bluuebunny/crossref_metadata_2025 huggingface dataset:
Computed Tomography Findings in Pancreas Divisum
Authors: Lindström E. , Ihse I.
Published: June 2015

In 29 patients with abdominal pain the diagnosis of pancreas divisum (PD) was verified by endoscopic retrograde pancreatography (ERP) via both the major and the minor papilla. Computed tomography (CT) was done in all patients to evaluate contour, volume, antero-posterior diameters and attenuation values of the gland in comparison with a normal reference series. Also, the validity of the CT grading of pancreatitis was assessed in comparison with ERP grading. Patients with PD had an increased cranio-caudal diameter of the pancreatic head (p<0.001). Further, the main pancreatic duct was visualized more often in patients with PD (p<0.01), who also had an increasing frequency of pancreatic calcifications (p<0.05). Otherwise there were no differences compared with the normal series. The observed reduction in the volume of the gland in patients with marked pancreatitis at ERP seemingly reflected the severity of inflammation. No cleavage between the dorsal and ventral anläge was identified. CT was found to be too unspecific to be of any use in grading of pancreatitis. In conclusion, CT findings in patients with PD are sparse, unspecific and preferably a reflection of pancreatitis, if present. ERP remains the ‘gold standard’ for the diagnosis.
Accuracy of Digital Radiography Using Stimulable Phosphor for Diagnosis of Pneumothorax
Authors: Kehler M. , Albrechtsson U. , Andrésdóttir A. , Lárusdóttir H. , Lundin A.
Published: June 2015

To evaluate the efficacy of digitized radiography in diagnosing pneumothorax 78 patients were examined with both the conventional film-screen technique and digital radiography. Of these 78 examinations 40 were normal and in 38 a pneumothorax was found. Four observers with different experience reviewed the films. In an ROC analysis no significant differences were found between the two systems. Between the observers, however, there were slight differences, one of them showing significantly lower specificity.
Bone Marrow Scintigraphy in Paget's Disease of Bone
Authors: Rudberg U. , Ahlbäck S.-O. , Udén R.
Published: June 2015

Sixteen patients with 20 lesions of Paget's disease of bone were studied with bone marrow scintigraphy (colloid), bone tissue scintigraphy and radiography. Bone marrow scintigraphy showed normal or increased colloid uptake in 15 of 20 pagetic lesions, and decreased uptake in 4. Bone tissue scintigraphy showed increased metabolic activity in all lesions and was useful in detecting polyostotic disease as well as the extent of the lesions. Conventional radiography most often showed the typical appearance of Paget's disease, but the changes observed were sometimes difficult to differentiate from malignant disease. However, a preserved or increased reticuloendothelial function in the pagetic lesion contradicts metastatic disease as a differential diagnosis. Bone marrow scintigraphy with radiocolloid is a valuable method in the analysis of Paget's disease of bone.
Ultrasonically Guided Percutaneous Drainage of Breast Abscesses
Authors: Karstrup S. , Nolsøe C. , Brabrand K. , Nielsen K. R.
Published: June 2015

Four patients with breast abscesses developed during lactation were successfully treated by ultrasonically guided percutaneous drainage under local anaesthesia. Three patients continued nursing during and after the period of treatment and 2 patients were treated as out-patients. The cosmetic results were excellent. No recurrence of abscess was observed followig the treatment. Ultrasonically guided percutaneous drainage as an alternative to surgery is discussed.
Magnetic Resonance Imaging Compared with Computed Tomography and Angiography in Moyamoya Disease
Authors: Hasuo K. , Yasumori K. , Yoshida K. , Hirakata R. , Kuroiwa T. , Mizushima A. , Matsushima T. , Fukui M. , Masuda K.
Published: June 2015

Magnetic resonance (MR) imaging performed in 13 patients with moyamoya disease was reviewed and compared with computed tomography (CT) and angiography. The MR findings consisted of occlusion of arteries, collateral vessels and parenchymal changes. Narrowing or occlusion of the middle cerebral artery and the supraclinoid portion of the internal carotid artery were seen in all hemispheres but one. Collateral vessels, cerebral infarcts and atrophy with dilatation of the ventricles were observed on MR imaging. In general, the MR findings correlated well with angiography regarding occlusive changes and moyamoya vessels but was less sensitive in a few cases. Because of its higher sensitivity in detecting occlusive changes and collateral vessels, MR imaging was superior to CT in the diagnosis of this disease.
Prevention and Dispersion of Contrast Media Induced Red Cell Aggregates
Authors: Raininko R. , Ylinen S.-L.
Published: June 2015

Red cell aggregation was observed microscopically when human blood and contrast media were mixed on glass slides. Aggregation was more frequent in low-osmolal media: mainly rouleaux were formed in ioxaglate but irregular aggregates in non-ionic media. Aggregation was similar at concentrations of 150 and 300 mg I/ml. Pre-treatment of glass slides with heparinized saline reduced red cell aggregation but saline alone was almost as effective. Most of the irregular aggregates dispersed when saline or heparinized saline was applied to them. Saline and heparinized saline had an identical dispersing effect. After incubation of the aggregates in iopamidol in plastic tubes for one or five minutes, saline was injected into the tubes, and after mixing the solution was poured onto glass slides and examined under the microscope. Only a few small irregular aggregates were detected in 6/60 specimens. It is concluded that ionicity of a flushing medium and shear of the injection are able to disperse red cell aggregates during angiography.
Ultrasonography and Computed Tomography in Diffuse Liver Disease with Cholestasis
Authors: Partanen K. , Pikkarainen P. , Pasanen P. , Alhava E. , Soimakallio S.
Published: June 2015

Ultrasonography (US) and computed tomography (CT) were performed on respectively 67 and 42 (altogether 72) patients, for the assessment of intrahepatic cholestasis. The diagnostic ability to differentiate between malignant (17 patients) and benign (55 patients) liver disease was analyzed. Coarse echogenicity of the liver led to inconclusive results in differentiating between cirrhosis (2 out of 29 patients) and malignant infiltration (4 out of 15 patients) by US. Other benign liver diseases in 23 patients, including acute hepatitis, chronic active hepatitis, fatty liver, and liver congestion, were correctly interpreted as benign. CT correctly disclosed malignant liver disease in all cases. A false positive diagnosis of malignancy was encountered in 4 (out of 17) patients with decompensated hepatic cirrhosis because of non-homogeneous expansive areas on CT in 3 cases. The true cause was in 2 patients non-uniform fatty infiltration, and in one patient with acute hepatitis A, small hypodense lesions. Among cholestatic patients, decompensated cirrhosis and malignant liver infiltration could not always be differentiated on US or CT.
Oxygen Saturation of the Low Osmolar Contrast Media Iohexol, Ioxaglate and Iodixanol
Authors: Bååth L. , Almén T. , Öksendal A.
Published: June 2015

During coronary angiography the exchange of blood with a contrast medium solution causes a period of hypoxia. To investigate whether oxygen saturation of the contrast medium could be beneficial, low osmolar contrast media were infused without and with oxygen saturation into the coronary arteries of the isolated rabbit heart. Iohexol (150–300 mg I/ml, without NaCl or with 20–30 mM NaCl), iodixanol (320 mg I/ml, contains 24 mM NaCl) and ioxaglate (160 mg I/ml, contains 75 mM Na+) were infused without and with oxygen saturation. The decrease in contractile force (CF) of the heart, from the contrast medium solutions, was reduced when the solutions were saturated with oxygen. Oxygen saturation of iohexol (350 mg I/ml, without or with 10 mM NaCl) did not change the frequency of ventricular fibrillations (VF). Low osmolar contrast media, when saturated with oxygen, thus caused a reduced decrease in CF without changing the frequency of VF. This might be beneficial in clinical cardioangiography by reducing the adverse effects from the media.
Transrectal Ultrasonography Compared to Histopathological Assessment for Local Staging of Prostatic Carcinoma
Authors: Enlund A. , Pedersen K. , Boeryd B. , Varenhorst E.
Published: June 2015

Transrectal ultrasonography (US) was used to predict tumor stage prior to radical prostatectomy in 59 patients with clinically localized carcinoma of the prostate. In 35 cases, US-guided biopsy was done. Histopathological examination of whole tissue mounts was compared with US findings in 49 cases. The remaining 10 had US-guided biopsies proving extracapsular extension of the tumor. Tumor size, as measured by US, was inadequate to distinguish between organ-confined disease and locally advanced tumor. Strategically taken US-guided biopsies of the periprostatic tissue or seminal vesicles were necessary. In the first 30 (group I) in this series of 59 cases, 18 of 22 tumors with extraprostatic spread (pT3) were understaged. In the last 29 cases (group II) only 6 of 19 pT3 tumors were understaged. After an initial training period, transrectal US, in combination with US-guided biopsy, can prove valuable for the pretherapeutic assessment of local spread of prostatic cancer, and can thus aid in the choice of appropriate treatment.
Low Sodium Diet, Indomethacin, and Contrast Media
Authors: Thomsen H. S. , Hemmingsen L. , Golman K. , Skaarup P. , Larsen S.
Published: June 2015

Urine profiles were followed for 3 or 9 days after intravenous injection of diatrizoate, iohexol, or saline in 30 adult Wistar rats, which received a low sodium diet for 14 days, and indomethacin intravenously 2 hours and immediately before contrast medium or saline injection. A control group of 10 rats, which also received low sodium diet, got saline alone and no indomethacin or contrast medium. Diatrizoate increased albuminuria during the first 22 hours after its injection whereas iohexol did not have any significant effect on albuminuria. Both contrast media caused tubular dysfunction, but there was significant difference between them during the first 2 hours after injection. Compared to the effect of saline, iohexol but not diatrizoate caused increased excretion of lactate dehydrogenase and N-acetyl-beta-glucosaminidase for 2 days. Iodine measurements showed delayed excretion of both media. Light microscopy showed focal location of dilated tubular profiles with hydrophia, which were only present in kidneys exposed to contrast media. It is concluded that in rats fed on a low sodium diet administration of indomethacin in relation to iohexol has a greater tubular cell effect than diatrizoate, which in turn has a greater effect on the glomerular permeability. The excretion of both media is delayed.
Magnetic Resonance Imaging of Acute Myocardial Infarction in Pigs Using Gd-Dtpa
Authors: Wikström M. , Martinussen H. J. , Wikström G. , Ericsson A. , Nyman R. , Waldenström A. , Hemmingsson A.
Published: June 2015

Six pigs with coronary artery occlusion were investigated with MR imaging before and subsequently for about 2.5 hours at repeated intervals after the intravenous administration of Gd-DTPA (0.4 mmol/kg). The animals were sacrificed after a total occlusion time of 6 hours and the hearts were excised. The excised hearts were then reexamined in the MR equipment and stained with TTC (triphenyl tetrazolium) in order to define areas of infarction. Four control hearts with 6-hour-old infarctions were only imaged ex vivo without any previous administration of contrast media. In vivo, there was no clear demarcation of infarction with or without Gd-DTPA. Ex vivo, without any contrast media, the infarctions were poorly discriminated with a discretely increased signal intensity relative to normal myocardium in the T2 weighted images. Gd-DTPA was found to accumulate in the infarctions, which caused an elevated signal intensity most pronounced in the T1 weighted images. This considerably improved the delineation of the infarcted area.
Transrectal Ultrasound Findings of Prostate Cancer Mimicking Primary Rectal Tumor
Authors: Lorentzen T. , Torp-Pedersen S. , Nolsøe C.
Published: June 2015

Two patients with disseminated prostatic cancer underwent transrectal ultrasonographic examination. In the rectal wall, at the prostatic level, tumor infiltration was seen without obvious communication to the prostate. Biopsy demonstrated adenocarcinoma, and immunohistochemic staining for prostatic specific antigen (PSA) was positive. We recommend the application of PSA staining in biopsy specimens of unclear rectal masses.
Femoral Cortical/Cancellous Bone Related to Age
Authors: Høiseth A. , Alho A. , Husby T.
Published: June 2015

The femoral cancellous/cortical relationship with age has been determined in 53 dissected femoral specimens. By means of computed tomography (CT) values related to bone density and mass were assessed in the femoral head, neck, trochanter, shaft, and condyles. In the neck and trochanter separate measures were made in cortical and cancellous bone. The results were analyzed by means of correlation and regression analyses. There were significant negative linear correlations between the CT measures and age for all measures except for the isolated cancellous measures in the femoral neck and trochanter. Our results indicate that in the femoral neck and trochanter the cortical bone mass constitutes a substantial amount of the total bone mass. We conclude that, since bone strength to a large part is a function of the total bone mass, loss of cortical bone may be more important than loss of cancellous bone.
CT of Liver Steatosis after Subtotal Pancreatectomy
Authors: Lundstedt C. , Andrén-Sandberg Å.
Published: June 2015

The liver attenuation of 50 patients operated with a subtotal pancreatectomy for pancreatic and duodenal tumors was evaluated with CT. Of 18 patients surviving more than 18 months after surgery, 7 developed a markedly reduced liver attenuation indicating liver steatosis. No patient became diabetic or showed evidence of malnutrition after surgery. No correlation between the liver attenuation values and the patients' liver function tests was noted. The steatosis was reversible in 4 of the 7 patients. The pathophysiological cause of the steatosis remains unknown. Partial pancreatectomy should be included among the reasons listed for liver steatosis.
Effects of Contrast Media on the RR and QT Interval during Coronary Arteriography
Authors: Mitsumori M. , Hayakawa K. , Soga T. , Maeda M. , Torizuka T. , Okuno Y. , Misaki T. , Dokoh S.
Published: June 2015

During coronary arteriography, transient prolongation of the RR and QT intervals can be observed to occur. Animal experiments have suggested that low-osmolality contrast media have less effect, but there have been few clinical studies of this phenomenon. We analyzed 95 electrocardiographic records from patients who had undergone coronary arteriography and assessed the maximal prolongation of the RR and QT intervals. The contrast media used for arteriography included meglumine sodium diatrizoate, iopamidol, iohexol, and meglumine sodium ioxaglate. Diatrizoate caused the greatest electrocardiographic changes. Among the low osmolality contrast media, ioxaglate caused the smallest bradycardial effect and iohexol the smallest prolongation of the QT interval. It appears necessary to consider some additional factors for osmolality or ionicity, such as the chemotoxicity of the chemical structure of the iodinated contrast medium moiety, when assessing their potential adverse effect on the cardiac conduction system.
Effects of Varying Potential and Electrolytic Dosage in Direct Current Treatment of Tumors
Authors: Heiberg E. , Nalesnik W. J. , Janney C.
Published: June 2015

The effects of different voltages and dosages during direct current treatment were studied to determine the most effective tumor treatment. Groups of nude mice with subcutaneous human colon cancer nodules were treated with a single electrolytic dose (charge) of direct current using two percutaneously placed needle electrodes. All the treated groups responded and the residual tumor volumes were significantly lower (p < 0.001) than the control group. 7.5 V gave the greatest tumor reduction, significantly more than for 12.5, 10.0, and 2.5 V. 35 C/ml of tumor was more effective than 30 C/ml (p < 0.05) and no difference in response was obtained between 35 and 50 C/ml. Hyperthermia did not appear to play a significant part in direct current treatment in the examined voltage range as no intra-tumoral temperature elevation was observed. Direct current may allow effective percutaneous treatment of metastases which are unresponsive or unsuitable for conventional treatment.
CT and Angiography in a Patient with Three Intracranial Giant Aneurysms
Authors: Altinörs N. , Kars Z. , Çerezci A. , Oral N.
Published: June 2015

A patient with multiple giant aneurysms all located in the circle of Willis was treated conservatively. Literature pertaining to neuroradiologic features, especially dealing with the CT appearance of this entity, is scrutinized.
Perivascular Low Attenuation Zone at CT of Liver Transplants
Authors: Aspestrand F. , Mathisen Ø. , Bergan A.
Published: June 2015

A follow-up study of 30 liver transplant patients confirmed that periportal and pericaval rims of low attenuation found at CT reflect hepatic lymph stasis. The perivascular rims are found coexistent with acute allograft rejection, but are not correlated with acute rejection, immunosuppressive agents (cyclosporin A), or intercurrent infection. Disappearance of the perivascular low attenuation zone in our material coincided with normalization of liver biochemistry probably associated with reestablishment of lymphatic drainage. Like previous reports on experimental hepatic lymph stasis, our study thus indicates that lymph stasis may have harmful effects on human liver allografts.
Limitations of Quantitative CT in Corticosteroid Induced Osteopenia
Authors: Karantanas A. H. , Kalef-Ezra J. , Glaros D.
Published: June 2015

Single energy spectrum quantitative CT (SES-QCT) was applied for the assessment of the trabecular bone mineral status in patients under long-term corticosteroid treatment. Seventeen renal graft recipients (RGR) and 12 patients receiving corticosteroid treatment for collagen disease were studied. A reduction of about 40% in the spinal trabecular bone density relative to matched controls was found, associated with the corticosteroid administration. Repeated measurements showed significant reduction in density 4 months after transplantation, and an increase in density after graft rejection. Radiologic or clinical evidence of osteopenia in the spine was not found. Other non-invasive techniques, applied in the upper extremities of the RGR, showed only minor bone reduction compared to controls. The findings of the present study suggest that adipose tissue deposition in the spinal trabeculae can introduce errors in the measurements. Therefore, SES-QCT should not be applied during corticosteroid therapy.
Accuracy of Adrenal Biopsy Guided by Ultrasound and CT
Authors: Tikkakoski T. , Taavitsainen M. , Päivänsalo M. , Lähde S. , Apaja-Sarkkinen M.
Published: June 2015

We reviewed the results of fine needle biopsy of the adrenal glands guided by ultrasonography or CT in 56 patients. The final diagnoses, obtained at operation, autopsy or follow-up were: metastasis (n = 22), adenoma (n = 21), adrenal cyst (n = 6), hematoma (n = 3), lymphoma (n = 1), pheochromocytoma (n= 1), lymph node (n = 1), and amyloid mass (n= 1). Sufficient cytologic material was obtained in 96.4% (54/56). The overall accuracy to differentiate benign from malignant disease was 85.7% (48/56), 2 were false-negative, one was false-positive. The biopsy was inconclusive (“possibly malignant”) in 3 patients, 2 of whom had an additional cutting needle biopsy yielding a correct positive finding. No complications occurred. We conclude that in disseminated malignant disease with suspected adrenal metastases diagnostic results can be obtained with guided fine needle biopsy. Biopsy in primary adrenal lesions is helpful, especially if the aspirate of the lesion turns out to be composed of something other than adrenal cells.
Salivary Spect and Factor Analysis in Sjögren's Syndrome
Authors: Nakamura T. , Oshiumi Y. , Yonetsu K. , Muranaka T. , Sakai K. , Kanda S.
Published: June 2015

Salivary SPECT and factor analysis in Sjögren's syndrome were performed in 17 patients and 6 volunteers as controls. The ability of SPECT to detect small differences in the level of uptake can be used to separate glands from background even when uptake is reduced as in the patients with Sjögren's syndrome. In control and probable Sjögren's syndrome groups the uptake ratio of the submandibular gland to parotid gland on salivary SPECT (S/P ratio) was less than 1.0. However, in the definite Sjögren's syndrome group, the ratio was more than 1.0. Moreover, the ratio in all patients with sialectasia, which is characteristic of Sjögren's syndrome, was more than 1.0. Salivary factor analysis of normal parotid glands showed slowly increasing patterns of uptake and normal submandibular glands had rapidly increasing patterns of uptake. However, in the definite Sjögren's syndrome group, the factor analysis patterns were altered, with slowly increasing patterns dominating both in the parotid and submandibular glands. These results suggest that the S/P ratio in salivary SPECT and salivary factor analysis provide additional radiologic criteria in diagnosing Sjögren's syndrome.
Central Nervous System Reactions to Cervical Myelography
Authors: Vestergaard A. , Dons K. , Eskesen V. , Kruse-Larsen C. , Lyon B. Blatt , Søborg P. Arlien , Jensen N. O. , Præstholm J.
Published: June 2015

In a double blind prospective study of side effects to cervical myelography 38 patients were evaluated with neurologic examination, electroencephalography (EEG), brainstem evoked response (BER), somatosensory evoked responses (SSER), and continuous reaction times prior to and at 6 h and 24 h after myelography with either metrizamide or iohexol. A difference in the incidence of side effects (for example headache, dizziness, nausea, and neck pain) to the two different contrast media indicated that the inconveniences related to myelography were not only due to the spinal puncture. A contrast medium effect on the central nervous system varying from one agent to another was present. A high frequency of EEG deteriorations among patients with adverse clinical reactions and on only discrete affection upon BER indicated the reaction to be located to the cerebral cortex. Weakened tendon reflexes and reduced strength in the upper extremities were probably caused by blockade in the motor roots as SSER were normal indicating no affection of the sensory pathways. This hypothesis is in agreement with the fact that the patients were in the prone position in the first phase of the investigation causing the highest concentration of contrast medium around the motor roots and the anterior part of the spinal cord. Difference in metabolic effect may explain differences in side effects of metrizamide and iohexol.
Angiographic Profile in Childhood Moyamoya Disease
Authors: Jayakumar P. N. , Arya B. Y. T. , Vasudev M. K.
Published: June 2015

The cerebral angiograms of 8 patients with childhood moyamoya disease showed that the common findings were stenosis/occlusion of the supraclinoid internal carotid artery and the proximal segments of the anterior and middle cerebral arteries and basal moyamoya. The volume of basal moyamoya and its collateral supply depended upon the stage of the disease. Leptomeningeal collaterals were frequent in the later stages. Stenotic lesions in the posterior circulation were seen in a majority (75%) of patients. A feature unique to the study was evidence of intracranial small-vessel disease and stenotic cervical internal carotid artery in half of the cases. The disease in the ethnic caucasian Indians seems largely similar to the classical disease frequently reported in the Japanese literature.
Phlebography as the Gold Standard in Thromboprophylactic Studies?
Authors: Wille-Jørgensen P. , Borris L. , Jørgensen L. N. , Hauch O. , Lassen M. R. , Nehen A. M. , Kjær L. , Jensen R.
Published: June 2015

In 241 patients with total hip arthroplasty and entering a study on thrombosis prophylaxis, phlebography was adequately performed in 451 legs 7 to 11 days after surgery. The phlebograms were primary evaluated by 4 independent observers, and finally a consensus of the images in which disagreement primarily occurred was obtained. The diagnosis of thrombosis in the 4 primary observations varied between 65% and 83% (mean 70%) and the agreement on a negative diagnosis between 97% and 99% (mean 98%). Taking into account agreement by chance, kappa-values varied from 0.60 to 0.83 when the 6 different pairs of observations were compared. When comparing the primary evaluations with the final consensus, agreements on positive diagnosis varied between 70% and 90% (mean 80%) and on negative diagnosis between 97% and 99% (mean 98%). Kappa-values varied from 0.68 to 0.90. The factor of uncertainty in evaluation of phlebography may have to be considered when studies on postsurgical thromboprophylaxis are planned.
Colloid Scintigraphy Showing Red Bone Marrow Extension in Patients with Prostatic Carcinoma
Authors: Rudberg U. , Udén R. , Ahlbäck S.-O.
Published: June 2015

In 25 of 30 patients with bone metastases from prostatic carcinoma, red bone marrow extension was observed by scintigraphy of the reticuloendothelial system (RES). The degree of bone marrow extension in the lower extremities increased with increasing number of bone metastases. In 8 patients, 15 peripheral metastases were detected, all located in areas with extended red bone marrow. The distal level of bone marrow extension coincided with that of the most distal metastases. This is of importance for the detection of peripheral metastases at risk for fracture. Bone marrow extension was also seen in 5 of 8 patients with prostatic carcinoma without bone metastases and was interpreted as a paramalignant activation of RES.
Combined Ct-Guided Biopsy and Cytology in Diagnosis of Bony Lesions
Authors: Tikkakoski T. , Lähde S. , Puranen J. , Apaja-Sarkkinen M.
Published: June 2015

The results of 44 trephine (OD 1.4–4 mm) biopsies and 39 fine needle (0.7–0.9 mm) aspirations of skeletal, mainly vertebral, lesions performed under CT-guidance in 54 patients were evaluated. The fine needle sample was aspirated through the trephine as a complementary procedure in 29 patients and a fine needle aspiration only was performed in 10 patients. Trephine biopsy only was performed in 15 patients. Sufficient material for histologic and cytologic analyses was obtained in 93% (41/44) and 97% (38/39) and a correct benign or malignant diagnosis was obtained in 84% (37/44) and 90% (35/39), respectively. Among the combined examinations the fine needle aspiration alone was diagnostic in 2 cases while the trephine specimen alone provided diagnostic material in 2 cases. In 24 cases both the cytologic and histologic samples were adequate for diagnostic purposes. In one case both methods gave false-negative results. The combined use of cytologic and histologic samples in CT-guided bone biopsies increased diagnostic accuracy. The aorta was perforated once with a 1.4-mm needle but without sequelae. CT-guided bone biopsy was found to be a safe, reliable and cost-efficient method.
Aberrant Left Gastric Vein Directly Draining into Left Portal Venous System
Authors: Tajima H. , Murakami R. , Kumazaki T.
Published: June 2015

A 66-year-old man with early gastric cancer and liver cirrhosis was diagnosed by preoperative angiography as having an aberrant left gastric vein communicating directly with the left lateral portal vein system. This communication was confirmed during operation for the gastric cancer. Our report is the first of an aberrant left gastric vein showing direct communication with the left portal vein system.
Visual Interpretation Compared with Caliper and Computerized Measurements in Experimental Vessel Stenosis
Authors: Yanagihara Y. , Sugahara T. , Fukunishi Y.
Published: June 2015

To explain visual interpretation errors on angiograms, visual interpretation, caliper measurement, and computerized measurement of cine film were compared using each of 10 graphic models and 10 acrylic models with “stenotic vessels”. Stenosis > 40% was overestimated and stenosis < 40% underestimated by visual interpretation. In caliper measurement, stenosis > 40% at exposure of 90 kV was greatly overestimated by a degree similar to the estimation by visual interpretation, and stenosis > 40% at exposures of 74 kV and 58 kV was slightly overestimated. In computerized measurement, the estimation was consistent with the actual degree of stenosis. Therefore, visual interpretation was not reliable for estimation, and computerized measurement was indispensable for estimation of vessel stenosis. Moreover, we consider the most common cause of error in visual interpretation to be optical illusions.
Iodixanol in Cardioangiography in Patients with Coronary Artery Disease
Authors: Kløw N. E. , Levorstad K. , Berg K. J. , Brodahl U. , Endresen K. , Kristoffersen D. T. , Laake B. , Simonsen S. , Tofte A. J. , Lundby B.
Published: June 2015

Iodixanol is a new nonionic, dimeric contrast medium. With the addition of 18 mmol/l Na+ and 0.3 mmol/l Ca++ to iodixanol 320 mg I/ml a plasma-isotonic solution was obtained. The purpose was to evaluate the suitability of iodixanol for use in cardioangiography by determining the diagnostic efficacy, patient tolerability, and cardiac and renal side-effects. Initially, 14 patients with coronary artery disease were examined using iodixanol. A double-blind, randomized study was then performed in 72 patients, comparing iodixanol and iohexol. Serum and urine were sampled before the examination, and one and 2 days after. The diagnostic information was good and the number of adverse events low with iodixanol. The patients reported significantly less of a sensation of warmth following injection of iodixanol than iohexol. Our results also indicate that iodixanol 320 mg I/ml influences renal function to a lesser degree than does iohexol 350 mg I/ml. We therefore conclude that isotonic iodixanol is a safe contrast medium for use in cardioangiography.
Clot Formation in Angiographic Catheters — An in Vitro Comparative Study
Authors: Raininko R. , Söder H.
Published: June 2015

Clot formation was compared in 6 brands of angiographic catheters, each of which was tested in 3 states: untreated, heparinized, and albumin-coated. Forty-six samples of each brand in each state (in total 828) were filled with blood from 23 donors and incubated at +37 °C for 5 or 15 min. Physiologic saline was then injected through the catheters at a flow rate of 5 and 50 ml/s, respectively, and any expelled clots identified on a filter. Heparinization reduced the number of clotted catheters at 5 min, but not at 15 min. The only significant difference related to catheter brands was found between the heparinized nylon and polyurethane catheters at 5-min incubation with fewer clotted polyurethane catheters. This difference was not found between the same materials made by two other manufacturers. Albumin coating had no effect on clot formation, but clots were more easily expelled by low-flow injections in albumin-coated and, to a lesser degree, in heparinized than in untreated catheters.
Low-Field Strength Magnetization Transfer Contrast Imaging of the Patellar Cartilage
Authors: Koskinen S. K. , Komu M. E. S.
Published: June 2015

The time-dependent saturation transfer (TDST) method was applied at 0.1 T in order to evaluate the magnetization transfer contrast (MTC) of the patellar cartilage in vivo. Nine knees were examined. The MTC image of the knee is also demonstrated. The MTC of 63% of the patellar cartilage was attained. Magnetization transfer MR imaging may be of additional help in the evaluation of cartilage disorders at low-field MR imaging.
Sclerotherapy of Edematous Gallbladders with Different Agents
Authors: Lindberg C.-G. , Lundstedt C. , Jeppsson B. , Stenram U. , Stridbeck H.
Published: June 2015

Different sclerosing agents were tried in experiments with 32 pigs to achieve ablation of gallbladders rendered edematous by mechanical lithotripsy with the Rotolith lithotriptor. In 16 pigs sclerotherapy was performed with 6% acetic acid, Carnoy's solution, 95% ethanol + 3% sodium-tetradecylsulfate (STS) and hot metrizoate, respectively. These animals were sacrificed immediately after the procedure. Histologic examination showed persistent surface epithelium and glandular epithelium in all specimens. In 6 pigs, the sclerotherapy was done with Carnoy's solution, 95% ethanol + 3% STS and hot metrizoate, respectively, and the pigs were killed 6 days later. Fibrosis of the gallbladder remnants was seen in these animals, but also remnants of surface and glandular epithelium. Hot metrizoate was used in another 10 pigs and these animals were sacrificed after 8 weeks. At histologic examination fibrosis was seen in the gallbladder remnants of 9 surviving animals, but also areas of preserved muscular layer, and development of mucinous cysts were found in more than 50% of the specimens. Thus, none of the sclerosants was able to produce a total ablation of the gallbladder mucosa.
Percutaneous Rotational Lithotripsy of Urinary Bladder Stones
Authors: Lindberg C.-G. , Berggren T. , Lindstedt E. , Lundstedt C. , Stridbeck H.
Published: June 2015

Mechanical rotational lithotripsy of urinary bladder stones, up to 20 mm in diameter, was performed in 6 male patients with the Rotolith lithotriptor. The lithotriptor was introduced through a 10 F (OD 3.3 mm) suprapubically inserted sheath, and the procedure was performed under intermittent fluoroscopy and inspection through a transurethral cystoscope. In 3 patients, the bladder stones were fragmented to pieces small enough to be evacuated through the cystoscope. The instrument, which is designed for lithotripsy of gallbladder stones, was less efficient for fragmentation of urinary bladder calculi, primarily due to the large volume of the human urinary bladder, and possibly because of the higher gravity of bladder stones. There was no substantial damage to the mucosa of the urinary bladder.
Ultrasound-Guided Biopsies of Neuroendocrine Metastases
Authors: Elvin A. , Wilander E. , Öberg K. , Eriksson B. , Lindgren P. G.
Published: June 2015

Twenty-five patients with known neuroendocrine tumour disease were biopsied with 1.2 mm and 0.9 mm biopsy-gun needles to evaluate the respective diagnostic accuracy of the 2 needle sizes. The influence of treatment-related fibrosis on the histopathological diagnosis was also evaluated. The overall diagnostic accuracy with the 0.9 mm needle was 69% as compared to 92% with the 1.2 mm needle. This difference, however, seems more related to needle guiding difficulties with the 0.9 mm needle than to insufficient tissue yield. When the tumour was hit with both the 0.9 and the 1.2 mm needle the tissue yield was inferior with the 0.9 mm needle in only one of 16 cases. The increased amount of fibrous tissue due to interferon treatment did not seem to negatively influence the diagnostic accuracy.
Clinical Experience of 123I-IMP Scintigraphy in Detecting Vertebral Bone Metastases of Hepatocellular Carcinoma
Authors: Suto Y. , Iwamiya T. , Tanigawa N. , Shabana M. , Ohta Y.
Published: June 2015

Although bone scintigraphy with 99mTc-MDP is a sensitive diagnostic method to detect bone metastasis, it is not specific for malignancy. A radioactive substance which accumulates specifically into metastatic lesions should be of value. 123I-IMP and bone scintigraphy with 99mTc-MDP were consecutively performed in patients with vertebral bone metastases from hepatocellular carcinoma and lumbar spondylosis deformans in a 7-day interval or shorter. The intensity of uptake was compared. Eighteen of the 20 metastatic lesions (90%) were classified as increased uptake areas in 123I-IMP scintigraphy. MDP-scintigraphy disclosed 16 metastatic lesions (80%), 9 as “hot” lesions (56%) and 7 as “cold” lesions (44%). 123I-IMP scintigraphy was negative in all 12 lesions of lumbar spondylosis deformans. Compared to MDP-scintigraphy, 123I-IMP scintigraphy was more sensitive in detecting vertebral bone metastases of hepatocellular carcinoma with smaller rates of false-positive and false-negative findings.
A Prospective Comparison of Iotrolan and Iohexol in Lumbar Myelography
Authors: Wagner A. , Jensen C. , Sæbye A. , Rasmussen T. B.
Published: June 2015

In a double-blind study 238 patients were examined with lumbar myelography using iotrolan or iohexol in randomized sequence in order to evaluate the image quality, the safety and tolerance of iotrolan by monitoring the adverse effects with special attention to late reactions. There were no serious complications. On the first day 28 patients (24%) had headache after iotrolan and 41 (34%) after iohexol. This difference was not significant, and these frequencies are similiar to those found after spinal puncture alone. The second most frequent side effect was neck pain; the duration of neck pain were significantly longer after myelography with iohexol than with iotrolan. There was a significantly higher frequency of adverse effects in females the first 24 hours, but during examination and on days 2 to 4 there were no differences between males and females. Anamnestic information or myelographic diagnosis could not predict which patients would have side effects. The image quality was excellent or good in all examinations but one. It is concluded that iotrolan is a safe contrast medium well suited for lumbar myelography.
Nonionic Contrast Media in Pediatric CT
Authors: Wiklund L.-M. , Brolin I. , Sjöholm K.
Published: June 2015

In pediatric radiology there is a great demand for a safe contrast medium. In this pediatric CT trial, the safety, tolerability and efficacy of 2 nonionic contrast media, iopentol (Imagopaque) and iohexol (Omnipaque), were evaluated. The study was performed as a double-blind, randomized, parallel trial, with 55 children receiving iopentol (300 mg I/ml) and 55 receiving iohexol (300 mg I/ml). The dose injected was 2 ml/kg b.w. with an upper limit of 100 ml. Blood pressure and pulse rate were recorded. Adverse events were recorded by observation of the patients up to 24 hours after the examination. No clinically or statistically significant changes occurred. Seven adverse events other than discomfort (2 in the iopentol group and 5 in the iohexol group) were reported. The overall quality of CT enhancement was good or excellent in all cases. The results support the use of iopentol as an alternative to iohexol in pediatric CT examinations.
Relaxation Times of Normal Breast Tissues
Authors: Dean K. I. , Majurin M.-L. , Komu M.
Published: June 2015

The influence of age on the relaxation times of normal breast parenchyma and its surrounding fatty tissue were evaluated, and the variations during a normal menstrual cycle were analyzed using an ultra low field 0.02 T imager. Thirty-nine healthy volunteers aged 21 to 59 years were examined to determine T1 and T2 relaxation times, and 8 of these volunteers were studied once weekly during one menstrual cycle. The only significant trend was an increase in the T2 of breast parenchyma with increasing age. During the menstrual cycle there was a slight but insignificant (p = 0.10) increase in T1 of the breast parenchyma values during the latter half of the menstrual cycle, and a corresponding increase in T2 values between the 2nd and 3rd weeks of the menstrual cycle, which was significant (p = 0.003).
Assessment of Rotation in Proximal Humeral Osteotomy
Authors: Söderlund V. , Kronberg M. , Broström L.-Å.
Published: June 2015

The correlation between the shift measured on bone surface in rotatory osteotomy and the radiologic change of the retroversion angle was analyzed. The humeral head retroversion was measured radiographically in 7 isolated humeri by means of a semiaxial projection. All bones were then osteotomized and the humeral head rotated in order to increase and decrease the retroversion. The retroversion was measured radiographically for each new rotational position of the head. The relationship between the measured shift in rotatory osteotomy and the change of retroversion was found to be linear. Twelve patients with recurrent anterior shoulder joint dislocations and a small humeral head retroversion were operated on in order to increase the retroversion. In all patients the increase of retroversion angle was smaller (57%) than expected on the basis of the shift in osteotomy and humeral diameter. The mean increase of retroversion was 2°/mm shift (range 1.3–3.0°/mm).
Digital Rectal Examination and Transrectal Ultrasonography in Staging of Rectal Cancer
Authors: Rafaelsen S. R. , Kronborg O. , Fenger C.
Published: June 2015

Staging of rectal carcinoma before surgical treatment was performed in a prospective blind study, comparing digital rectal exploration and transrectal linear ultrasonography (TRUS) with the resulting pathological examination. TRUS underestimated depth of penetration in 3 of 33 patients and overestimation resulted in 9 of 74. The figures for digital examination were 5 of 18 and 20 of 76, respectively. Penetration of the rectal wall was correctly identified in 56 of 61 patients by digital examination and in 59 of 61 by TRUS. Specimens without penetration of the rectal wall were identified in 26 of 33 patients by TRUS, but in not more than 13 of 33 by digital examination. Regional lymph node metastases were present in 19 patients; none were diagnosed by digital examination, but TRUS identified 11 of the 19. It is concluded that TRUS will result in more patients having the possibility of local surgery for cure.
Partial Splenic Embolization with Y-Shaped Silicone Particles
Authors: Yamauchi T. , Furui S. , Irie T. , Kusano S.
Published: June 2015

We have developed an embolizing material consisting of Y-shaped silicone particles for partial splenic embolization. Wide spaces for blood flow are left around the particles when these are lodged in arterial branches. We embolized one kidney in each of 3 dogs with the particles and observed a slowly induced occlusion of renal arterial branches during one month. The particles were also used for partial splenic embolization in 14 patients. The average portion of infarcted spleen tissue 7 days after embolization was 51% calculated from CT images. In 6 patients who had CT both 2 and 7 days after embolization, the average rate of splenic infarction increased from 29% at 2 days to 60% at 7 days. Our patients required analgesics for only 2.3 days on average. The Y-shaped silicone particles by slowly occluding splenic arterial branches produce ischemia in a gradual fashion which may minimize the pain after embolization.
CT Changes after Lumbar Percutaneous Automated Nucleotomy
Authors: Dullerud R. , Amundsen T. , Nakstad P. H. , Magnæs B.
Published: June 2015

In order to assess changes occurring in disk hernias and disk spaces following percutaneous nucleotomy a follow-up CT was carried out an average of 6 months after treatment of 69 disks in 60 patients. Forty-three of the disks were also reexamined at an average of 11 months after the first follow-up. Twenty-seven percent of the hernias were reduced in size at the first follow-up. Fourteen percent were reduced and 7% had increased between the first and second follow-ups. The medium-sized and large hernias were more frequently reduced compared to the smaller ones. Reduction of the disk space was found in 29% of the cases at first follow-up. An additional 24% were reduced between the first and second follow-ups. No association was demonstrated between change in size of the herniation or disk space and clinical outcome or amount of nucleous material removed at nucleotomy.
Femoral Head Shape in Legg-Calvé-Perthes Disease
Authors: Hochbergs P. , Eckerwall G. , Egund N. , Jonsson K. , Wingstrand H.
Published: June 2015

Twenty-three children with Legg-Calvé-Perthes disease were examined to determine the femoral head shape. We evaluated and correlated conventional radiography, arthrography and MR imaging. In the a.p. view, measurements were obtained from the center of the femoral head along the bony or cartilaginous outline at 30° intervals. Maximum flattening of the cartilaginous outline appeared laterally, 60° from the center of the baseline of the epiphyseal index and the caput index. Maximum flattening of the bony outline was found at 75°. Arthrography and MR imaging gave the same information about the shape of the femoral head cartilage. The bony femoral head shape on conventional radiographs in the a.p. view did not reflect the cartilage shape obtained by MR and arthrography.
Addition of Sodium to Iohexol
Authors: Flinck A. , Selin K. , Dellborg M. , Skinningsrud K. , Ekholm S.
Published: June 2015

The addition of sodium to nonionic contrast media has reduced the incidence of arrhythmias in animal models. The influence on cardiac function and safety of sodium addition to the nonionic contrast medium iohexol (Omnipaque) was studied in a randomized, double-blind trial in patients undergoing cardioangiography. Fifty-nine patients received iohexol 350 mg I/ml with NaCl 28 mmol/l and 58, iohexol only. ECG changes after contrast injections were evaluated with continuous computerized dynamic vectorcardiography (VCG). QRS-vector difference (QRS-vd), which reflects changes in the QRS-complex, was chosen as the main parameter. Both contrast media caused changes in the QRS-complex, but there was no significant difference between the two. No serious arrhythmias were observed. Both contrast media were well tolerated. No beneficial effects from enriching iohexol with sodium were found. VCG was found to be a valuable tool in the study of contrast medium-induced ECG changes.
Pyloric Size in Normal Infants and in Infants Suspected of Having Hypertrophic Pyloric Stenosis
Authors: Hallam D. , Hansen B. , Bødker B. , Klintorp S. , Pedersen J. F.
Published: June 2015

Pyloric muscle thickness (PMT) and pyloric diameter (PD) were determined by sonography in 92 healthy infants aged 8 to 70 days. PMT and PD measured median 2.0 mm and 10.0 mm. There was a significant correlation between the pyloric dimensions and the infant's age, p<0.02 and p<0.00001 for PMT and PD, respectively. In 26 infants with an initial diagnosis of hypertrophic pyloric stenosis (HPS), but with a final diagnosis of no HPS the mean figures were 2.4 and 11.0 mm, and in 21 infants with HPS, confirmed at surgery, the figures were 4.0 and 14.0. The pyloric dimensions in the 3 groups differed significantly. The larger-than-normal pyloric dimensions in the “no HPS” group suggest that some of these patients suffered from milder degrees of HPS.
Carbon Dioxide in Vascular Imaging and Intervention
Authors: Yang Xiaoming , Manninen Hannu , Soimakallio Seppo
Published: June 2015

Angiography with iodinated contrast agents is bound up with the risks of contrast-induced nephrotoxicity and hypersensitivity, which led to the idea of using carbon dioxide (CO2) gas as a negative contrast medium to eliminate these drawbacks. During the last decade, refinements and experiences have proved carbon dioxide digital subtraction angiography (CO2-DSA) to be an accurate, safe, and clinically promising vascular imaging modality, with the advantages of no hypersensitivity and no nephrotoxicity as well as minimal patient discomfort. In this article, we have reviewed the history, physical and chemical aspects, techniques, and pathophysiologic changes with the use of CO2-DSA as well as some clinical trials. Applications of CO2gas in vascular interventions and other imagings, and the advantages and limitations of using CO2gas in DSA are also discussed.