeffer P. , Scholz T. , Fauchald P.
Published: June 2015

The angiograms of 258 potential kidney donors were retrospectively reviewed to assess the influence of angiography for deciding whether or not to accept the potential donor for nephrectomy and which kidney to use for transplantation. Twenty-five potential donors were rejected. In only 8 of these was angiography necessary to reveal the pathology. Angiography was found to be important in deciding which kidney to donate. In 81 donors the right kidney was used for donation and in 50 this decision was based on findings at angiography.
Powdered Diatrizoic Acid for Radiography of the Respiratory Tract
Authors: Szmigielski W. , Klamut M. , Siezieniewska Z. , Chibowski D. , Korobowicz E. , Rubaj B. , Wolski T. , Tynecka Z.
Published: June 2015

Powdered diatrizoic acid as a contrast medium administered by inhalation and insufflation for visualization of the airways was tested in vitro and in 21 dogs. Good radiopacity of the contrast medium and its antibacterial activity was found in vitro. In the majority of animal experiments visualization of the bronchial tree down to segmental and partially to subsegmental bronchi with only minimal agglomeration of contrast medium and with good or very good demonstration of anatomic details was achieved. In the majority of dogs contrast medium was eliminated from the lungs within 18 hours. Arterial blood gases tested on 5 dogs showed only unimportant changes after contrast medium administration. No adverse reactions were observed. Histologic and ultrastructural examinations after contrast studies showed phagocytic reaction to diatrizoic acid, transient impairment of production of surfactant, reactive changes of bronchial mucosa, and no fibrotic changes in the long-term observation.
Digital Image Processing to Remove Blur from Linear Tomography of the Lung
Authors: Sone S. , Kasuga T. , Sakai F. , Izuno I. , Oguchi M.
Published: June 2015

We have studied digital image processing methods to reduce blur in linear tomography of the lung performed with the Fuji computed radiography (FCR) system. One-dimensional unsharp (blur) mask filtering in the direction of tomographic movement was found to be effective in reducing blur. The appearance of the processed tomograms varied depending largely on the properties of the unsharp mask filters applied. With regard to the spatial frequency response of the filter, a high mid-frequency response and a low low-frequency response of the tomographic image data was most effective in obtaining high image quality tomograms. When the standard 2-dimensional unsharp mask technique of the FCR system was additionally applied to the one-dimensional unsharp mask processed tomogram, the clarity of the tomogram was further enhanced. These observations may also be helpful when considering image processing to obtain diagnostically informative digital radiography.
Lung Deposits of Lipiodol in Normal and Cirrhotic Rats
Authors: Chiang J.-H. , Cheng H.-C. , Yang M. C. M. , Lo J.-G. , Chi C.-W. , Lui W.-Y. , Liu R.-S. , Chang T.
Published: June 2015

The distribution of Lipiodol in the liver and lungs following arterial or portal injection was studied in normal (n = 55) and cirrhotic rats (n = 20). Using magnified xeroradiography and radioisotope labeled tracers, it was found that Lipiodol was deposited mainly in the liver and lung after either arterial or portal administration. In control rats after arterial injection, deposits in the lung peaked after 2 hours and gradually declined over 48 hours; whereas after portal injection, the deposit steadily increased for 48 hours. Twenty-five percent of cirrhotic rats demonstrated a Lipiodol-induced miliary pattern in the lung. An increased number of portosystemic shunts in cirrhotic rats was also noted. These results suggest that cirrhosis of the liver may be a potential risk factor for developing pulmonary complications after Lipiodol administration.
A Prospective Comparison of 99mTc-Labeled Polyclonal Human Immunoglobulin and 111In Granulocytes for Localization of Inflammatory Bowel Disease
Authors: Arndt J.-W. , van der Sluys Veer A. , Blok D. , Griffioen G. , Verspaget H. W. , Peña A. Salvador , Lamers C. B. H. W. , Pauwels E. K. J.
Published: June 2015

There is a need for an easily prepared radiopharmaceutical agent for the detection of inflammation and infection. In a group of 14 patients with inflammatory bowel disease (IBD), the detection of actively involved intestinal segments by nonspecific human polyclonal immunoglobulin (IgG) labeled with 99mTc was compared with that of 111In granulocytes. To determine the specificity of 99mTc-IgG scintigraphy, 8 control patients without clinical indications of intestinal inflammation were examined. 99mTc-IgG was found in the left colon in 8 and in the right colon in 7 of the 8 controls 4 hours after the injection. At that time of scintigraphy only 4 IBD patients exhibited a more intense accumulation at the site of the intestinal segments with active disease. In contrast, in a randomized comparison with 111In granulocytes scintigraphy was positive in 11 patients with the latter technique. Moreover, fewer diseased segments were seen in the 4 patients with positive 99mTc-IgG scintigraphy (6 versus 12 with 111In granulocytes). In view of the low sensitivity and specificity, it is concluded that 99mTc-IgG is not suitable for the scintigraphic staging of IBD patients.
Application of Expandable Metallic Stents to the Venous System
Authors: Sawada S. , Fujiwara Y. , Koyama T. , Kobayashi M. , Tanigawa N. , Iwamiya T. , Katsube Y. , Nakamura H. , Furui S.
Published: June 2015

Expandable metallic stents were successfully introduced in 12 patients; 6 with superior vena cava (SVC) obstruction due to tumor invasion or lymph node metastases, 3 with inferior vena cava (IVC) obstruction or stenosis due to lymph node metastases or hepatic tumor, one with common iliac vein (CIV) obstruction due to lymph node metastases, one with idiopathic obstruction of the hepatic IVC and Budd-Chiari syndrome, and one with CIV obstruction following a dialysis shunt. The length of the lesions was between 2 and 15 cm. Multiple (2–7) stents in tandem were inserted percutaneously from a femoral venous approach through a 12 to 16 F (4.0–5.3 mm) Teflon sheath. Postoperatively, all 12 patients became free from symptoms such as SVC syndrome or IVC syndrome. In 11 patients, the symptoms did not recur during the follow-up periods of 1 to 21 months.