bluuebunny/crossref_metadata_2025 huggingface dataset:
Ultrasonography of Jumper's Knee
Authors: Myllymäki T. , Bondestam S. , Suramo I. , Cederberg A. , Peltokallio P.
Published: June 2015

The aim of the study was to evaluate the role of ultrasonography (US) in the management of jumper's knee. Sixty-two cases of clinically suggested jumper's knee, 52 asymptomatic contralateral knees and 100 asymptomatic knees of healthy middle aged men were examined. In the symptomatic group US was normal in 25 cases, all recovered with conservative therapy. In 31 symptomatic knees the findings were consistent with jumper's knee as a hypoechoic lesion located in the upper insertion of the patellar tendon in 23 cases and in the distal insertion in one case. In 7 cases the lesion was situated in the insertion of the quadriceps tendon. Surgery was performed on 20 knees and in all of them there was a lesion matching the lesion detected by US. In 6 cases US findings were pathologic, but different from jumper's knee. US findings consistent with jumper's knee could not be detected in the asymptomatic group.
Blood Clot Formation in Angiographic Catheters
Authors: Raininko R. , Riihelä M.
Published: June 2015

Human blood was injected into angiographic catheters filled with contrast media or flushing media. The catheters were allowed to stand at 37°C for 10, 20 or 30 min. Physiologic saline was then injected through the catheters, the catheter contents were shaken and filtered, and any clots were identified. Diatrizoate, ioxaglate, iohexol, iopamidol and iopromide were tested. Physiologic and heparinized saline were used as controls. At 10 min, clots were found in 65 per cent of the catheters filled with physiologic saline, in 25 per cent with non-ionic media, in 19 per cent with heparinized saline, and in 4 per cent with ionic contrast media. At 30 min, all catheters with physiologic saline, 85 per cent with non-ionic contrast media, 46 per cent with heparinized saline and 23 per cent with ionic contrast media contained a clot. Although all the contrast media were anticoagulants, a more careful angiographic technique is needed for non-ionic media. All the non-ionic agents showed equal results. Physiologic saline without heparin is not suitable for flushing during angiography.
Radiography of the Wrist
Authors: Larsen C. Falck , Stigsby B. , Mathiesen F. K. , Lindequist S.
Published: June 2015

A number of methods exist for determination of carpal bone angles on lateral wrist radiographs. However, there is no general or precise definition of the angles measured. In this study the positioning of the wrist is emphasized and a device used to obtain standardized radiographs is presented. An analysis of variance of two series of patients revealed no radiological difference between the contralateral wrists in the same person. We conclude that the asymptomatic wrist can be used as normal reference in the assessment of carpal bone angles in the pathological wrist and a difference between the carpal bone angles in the two wrists in the same person exceeding 5° can be considered significant.
Diagnostic Value of Spinal Computer Tomography in Patients with Intraspinal Metastases Causing Complete Block on Myelography
Authors: Boesen J. , Johnsen A. , Helweg-Larsen S. , Sørensen P. Soelberg
Published: June 2015

The value of post-myelographic spinal computer tomography (CT) was evaluated in cancer patients with spinal metastases causing complete myelographic block. In 22 out of 25 lumbar myelographies (88%) showing complete blockade, sufficient contrast medium had leaked proximally to allow determination of the cranial limit of the metastasis on the CT-scan. It is concluded that the post-myelographic spinal CT can replace a supplementary cervical myelography in the majority of patients with epidural metastasis, causing a complete myelographic block.
Atherosclerosis-Related Measures in Digitized Femoral Arteriograms
Authors: Nilsson S. , Berglund I. , Erikson U. , Högman N. , Johansson J. , Walldius G.
Published: June 2015

Atherosclerosis is reflected in the arteriogram as narrowing of the arterial lumen and irregularity of the arterial wall. We have quantified these changes in digitized femoral arteriograms from 107 hypercholesterolaemic patients and defined 10 different measures concerning arterial diameter, cross-sectional area, stenosis and edge irregularity. We examined the precision of these measures and the correlations between them. Lumen volume and mean diameter for defined arterial segments had the highest precision and may be useful for follow-up studies. The linear correlation between the mean diameter and the square root of the lumen volume was > 0.99, so these two measures seem to be equivalent for all practical purposes. The measured variables could be separated into 2 groups: the measures concerning arterial diameter and lumen volume and those concerning edge irregularity and localized stenosis. The measures within each group showed strong positive mutual correlations, while the correlations between measures from different groups were negative and small. It was concluded that if the results of one measure from each group, suitably those of lumen volume and edge roughness, are known, the other described measures will add no further information about the atherosclerotic process.
Progeria Syndrome with Characteristic Deformation of Proximal Radius Observed on Ct
Authors: Sood S. , Rao R. C. K. , Ragav B. , Berry M.
Published: June 2015

The progeria syndrome (Hutchinson-Gilford) is an uncommon disease. A peculiar shape of the proximal radial metaphyseal region caused by an infolding of the cortex was observed on CT in 2 brothers suffering from this disorder, a feature not previously reported. A brief review of the radiologic literature was undertaken. This new observation needs to be further evaluated as it may provide a clinching diagnostic feature of this disease.
Radiologic Manifestations of Focal Cerebral Hyperemia in Acute Stroke
Authors: Olsen T. Skyhøj , Skriver E. Bech , Herning M.
Published: June 2015

In 16 acute stroke patients with focal cerebral hyperemia angiography and regional cerebral blood flow (rCBF) were studied 1 to 4 days post stroke. CT was performed twice with and without contrast enhancement 3 ± 1 days and 16 ± 4 days post stroke. Angiographic evidence of focal cerebral hyperemia was seen in 8 patients in the form of early filling veins. In 5 of these the hyperemic areas were located within infarcted areas and in 3 patients in areas which appeared normal on CT. In the remaining 8 patients the hyperemias were located perifocally around ischemic infarcts. Early filling veins were not seen in this type of hyperemia. The blood flow was higher and the transit time of the contrast medium was faster in the former type of hyperemia probably because of arteriovenous shunting. Contrast enhancement was not observed on the early CT but was typically seen in the infarcts on the late CT at a time when the hyperemic state is known to have vanished. It is concluded that focal cerebral hyperemia is not responsible for contrast enhancement on CT.
Effect of an Iso-Osmolar Contrast Medium on Pulmonary Arterial Pressure at Pulmonary Angiography
Authors: Tajima H. , Kumazaki T. , Ito K. , Tajima N. , Gemma K. , Ebata K.
Published: June 2015

A clinical comparison of the effects on pulmonary arterial pressure induced by contrast media with various osmolalities, iohexol 140 mg I/ml (300 mosm/kg H2O), iohexol 300 mg I/ml (690 mosm/kg H2O), and diatrizoate 292 mg I/ml (1480 mosm/kg H2O) following selective pulmonary angiography was made in 12 patients with normal pulmonary arterial pressure. A double-blind crossover study was performed and the contrast media were administered in random order. The pulmonary arterial pressure was recorded continuously before, during, and for 3 min after the injection. The effect of iohexol 140 on the pulmonary arterial pressure was significantly less marked than that of diatrizoate 292, whereas no statistical significance was shown between iohexol 140 and iohexol 300. These results indicate that iso-osmolar contrast medium (iohexol 140), as well as iohexol 300, would be better tolerated than diatrizoate 292, and is therefore a safer contrast medium for selective pulmonary angiography.
MR Imaging of Adult Glomerulocystic Kidney Disease
Authors: Egashira K. , Nakata H. , Hashimoto O. , Kaizu K.
Published: June 2015

A 59-year-old man with hypertension and severe renal dysfunction was diagnosed as having adult glomerulocystic kidney disease. MR imaging of the kidney showed a diffuse reduction of the intensity of the renal cortex with a loss of normal cortico-medullary differentiation on T1-weighted images. Numerous small cortical cysts were also demonstrated. These MR findings complemented the results of the biopsy and were useful for making a definitive diagnosis.
Videoradiography at Submental Electrical Stimulation during Apnea in Obstructive Sleep Apnea Syndrome
Authors: Hillarp B. , Rosén I. , Wickström O.
Published: June 2015

Percutaneous submental electrical stimulation during sleep may be a new therapeutic method for patients with obstructive sleep apnea syndrome (OSAS). Electrical stimulation to the submental region during obstructive apnea is reported to break the apnea without arousal and to diminish apneic index, time spent in apnea, and oxygen desaturation. The mode of breaking the apnea by electrical stimulation has not yet been shown. However, genioglossus is supposed to be the muscle responsible for breaking the apnea by forward movement of the tongue. To visualize the effect of submental electrical stimulation, one patient with severe OSAS has been examined with videoradiography. Submental electrical stimulation evoked an immediate complex muscle activity in the tongue, palate, and hyoid bone. This was followed by a forward movement of the tongue which consistently broke obstructive apnea without apparent arousal. Time spent in apnea was diminished but intervals between apnea were not affected.
A Radiologic Reporting System for Computer-Aided Diagnosis with Associated Database
Authors: Ito S.
Published: June 2015

A reporting system which assists radiologists reporting on medical images and calculates alternatives of probable diseases was developed with proven applicability for CT and ultrasonography. The diagnostic information found by radiologists in various types of images is managed as a database in the reporting system and is also transferred to a medical record database, the HIS (Hospital Information System) of Hokkaido University Hospital. The reporting system supports both data conversion and transfer to the host computer of the HIS. The system has processed about 20 000 reports over the last 5 years. Here we present the efficiency of producing reports, the structure of the database, and the hit ratio of calculated diagnoses in this system.
Tumor Seeding Occurring after Fine-Needle Biopsy of Abdominal Malignancies
Authors: Lundstedt C. , Stridbeck H. , Andersson R. , Tranberg K.-G. , Andrén-Sandberg Å.
Published: June 2015

Percutaneous fine-needle aspiration biopsy is a commonly used diagnostic procedure with a high accuracy and a low complication rate. However, tumor seeding in the biopsy tracts has been recorded with a frequency of one in 20 000–40 000 biopsies. We report 5 cases of percutaneous tumor seeding recorded after 5 000 fine-needle biopsies of abdominal malignancies at our institution. The risk of implantation metastases induced by fine-needle biopsy warrants consideration in patients with abdominal malignancies since it may compromise the outcome of radical surgery. It should only be performed when the result of the procedure has a direct impact on the choice of therapy.
Epicardial Fat Causing Pitfalls in CT and MR Imaging of the Pericardium
Authors: Duvernoy O. , Larsson S. G. , Thurén J. , Rauschning W.
Published: June 2015

To study the complex anatomy of the pericardium and the pericardial recesses, notably the transverse sinus and the recess behind and under the common pulmonary artery, cryomicrotomy sections of 4 frozen cadaver specimens were correlated with CT and MR imaging in multiple planes. In addition, CT chest studies of 254 patients and MR chest studies from 78 patients were reviewed. Epicardial fat interposed between the transverse sinus of the pericardium and the ascending aorta was a normal finding confirmed by cryomicrotomy studies and seen by CT in 23 of 245 patients and in MR imaging in 3 of 78 patients. Epicardial fat indenting the pericardial sac below the common pulmonary artery caused an inhomogeneous signal, mimicking lymphadenopathy on coronal T1 weighted MR images in 4 patients.
Computer-Aided Interpretation of Coronary Cineangiograms
Authors: Sugahara T. , Yamagihara Y. , Sugimoto N. , Kimura K. , Awano K. , Azumi T.
Published: June 2015

To accurately diagnose stenotic lesions on coronary cineangiograms, an automatic detection method using computer image processing was developed. We evaluated its accuracy by comparing the results of computer-aided interpretation (CAI) with those obtained independently by 3 observers. Evaluation was performed on 129 segments from 27 arteries visualized on angiograms obtained in 18 patients. The detection rates of stenosis of the 3 observers by pure visual interpretation were 7.0%, 27.9%, and 17.1%, and using CAI 40.0%, 42.6%, and 47.3%. By computer recognition alone, a detection rate of 51.9% was achieved. The agreement by at least 2 observers (consensus) on the sites with lesions was 41.1% while the consensus of computer recognition regarding the sites with lesion was 40.3%. Therefore, our findings indicated that computer recognition of cineangiograms is likely to result in overdetection of lesions. However, all 3 observers detected stenotic lesions better with CAI than with pure visual interpretation. Accordingly, CAI may improve the reliability of cineangiographic diagnosis.
Interobserver Variability in the Radiographic Diagnosis of Adult Outpatient Pneumonia
Authors: Melbye H. , Dale K.
Published: June 2015

Acute chest radiographs were obtained from 319 adult patients with acute respiratory infections. Where a lower respiratory infection was diagnosed, follow-up chest radiographs were obtained in most patients. A radiologic panel diagnosed pneumonia in 21 patients. The agreements between the panel and 3 independent interpreters, 2 residents in radiology, and one senior chest physician, were assessed. Also the reports given by the specialist in radiology at the Department of Radiology were compared with the panel's evaluation. While the kappa-agreements between the panel's interpretations and those by the Department of Radiology and the consultant in chest medicine was 0.71 and 0.72, respectively, the corresponding kappa-values between the residents and the panel was only 0.50. The proportion of agreement when pneumonia was diagnosed was 0.56 between the panel and the Department of Radiology, and 0.59 between the panel and the chest consultant, compared to 0.36 between the panel and the residents. The study demonstrates the difficulty of diagnosing outpatient pneumonia and the importance of experience.
Restenosis after Percutaneous Transluminal Coronary Angioplasty
Authors: Pedersen H. K. , Vatne K. , Simonsen S.
Published: June 2015

Restenosis after percutaneous transluminal coronary angioplasty was demonstrated in 61 (29%) of 210 successfully treated patients. Mostly it occurred within 4 months after treatment and in arteries less than 3 mm in diameter. Careful clinical follow-up is therefore particularly important early after angioplasty of smaller arteries. Redilation can be performed without increased risk of restenosis.
Clinical Utility of Real-Time Compression Ultrasonography for Diagnostic Management of Patients with Recurrent Venous Thrombosis
Authors: Heijboer H. , Jongbloets L. M. M. , Büller H. R. , Lensing A. W. A. , ten Cate J. W.
Published: June 2015

In the diagnostic management of patients with clinically suspected recurrent deep-vein thrombosis (DVT), there are potential limitations to all available diagnostic techniques. Since venous abnormalities may persist for some time after an acute thrombosis, the usefulness of compression ultrasonography (US) for the detection of recurrent DVT may be jeopardized. We determined the rate of normalization of an abnormal compression US test of the popliteal and the common femoral veins in patients after a first episode of proximal DVT. In a cohort of 60 consecutive patients, the test result was normalized in only 29, 44, 54, and 60% of patients at 3, 6, 9, and 12 months, respectively. The investigation shows that for the detection of recurrent DVT of the leg, real-time compression US (using the single criterion of compression of the common femoral and popliteal vein) is of limited value. Future studies need to be performed, using more subtle interpretation of the compression US result, by quantifying the extent of residual thrombus, which may increase the usefulness of this test in patients with recurrent symptoms.
Iopentol in Urography
Authors: Sortland O. , Johansen J. G. , Øksendal A. N. , Waaler A.
Published: June 2015

A double-blind comparative study of the nonionic contrast medium iopentol and the ionic contrast medium metrizoate for urography was carried out in 200 adult outpatients. Significantly less discomfort and other side effects were observed following iopentol than following metrizoate. No serious adverse reactions and no clinically significant alterations in heart rate or blood pressure were observed. A questionnaire was used to record delayed symptoms, from 30 min after contrast medium injection and for one week. The response rate was 92% and delayed adverse events were reported by 45%. The incidence of delayed reactions was significantly lower following iopentol than following metrizoate, i.e., delayed arm pain, fatigue, headache, diarrhea, nasal congestion, and rash. Delayed arm pain was probably due to contrast medium induced thrombosis in 1% following iopentol and in 8% following metrizoate. Most other symptoms were probably related to a combination of nocebo effect and coincidentally occurring symptoms. The urograms with both media were of similar high quality. Iopentol was found a suitable contrast medium for urography.
Thrombosed Hemorrhoid Mimicking Rectal Carcinoma at Ct
Authors: Ben-Chetrit E. , Bar-Ziv J.
Published: June 2015

A 46-year-old male with cirrhosis and portal hypertension complained of lower pelvic pain. CT of the rectum raised a strong suspicion of a rectal tumor. However, rectal examination, anoscopy, direct rectoscopy, and, unfortunately, post-mortem dissection, failed to confirm its existence. Nevertheless, large flat hemorrhoids were evident. Review of the patient's chart disclosed the presence of large thrombosed hemorrhoids detected by rectal examination prior to the CT examination. It is suggested that rectal hemorrhoids be included in the differential diagnosis of rectal tumor shown by CT in patients with portal hypertension.
Quantification of Inhomogeneities in Malignancy Grading of Non-Hodgkin Lymphoma with Mr Imaging
Authors: Rehn S. , Sperber G. O. , Nyman R. , Glimelius B. , Hagberg H. , Hemmingsson A.
Published: June 2015

In a previous study of 50 patients with non-Hodgkin lymphoma (NHL) it was shown that the inhomogeneous appearance of a tumor at MR imaging strongly indicated a high malignancy grade. In this study of 33 patients with NHL, the administration of an i.v. contrast medium, Gadolinium-DTPA, improved the subjective detectability of the inhomogeneities. A method of quantifying the degree of inhomogeneity in the tumors (inhomogeneity index, IH-index) was developed and tested. The mean value of IH-index in the T2-weighted image before contrast medium administration, and of the T1-weighted image after contrast medium administration, as well as the IH-index value in the T2-weighted image before contrast medium administration alone, was able to discriminate well between low- and high-grade NHL. This method of quantifying the degree of inhomogeneity in tumors improved sensitivity in detecting high-grade NHL.
Double-Contrast Enhanced Mr Imaging of Myocardial Infarction in the Pig
Authors: Wikström M. , Martinussen H. J. , Ericsson A. , Wikström G. , Waldenström A. , Hemmingsson A.
Published: June 2015

Myocardial infarction was induced by ligating a diagonal branch of the left anterior descending artery in 18 pigs. All pigs were sacrificed 6 h after the occlusion. Dysprosium diethylenetriaminepentaacetic acid bismethylamide (Dy-DTPA-BMA, 1.0 mmol/kg) was administered i.v. to 6 pigs, starting 3 min before sacrifice (injection time approximately 1 min). In a second group of 6 pigs, a double-contrast technique was used, consisting of an i.v. injection of gadolinium-DTPA-BMA (0.4 mmol/kg) 2 h before sacrifice, followed by an i.v. injection of Dy-DTPA-BMA (1.0 mmol/kg) 3 min before sacrifice. Six additional pigs, subjected to 6 h of coronary artery occlusion without administration of contrast medium, served as controls. The hearts were excised and imaged with MR. In the control animals, the infarctions demonstrated an increased signal intensity in the proton density- and T2-weighted images. Administration of Dy-DTPA-BMA primarily improved infarct visualization in the proton density- and T2-weighted images, due to reduction of signal intensity in nonischemic myocardium. The double-contrast technique further improved infarct visualization in all sequences.
Lumbar Herniated Disk Mimicking Neurinoma
Authors: Emamian S. A. , Skriver E. B. , Henriksen L. , Cortsen M. E.
Published: June 2015

A case of huge foraminal herniated nucleus pulposus is reported, with scalloping of the vertebral body, mimicking neurinoma on CT and MR images.
Observer Variability of Radionuclide Left Ventricular Volume Determination at Rest and during Exercise
Authors: Kelbæk H. , Gjørup T. , Bülow K. , Nielsen S. L.
Published: June 2015

The reproducibility expressed as the intra- and interobserver variation in the determination of cardiac left ventricular (LV) volumes by the radionuclide multigated equilibrium technique in the upright position is presented. No systematic difference was found in the reproducibility between LV volumes determined in healthy subjects and cardiac patients or between examinations performed at rest and during exercise. The intra- and interobserver variation were of the same magnitude. SD of the difference was 8 to 9 ml for LV end-diastolic volume, 4 to 7 ml for LV end-systolic volume, and 2 to 5% for LV ejection fraction. Thus, there is a 95% probability that repeat measurements, either by the same observer or by 2 independent observers, will result in the same LV end-diastolic volume within 18 ml, LV end-systolic volume within 11 ml, and LV ejection fraction within 8%. Only 15% of the variation can be ascribed to determination of the attenuation correction factor.
Electrolytic Stents to Inhibit Tumor Growth
Authors: Cwikiel W. , Stridbeck H. , Stenram U.
Published: June 2015

Obstruction of metallic stents used in the management of malignant biliary strictures is common and in several cases due to tumor growth through the stent wall. In an experimental animal model in rats, a tumor was implanted subcutaneously adjacent to different metallic stents. Ingrowth of tumor through the wall of these stents was frequent. A stent generating direct electric current on the basis of electrolysis was developed and tested in vitro and in the experimental model. The study confirms that an “electrolytic” stent can inhibit ingrowth of tumor.
Detection of Subcarinal Lymph Node Enlargement on Conventional Chest Radiographs
Authors: Szamosi A.
Published: June 2015

Sixty-nine consecutive cases were collected where subcarinal masses had been detected on conventional chest radiographs, including p.a., lateral and oblique views. The subcarinal masses represented metastases from lung carcinomas, from carcinomas in other organs or lymphomas. The radiologic findings were of 3 types: a) distortion of the mediastinal/lung interface; b) abnormal density of the subcarinal region; and c) deformation of the inferior wall of the left or right main bronchus, with or without simultaneous deformation of the tracheal carina. These changes occurred alone or in combination with each other. In the individual patient the subcarinal masses did not appear equally well on all radiographs obtained in different projections: on average they could be discerned in only 2 (1.86) projections out of the 4 obtained (p.a., lateral, LAO, RAO). There were no false-positive cases in the series.
MR Imaging of Anomalous Lobes of the Liver
Authors: Kakitsubata Y. , Kakitsubata S. , Asada K. , Ochiai R. , Watanabe K.
Published: June 2015

Four patients with anomalous lobes of the liver were observed at MR imaging. In one patient the anterior segment of the right hepatic lobe was absent and in 3 patients the left hepatic lobe was anomalous. The hepatic vasculature supporting the information of the anomalous hepatic lobes was well observed in all patients.
Target Delineation in Radiosurgery for Cerebral Arteriovenous Malformations
Authors: Guo W. Y. , Nordell B. , Karlsson B. , Söderman M. , Lindqvist M. , Ericson K. , Franck A. , Lax I. , Lindquist C.
Published: June 2015

A study of 6 selected arteriovenous malformation (AVM) patients was performed to investigate the feasibility of delineating an AVM on MR images and to compare the AVM volume outlined on different images. Conventional stereotaxic angiograms, stereotaxic MR images and MR angiograms using several different pulse sequences were obtained prior to radiosurgery. Treatment plans were made from the conventional stereotaxic angiograms. These plans were then transferred to a separate dose planning computer which displayed the MR images with the superimposed isodose lines. The radiated volumes of AVM and brain tissue were measured from these MR images. Last, an assessment was made of the radiation volume needed for an appropriate treatment of the AVM if the treatment plan was made from the MR images rather than from the conventional stereotaxic angiogram. It was possible to delineate medium and large size AVM nidi on stereotaxic MR images based on an integration of information obtained from various pulse sequences. The estimated volumes of the AVM nidi were found to be larger on the conventional stereotaxic angiograms than on the stereotaxic MR images. Consequently, a dose plan based on a conventional stereotaxic angiogram would result in a higher integral dose to the brain with the same target dose. By using reliable MR information it is expected that the volume of brain exposed to radiation could be decreased and the adverse effects of stereotactic radiosurgery for AVM thereby minimized.
In Vivo Fluorescence Microscopy of Microcirculation in the Renal Cortex of Mice
Authors: Högström B. , Hietala S.-O. , Rooth P.
Published: June 2015

In vivo fluorescence microscopy was used for experimental studies of the renal cortical microcirculation in mice. The effects of i.v. infusions of mannitol and iohexol were studied in untreated mice as well as in mice after temporary renal ischemia. All infusions produced marked effects on the distribution and velocity of cortical blood flow with no differences between iohexol and mannitol. The renal cortical blood flow was inhomogeneous with respect to different capillaries and there was an initial rise in the number of capillaries with increased blood flow after infusions of both mannitol and iohexol. There was an initial increase in the number of capillaries with a decreased blood flow following 30 min of ischemia. This increase was reduced by both types of infusions, suggesting a beneficial effect on renal cortical blood flow. Neither mannitol nor contrast medium exhibited any adverse effects in ischemic kidneys that would be likely to affect renal function. However, 5 min after the infusions there was an increasing number of capillaries with decreased blood flow in all groups.
Computed Tomographic Percutaneous Transsplenic Portography
Authors: Sawada S. , Nakamura K. , Tanigawa N. , Kobayashi M.
Published: June 2015

The diagnosis of liver tumors should be utilized for determination of not only the number of lesions, but also their size, segmental location and extent, and the relationship of the mass or masses to the hepatic vasculature. CT during arterial portography (CTAP) is the most sensitive imaging modality for precise diagnosis of hepatocellular carcinoma (1–3, 5). CTAP is thus widely used as a diagnostic imaging technique, particularly for the detection of small hepatocellular carcinomas (4, 6, 8).

Conventional splenic portography has been carried out for many years using a wide diameter needle, a large amount of contrast medium and a film-screen system (7). Since the development of arterial portography, fewer splenoportograms have been performed due to the high incidence of bleeding and other complications (7). In this study a 0.6-mm (23 gauge) thin needle was used for splenic puncture and CT was used as a detector instead of a film-screen system. With this technique CT during percutaneous transsplenic portography may be performed on an outpatient basis.
Radiology of the Ileal J-Pouch — Anal Anastomosis (IPAA)
Authors: Hagen G. , Kolmannskog F. , Aasen S. , Bakka A. , Løtveit T. , Mathisen Ø.
Published: June 2015

Forty-four consecutive patients operated on with ileal J-pouch-anal anastomosis (IPAA) and diverting ileostomy were examined with barium contrast medium of the pouch before closure of the ileostomy. CT was performed in 4 of the patients. The anatomy of the ileal reservoir as well as complications were assessed. As normal postoperative anatomy we found a “blind loop” at the upper part of the reservoir in 29 patients and a contrast lucency at the anastomosis between the anal channel and the pouch in 5 patients. Complications were revealed at barium contrast medium examinations in 13 patients, including stenoses at the anastomosis between the pouch and the anal channel in 8 patients and fistulas in 5 patients. CT was especially valuable in the exact diagnosis and location of a pelvic abscess in 3 patients, none of which was shown at pouchography.
Cranial MR Imaging and Cerebral 99MTC HM-PAO-Spect in Patients with Subacute or Chronic Severe Closed Head Injury and Normal CT Examinations
Authors: Prayer L. , Wimberger D. , Oder W. , Kramer J. , Schindler E. , Podreka I. , Imhof H.
Published: June 2015

Eighteen patients in the subacute or chronic state following severe closed head injury with normal cranial CT scans were examined by MR and 99mTc HM-PAO SPECT. Correlations were sought between these 2 imaging modalities and the clinical outcome, as defined by the Glasgow Outcome Scale (GOS) score. Both MR and SPECT revealed cerebral damage in all patients examined but structural and functional alterations did not coincide topographically in 64.9% of lesions. Nevertheless, complementary injury patterns suggesting poor recovery were found; cortical contusions and diffuse axonal injury (MR) in conjunction with cortical and thalamic hypoperfusion (SPECT) were noticed in 8 out of 12 patients with unfavorable outcome (GOS = III and IV). The synthesis of MR and SPECT information clearly enhanced the ability both to accurately assess posttraumatic brain damage and to improve patients' outcome prediction.
Ultrasonography of Thymoma with Pathologic Correlation
Authors: Sakai F. , Sone S. , Kawai T. , Maruyama A. , Kiyono K. , Morimoto M. , Haniuda M. , Honda T. , Ishii K. , Ikeda S.-I. , Kobayashi O. , Nishimura H.
Published: June 2015

Preoperative ultrasonograms of 11 surgically proved thymomas and ex vivo ultrasonograms of 3 resected specimens were compared with pathologic findings of resected specimens. Among 11 thymomas 7 appeared solid, 3 were solid with several cystic regions, and the remaining one was unilocular cystic in appearance. Cystic regions on ultrasonograms corresponded to cystic changes on pathologic specimens. Six malignant thymomas showed a typical lacy appearance on ultrasonograms, which corresponded to the lobulated configuration separated by fibrous septa shown on the pathologic specimens.
Dual Photon Absorptiometry for Bone Mineral Measurements Using a Gamma Camera
Authors: Valkema R. , Prpic H. , Blokland J. A. K. , Camps J. A. J. , Papapoulos S. E. , Bijvoet O. L. M. , Pauwels E. K. J.
Published: June 2015

A gamma camera was equipped with a special collimator and arm assembly for bone mineral measurements with dual photon absorptiometry (DPA). The system was evaluated in vitro and in vivo and compared both with a rectilinear DPA and a dual energy X-ray (DEXA) system. All 3 systems showed a linear response in measurements of 4 vials, containing different amounts of hydroxyapatite. Phantom measurements with the gamma camera system showed a precision of 1.6% to 2.8%. Results obtained in 8 healthy volunteers with rectilinear and gamma camera systems were well correlated (R2 = 0.78). With the photon beam directed from posterior to anterior, the separation of vertebrae was easy with the gamma camera system. We conclude that bone mineral measurements can be made with a gamma camera for assessment of fracture risk and in the decision process whether a patient needs treatment or not. For follow-up, the precision of DPA with a gamma camera is inadequate.
Distribution and Dosimetry of111In Dtpa-D-Phe-Octreotide in Man Assessed by Whole Body Scintigraphy
Authors: Bajc M. , Palmer J. , Ohlsson T. , Edenbrandt L.
Published: June 2015

The distribution and dosimetry of the somatostatin analog111In-DTPA-octreotide was evaluated in 6 patients. Whole body scintigraphy in anterior and posterior projections was performed 0.5, 5, 24 and 48 hours after injection. Region-of-interest analysis for different organs and the whole body was used to determine111In octreotide half-life-corrected uptake in absolute and relative terms. A rapid initial uptake was seen in the kidneys (2–7%), the spleen (2–6%) and in the liver (4–8%). A lower uptake was seen in the pituitary gland (maximum 0.3%), the thyroid (maximum 0.07%), in the female breast (maximum 1.2%), in the urinary bladder and in the intestinal tract. The elimination pattern varied between different organs. The effective dose equivalent was evaluated to be in the range 0.08 to 0.13 mSv/MBq (average 0.10 mSv/MBq). The behavior of111In-DTPA-octreotide suggests follow-up scintigraphy in a period extending up to at least 24 hours after injection.
Fracture of the Occipital Condyle as an Incidental Finding during CT-Evaluation of a Maxillary Fracture
Authors: Olsson R. , Kunz R.
Published: June 2015

A 43-year-old male presented with blunt facial trauma after a motor-vehicle accident. CT-evaluation revealed a right-sided maxillary fracture and a fracture of the left occipital condyle. The fracture of the occipital condyle is potentially unstable and fatal cases have been described. Plain radiographs are not diagnostic. This occipital condyle fracture was an incidental finding during CT-evaluation of a maxillary fracture and is probably the first case with coronary CT scans of this type of fracture.
Iodized Oil in the Portal Vein after Arterial Chemoembolization of Liver Metastases — A Caution regarding Hepatic Necrosis
Authors: Tarazov P. G.
Published: June 2015

Of 20 patients with hepatic metastases from colorectal cancer treated by arterial chemoembolization, 4 showed iodized oil in peripheral branches of the portal vein. Aseptic necrosis of both the tumor and normal parenchyma in corresponding liver segments developed in 2 of these patients. They were successfully treated with antibiotics and percutaneous drainage. In the 2 remaining patients, the procedure was interrupted before complete arterial occlusion when oil was detected in the portal vein on fluoroscopy, and there was no complication. Appearance of iodized oil in the portal vein during arterial chemoembolization of colorectal liver metastases is an unfavorable event signaling the risk of liver necrosis.
A Comparative Analysis of Similarity Mapping and Eigenimaging as Applied to Dynamic MR Imaging of a Low Grade Astrocytoma
Authors: Rogowska J. , Preston K. , Aronen H. J. , Wolf G. L.
Published: June 2015

This paper compares the abilities of similarity mapping and eigenimaging for the purpose of identifying (segmenting) different image structures in dynamic MR imaging. As an illustrative example a case of dynamic images with a low grade astrocytoma was chosen. It was found that the similarity mapping was more successful than eigenimaging in determining the extent and position of a low grade astrocytoma. Also, similarity mapping was able to identify another region with a different and uncorrelated temporal pattern that was later diagnosed as a cyst.
Complications of Ultrasound-Guided Nephrostomy
Authors: von der Recke P. , Nielsen M. B. , Pedersen J. F.
Published: June 2015

In a 5-year period (January 1987 to December 1991) a total of 285 US-guided nephrostomy procedures were performed in 159 patients. All nephrostomies were performed with a 2.3 mm one-step trochar catheter without internal fixation. The hospital case records were reviewed retrospectively, and complications were registered. The overall success rate was 92%. The catheters were maintained for a median of 17 days (range 1–150 days). Thirty-three catheters slipped out unintentionally in the first 10 days. Haematuria through the catheter for more than 3 days occurred in 14 cases. Complications occurred in 19 (6.7%) of the procedures. One uraemic patient had cardiac arrest but was resuscitated. Two patients had severe haematuria and one of them had a nephrectomy. Seven patients developed septicaemia, and 6 had perirenal bleeding or urinary leakage. Three patients developed skin infection. Ultrasound-guided nephrostomy is a gentle procedure with only few major complications, but the risk of the procedure should still be weighed against the expected benefit.
Ultrasonographic Measurements of the Achilles Tendon in Elderly Athletes and Sedentary Men
Authors: Kallinen M. , Suominen H.
Published: June 2015

Ultrasonography was performed on the Achilles tendon of the dominant limb of 18 male elderly athletes and 11 sedentary men, aged 70 to 80 years. The tendons were examined with a real-time linear array scanner using a 7.5 MHz transducer. Both longitudinal and transverse images were taken. The mean width of the Achilles tendon was significantly larger in the athletes than in the control subjects. The tendon thickness and cross-sectional area did not differ significantly between the groups, but the figures may indicate a tendency for larger cross-sectional area in the athletes. The results suggest tendon hypertrophy following long-term training.
Gd-DTPA-Enhanced MR Imaging in Mediastinal Hodgkin's Disease
Authors: Forsgren G. , Nyman R. , Glimelius B. , Hagberg H. , Rehn S. , Hemmingsson A.
Published: June 2015

Gd-DTPA-enhanced MR imaging of 15 patients with primary mediastinal Hodgkin's disease was done before, during and after treatment. A total of 43 MR examinations were performed. After successful treatment, 13 patients had residual masses with reduced signal intensity (SI) ratio in the T2-weighted images. The majority of these also had decreased contrast enhancement as compared with the corresponding primary tumour. There was a significant positive correlation between the contrast enhancement and the SI ratios in the T2-weighted images of the primary tumours and/or the residual masses. Necrosis was seen in 3 of the primary tumours and one patient had a cystic residual mass. These necrotic/cystic lesions were easier to detect with the use of Gd-DTPA. Low SI ratio in the T2-weighted image and low contrast enhancement of the residual mass seem to indicate residual inactivity. Gd-DTPA facilitates the differentiation between cystic/necrotic and solid lesions.
Experimental Studies Comparing Iohexol and 51Cr-Edta for Glomerular Filtration Rate Measurements
Authors: Lundqvist S. , Hietala S.-O. , Karp K.
Published: June 2015

The total plasma clearance as well as the renal clearance of iohexol were evaluated for determination of the glomerular filtration rate (GFR) in 16 anesthetized pigs. The iohexol levels in urine and plasma were measured by X-ray fluorescence. The total plasma clearance of 1 and 4 ml/kg b.w. of iohexol 300 mg I/ml was compared to the simultaneously as well as nonsimultaneously calculated total plasma clearance of 51Cr-EDTA. The total plasma clearance of 51Cr-EDTA and of iohexol turned out to be equal and independent of the injected dose of iohexol. The injected dose did not have any effect on the renal clearance of iohexol either. It is concluded that iohexol and 51Cr-EDTA are similar as marker substances for determination of the GFR.
Cerebral Thromboembolic Complications Associated with the Use of a Nonionic Contrast Medium in Coronary Angiography
Authors: Levorstad K. , Vatne K. , Brodahl U. , Aakhus T. , Simonsen S. , Vik H.
Published: June 2015

Cerebrovascular complications were registered in 11 patients (0.21%) of 5 339, consecutively submitted to coronary angiography with the nonionic contrast medium iohexol (Omnipaque). Six of the patients had diseases predisposing them to thromboembolic complications, 3 of whom earlier had symptoms of cerebral stroke. Excluding these 6, the incidence of cerebral thromboembolic events was 0.10% in patients with no predisposing diseases. Precise catheterization technique and some anticoagulation and antiplatelet activity therapy are definite precautions against these complications, while the role of the contrast medium is still debated.
Prediction of the Time to Peak Hepatic Enhancement to Optimize Contrast-Enhanced Spiral CT
Authors: Irie T. , Suzuki S. , Yamauchi T. , Kusano S.
Published: June 2015

A technique for the prediction of the time to peak hepatic enhancement to optimize contrast-enhanced spiral CT has been developed. The procedures are (a) to inject a small amount of contrast medium rapidly via the antecubital vein and measure aortic transit time (ATT) of the bolus by single slice dynamic CT; (b) to inject contrast medium at a high rate, expecting peak hepatic enhancement to occur at ATT plus 8 seconds after the end of injection; (c) to perform spiral scanning of the liver using thin collimation and caudo-cranial table movement beginning at ATT after the end of contrast medium injection.
Digital Luminescence Radiography and Conventional Radiography in Abdominal Contrast Examinations
Authors: Krug B. , Harnischmacher U. , Krahe T. , Fischbach R. , Altenburg A. , Krings F.
Published: June 2015

In 326 patients abdominal contrast radiographs were compared to digital luminescence radiographs (DLR) and conventional screen-film system ones. The digital exposure dose was 50% of the conventional. In DLR, 2 different types of postprocessed images were obtained from each data set. A display with low spatial frequency enhancement filtered to look like a conventional radiograph was compared to a display with high spatial frequency enhancement. Conventional and DLR images were evaluated randomly and separately by 4 radiologists by means of a questionnaire. DLR proved to be diagnostically equivalent to the conventional technique with the exception of a slightly diminished visibility of the mucosal pattern. High spatial frequency enhancement did not provide additional diagnostic information and should be dispensed with in abdominal examinations.
Brain Metastases — Comparison of Gadodiamide Injection-Enhanced MR Imaging at Standard and High Dose, Contrast-Enhanced CT and Non-Contrast-Enhanced MR Imaging
Authors: Åkeson P. , Larsson E.-M. , Kristoffersen D. T. , Jonsson E. , Holtás S.
Published: June 2015

The aim was to compare the abilities of contrast-enhanced CT, non-contrast-enhanced MR imaging and contrast-enhanced MR imaging using standard (0.1 mmol/kg b.w.) and high (0.3 mmol/kg b.w.) doses of Gadodiamide injection to detect brain metastases (i.e. blood-brain barrier damage). Sixteen patients with at least 2 metastases found by CT were evaluated by MR imaging using non-contrast-enhanced spin-echo, T1-weighted, T2-weighted sequences, and contrast-enhanced spin-echo T1-weighted sequences at 2 dose levels. Gadodiamide injection was first given at the dose of 0.1 mmol/kg b.w. After imaging, another 0.2 mmol/kg b.w. was given, yielding a cumulative dose of 0.3 mmol/kg b.w. No contrast media-related adverse events were recorded. The images were evaluated openly by one and blindly by 2 investigators and the number of metastases, size, delineation (open study) and diagnostic certainty (blind study) of each individual metastasis noted. High-dose MR imaging showed significantly more and smaller metastases than any other examination, and gave a higher diagnostic certainty. All high-dose images were superior to those with the standard dose MR imaging when compared blindly in pairs. We conclude that spin-echo MR imaging with a high dose of Gadodiamide injection is an efficient way to improve the detection of brain metastases, in particular of small ones.
CT Features of Olivopontocerebellar Atrophy in Children
Authors: Kumar S. Dilip , Chand R. Pratap , Gururaj A. K. , Jeans W. D.
Published: June 2015

Between 1990 and 1992, 14 children were seen in whom a clinical diagnosis of olivopontocerebellar atrophy (OPCA) had been made. The majority of patients presented with cerebellar ataxia and hypotonia. Five children had a family history of a similar illness in first-degree relatives. All cases had undergone clinical and neurologic examinations, routine laboratory tests and cranial CT. CT features were graded to quantitate the degree of atrophy in each cerebellar hemisphere, vermis and brain stem. All patients had varying degrees of atrophic changes of cerebellum, brain stem and cerebrum. These CT features appear to be distinctive enough to enable the diagnosis of OPCA to be made.
Diagnosis by Ultrasound of Dislocated Ulnar Collateral Ligament of the Thumb
Authors: Höglund M. , Tordai P. , Muren C.
Published: June 2015

The ability of ultrasound to assess a displaced ulnar collateral ligament of the 1st metacarpo-phalangeal (MCP) joint was evaluated. If the ligament is ruptured and displaced proximal to the adductor aponeurosis, a surgical repair should be undertaken to restore stability. Ultrasound accurately diagnosed these lesions in 32/39 operated patients. In 4 cases the ultrasound examination suggested a more severe lesion than was found at operation. In 3 cases a lesser injury was suspected than later proved to be present.
MR Imaging of Gadolinium-DTPA-BMA-Enhanced Reperfused and Nonreperfused Porcine Myocardial Infarction
Authors: Nilsson S. , Wikström G. , Ericsson A. , Wikström M. , Waldenström A. , Hemmingsson A.
Published: June 2015

To investigate whether Gd-DTPA-BMA-enhanced MR imaging permits differentiation between reperfused and nonreperfused myocardial infarction, myocardial infarction was induced in 12 domestic pigs. In 6 pigs, Gd-DTPA-BMA, 0.3 mmol/kg b.w. was administered i.v. 60 min after the occlusion. In 6 other pigs, the infarctions were reperfused 80 min after the occlusion, followed by injection of Gd-DTPA-BMA after 20 min of reperfusion. Radiolabeled microspheres were used to confirm zero-flow during the occlusion period and reperfusion in the infarcted myocardium. All pigs were killed 20 min after injection of contrast medium, and the hearts were excised and imaged with MR. The Gd concentration was measured in infarcted and nonischemic myocardium by ICPAES. In the reperfused hearts, the infarctions were strongly highlighted, corresponding to a 5-fold higher Gd concentration in infarcted vis-à-vis nonischemic myocardium. In the hearts subjected to occlusion without reperfusion, there was only a rim of enhancement in the peripheral part of the infarctions.
MR Imaging of Adult Colo-Rectal Intussusception
Authors: Blomqvist L. , von Rosen A. , Hindmarsh T.
Published: June 2015

MR imaging of an intussuscepted sigmoid cancer misinterpreted as a rectal carcinoma is described. High-resolution technique with pelvic-phased array coils and fast spin-echo was used. The diagnosis is discussed in relation to the MR findings.