bluuebunny/crossref_metadata_2025 huggingface dataset:
Diagnosis of liver metastases from colorectal adenocarcinoma
Authors: Strotzer M. , Gmeinwieser J. , Schmidt J. , Fellner C. , Seitz J. , Albrich H. , Zirngibl H. , Feuerbach S.
Published: January 2010

Purpose: the purpose of this study was to determine whether MR with and without SPIO (AMI-25) could replace spiral-CTAP in the staging of colorectal adenocarcinoma

Material and Methods: Thirty-five patients were studied prospectively by means of i.v. contrast-enhanced spiral-CT, spiral-CTAP, and MR of the liver. MR imaging was performed before and after infusion of AMI-25. Diagnoses were compared to intraoperative findings (n=35) which included intraoperative ultrasound (n=21), and follow-up CT (n= 18)

Results and Conclusion: Fifteen patients were found to have a total number of 53 liver metastases and 43 benign lesions were detected. Evaluation was performed in four different ways: 1) i.v. contrast-enhanced spiral-CT; 2) i.v. contrast-enhanced spiral-CT + spiral-CTAP; 3) plain MR; 4) plain MR + SPIO-enhanced MR. I.v. contrast-enhanced spiral-CT, spiral-CTAP and SPIO-enhanced MR identified patients with liver metastases with equal sensitivity. However, owing to its significantly higher sensitivity, based on a lesion-by-lesion analysis, spiral-CTAP cannot be replaced by SPIO-enhanced MR in patients who are to undergo liver resection. A limitation in spiral-CTAP is its relatively low specificity
Single-session alcohol sclerotherapy in benign symptomatic hepatic cysts
Authors: Larssen T. B. , Viste A. , Jensen D. K. , Søndenaa K. , Røkke O. , Horn A.
Published: January 2010

Purpose: to evaluate the results of single-session alcohol sclerotherapy in benign symptomatic liver cysts

Material and Methods: Ten cysts (volume 200–4800 ml) in 10 patients were treated by percutaneous catheterization and injection of 96% ethanol at a dose of 10% of the cyst volume but never more than 100 ml. the treatment was applied for a maximum of 20 min, after which the alcohol and catheter were removed

Results: A satisfactory reduction in cyst volume was achieved in all patients. in 8 patients there was a re-accumulation of fluid during the first period after therapy, followed by a significant reduction in volume on later follow-up examinations. Except for pain, there were no complications

Conclusion: Sclerotherapy as a single-session procedure resulted in a significant reduction in cyst volume in all 10 patients. the postprocedural re-accumulation of fluid seen in 8 patients proved to be temporary. It was not necessary to repeat the sclerotherapy procedure in any patient
Human hepatic carbohydrate metabolism
Authors: Ikehira H. , Obata T. , Koga M. , Yoshida K.
Published: January 2010

Purpose: Dynamic natural-abundance 13C MR spectroscopy (MRS) studies without proton decoupling were performed in the human liver using commercial 1.5 T MR equipment

Material and Methods: A single tuned custom-made circular surface coil with an OD of 20 cm operating at 16.04 MHz was used for the 13C study. Seventy-five grams of glucose dissolved in water was administered for the natural-abundance 13C-MRS dynamic study which lasted for approximately 40 to 60 min. Data acquisition was broken into 20-min and 1.7-min blocks. Localized proton shimming with a whole-body coil was performed with sufficient volume to include the observing area of the surface coil; the line width of the water signal was less than 20 Hz

Results and Conclusion: the glucose and glycogen spectra were clearly visible at 80 to 120 ppm after oral administration of the glucose solution. These data demonstrate that dynamic hepatic carbohydrate metabolism can be observed with commercially available MR equipment. Given that the human hepatic glycogen pool reaches maximum level within less than 10 min, this technique should provide a direct diagnosis of hepatic carbohydrate metabolic disorders
CT with different doses of the hepatocyte-specific contrast medium fp 736-03
Authors: Bergman A. , Sundin A. , Magnusson A.
Published: January 2010

Purpose: to study the dose-response relationship in FP 736-03 (48 mg I/ml), a hepatocyte-specific contrast medium for CT of the liver

Material and Methods: A nude-rat model of experimental hepatic metastases was used. CT of the liver was performed before and after i.v. injection of FP 736-03 at 4 different doses: 0.25, 0.5, 1.0 and 2.0 ml/kg b.w. Attenuation in the normal liver parenchyma and in the metastases was measured and plotted as a function of time

Results: the enhancement of the normal liver parenchyma increased in the dose range studied. No increase was found in the metastases; the attenuation here remained constant during the observation period. the maximum enhancement values at doses of 0.25, 0.5, 1.0 and 2.0 ml/kg b.w. were (mean ± SD) 13.5±2.7, 30.1±4.2, 33.2±4.5 and 59.7±13.1 HU respectively
A case of hyperoxaluria
Authors: Elmståhl B. , Rausing A.
Published: January 2010

Purpose: Oxalosis is an unusual pathological condition with calcium oxalate deposits in soft tissue and bone, recognized as osteosclerosis on radiography. Osteosclerotic bone changes in patients treated with hemodialysis are in most cases due to secondary hyperparathyroidism, but several other diagnoses have to be considered

Material, Methods and Results: We describe the case of a young woman with advanced renal failure treated with hemodialysis since her youth. She had skeletal pain and radiological examination showed: osteosclerosis with sclerotic vertebral bodies; irregular sclerosis and unsharp periostal outline in the tubular bones of the extremities; and acrolysis and calcifications of vascular and soft tissue in the hands. Histological examination showed changes typical of oxalosis. A liver biopsy excluded primary oxalosis type I, and she probably had a secondary oxalosis due to renal failure. This condition (as opposed to primary oxalosis) can be treated with renal transplantation

Conclusion: Oxalosis is a rare condition but it should be considered in patients with radiological skeletal changes and chronic renal failure and should not be misinterpreted as renal osteodystrophy. the classification of oxalosis as primary or secondary is important for further treatment
Cine-mr imaging of the shoulder
Authors: Allmann K.-H. , Uhl M. , Gufler H. , Biebow N. , Hauer M. P. , Kotter E. , Reichelt A. , Langer M.
Published: January 2010

Purpose: Shoulder lesions are usually examined with the joint in only one or two positions. We examined the shoulder with the joint in a variety of positions. We also assessed the application of cine-MR to the detection of instability and impingement

Material and Methods: the cine-MR examinations were performed in 30 patients and 15 healthy volunteers. We used an open 0.2 T system and a closed 1.0 T system. Spoiled gradient echo 2D T1-weighted images and turbo spin-echo T1- and T2-weighted images were obtained with a field of view of 180 mm. the examinations were videotaped and evaluated later

Results: Normal variations of the glenohumeral joint were easy to recognize. Subluxations and luxations of the humeral head as well as rupture of the labrum were identified. It was also possible to identify the labrum with a signal change after arthroscopic refixation. and we were able to objectively assess distances between the osseous structures during dynamic movement

Conclusion: Unlike static MR, cine-MR would appear to be useful in visualizing the capsular ligament complex of the gleno-humeral joint in impingement and instability. It also provides information on dynamic changes and may thus prove to be an important tool for shoulder diagnostics. the method may provide an early diagnosis in the sub-acromial impingement syndrome
A simple device for the stereoscopic display of 3d CT images
Authors: Haveri M. , Suramo I. , Junila J. , Lähde S. , Karhula V.
Published: January 2010

We describe a simple device for creating true 3D views of image pairs obtained at 3D CT reconstruction. the device presents the images in a slightly different angle of view for the left and the right eyes. This true 3D viewing technique was applied experimentally in the evaluation of complex acetabular fractures. Experiments were also made to determine the optimal angle between the images for each eye. the angle varied between 1° and 7° for different observers and also depended on the display field of view used
A new radiographic method for evaluating the degree of sliding in devices used in hip-fracture surgery
Authors: Lunsjö K. , Åström K. , Stigsson L. , Sparr G. , Hauggaard A. , Heyden A. , Ceder L. , Spanne S.
Published: January 2010

Purpose: to find a practical method for estimating the degree of sliding that occurs in screw-plate devices used in hip-fracture surgery. Greater understanding of the sliding mechanisms in different fracture types should improve surgical technique and reduce the failure rate

Methods and Results: in dynamic screw-plate devices, the lag screw slides inside the barrel of the plate. A recent innovation allows the barrel-plate to slide inside a side-plate, thus making possible a combined fracture compression along the neck and the shaft of femur. the lengths of the different parts and the angle of a device in vivo, measured on a radiograph, depend on the position of the femur relative to the photographic film and the roentgen source. We obtained these measurements with a ruler and a protractor from sequential a.p. radiographs of the hip and implemented them in a special computerized program that used the principles of the scaled orthographic and the central projection models. These calculations provided the correct amount of sliding by the lag screw and by the barrel-plate within the side-plate

Conclusion: the method presented here can establish the real degree of sliding in screw-plate devices from standard a.p. radiographs independently of the position of the hip
Correlation of T1 and T2 relaxation rates in normal bone-marrow water with serum ferritin concentration
Authors: Ishizaka H. , Ishijima H.
Published: January 2010

Purpose: This study was made to clarify the paramagnetic effect of iron stored in the hematopoietic tissue of bone marrow

Material and Methods: the T1 and T2 relaxation times of bone-marrow water in the L1-3 vertebrae of 20 healthy individuals were measured by MR imaging with a 1.5 T magnet. the chemical shift misregistration effect was used to isolate the bone-marrow water. the results were compared with the serum ferritin concentration

Results and Conclusion: Although no correlation between the T1 relaxation rate of the water fraction and the serum ferritin concentration was evident, the T2 relaxation rate of the water fraction showed strong linear correlation with the serum ferritin concentration (r=0.87, p<0.00001). Thus, T2 of bone-marrow water accurately reflects the amount of iron in normal bone marrow. This finding may be useful in the evaluation of the characteristics of hematopoietic tissue in bone marrow
An in vitro1H-MRS Model of Oncogene Transfection
Authors: Nakai T. , Ishima R. , Sakahara H. , Endo K. , Konishi J. , Akasaka K.
Published: January 2010

Purpose: Malignancy is an abnormality of cell division and differentiation based on abnormal expression of oncogenes. This note describes the in vitro1H-NMR spectral features of oncogene-transfected NIH3T3 fibroblast cells compared to non-transfected cells

Material and Methods: 1H-NMR spectra of cultured NIH3T3 cells and c-erbB-2 or c-Ha-ras gene-transfected cells were obtained by 400 MHz high resolution NMR. the peaks were assigned by 2D HOHAHA spectra of the cell suspension and the spectral changes were evaluated in 1D and 1D differential spectra

Results: the 1H spectra obtained from both transfected cell lines were broadened over all peaks, suggesting reduced mobility in plasma membrane lipid molecules. No other differential spectra for characterizing metabolic change was detected

Conclusion: Broadened 1H spectra observed after c-erbB-2 or c-Ha-ras transfection suggest changes of plasma membrane viscosity, which may be related to the oncogene expression
Liver imaging
Authors: Rummeny E. J. , Marchal G.
Published: January 2010

Primary hepatocellular carcinoma and liver metastases affect several millon people each year. The main imaging modalities to detect and assist diagnosis of primary and secondary liver tumours include MR imaging, CT, and US. The value of these techniques is further increased by the use of contrast agents which increase the sensitivity, and sometimes also the specificity, of the investigations.

The relative advantages and drawbacks of the different contrast agents and imaging modalities in the detection and characterisation of liver tumours are discussed. Currently there is no consensus amongst investigators as to which is superior, due to the technical complexities and number of combinations possible within each of the different modalities.

There continues to be advances in the hardware and software of imaging equipment, as well as a trend to develop new contrast agents with more organ-specificity. These include those targeting the hepatocytes, such as mangafodipir trisodium (MnDPDP, Teslascan), and those with reticuloendothelial cell specificity, such as the superpara-magnetic iron oxides. These developments have the potential for making significant contributions to the diagnostic value of imaging procedures and, by reducing the number of investigations necessary to reach a final diagnosis, having a significant and beneficial impact on the pharmaco-economics of patient health care.
NMR relaxation studies with MnDPDP
Authors: Southon T. E. , Grant D. , Bjørnerud A. , Moen O. M. , Spilling B. , Martinsen I. , Refsum H.
Published: January 2010

Purpose: Our studies were designed to compare the efficacy of mangafodipir triso-dium (MnDPDP, Teslascan) as a tissue-specific MR agent with that of manganese chloride (MnCl2), to compare the efficacy of different doses and rates of administration of MnDPDP, and to collect the data needed for predicting optimum pulse sequences.

Material and Methods: The dose response for the relaxation rates R1 and R2 at 0.47 T, and the manganese (Mn) concentrations in rat liver and in the liver, pancreas, heart and adrenals of pigs was determined for both MnDPDP and MnCl2 administered i.v. Computer simulations were carried out to model the effects of different tissue Mn concentrations and TR on signal intensities and contrast-to-noise ratios.

Results: In rat liver and pig organs both compounds produced a positive dose-response in R1 and tissue Mn concentration, and only small or no response in R2. The Mn concentration in rat liver was positively correlated with R1, regardless of the form in which Mn was given, or the rate of administration. Optimal imaging parameters are therefore expected to be different pre- and post-MnDPDP administration.

Conclusion: The added cardiovascular safety of MnDPDP compared with MnCl2 does not result in loss of efficacy in increasing R1 at the intended clinical dose of 5 μmol/kg MnDPDP. The changes in R2 were too small to affect T2-weighted images. The data give the basis for choosing the appropriate pulse sequences for MnDPDP-en-hanced MR imaging.
MnDPDP enhancement in rabbit liver after intravenous bolus injection and slow infusion
Authors: Thorstensen Ö. , Isberg B. , Jorulf H. , Westman L. , Svahn U. , Venizelos N.
Published: January 2010

Purpose: To investigate the MR-enhancing effect of mangafodipir trisodium (MnDPDP, Teslascan) in the rabbit liver in relation to dose, mode of administration and imaging window.

Material and Methods: MnDPDP was administered to 18 rabbits at a dose of 10 μmol/kg or 20 μmol/kg, as a bolus injection or infusion. MR imaging of the liver was performed at different time intervals.

Results: Peak liver enhancement was typically observed 10–30 min after administration and the enhancement declined with a half-time of about 5 h. This pattern was observed in all sequences (SE 400/15, FLASH, and SE 132/10), with both doses and with both rates of administration. The peak enhancement was greater, though not significantly so after 20 μmol/kg than after 10 μmol/kg. A higher relative peak signal was observed with SE 132/10 than with FLASH or SE 400/15.

Conclusion: A good liver imaging result was obtained after a dose of 10 μmol/kg, either bolus or infusion, 10–30 min post-contrast with heavily T1-weighted sequences.
The reproductive toxicology of intravenously administered MnDPDP in the rat and rabbit
Authors: Grant D. , Blazak W. F. , Brown G. L.
Published: January 2010

Purpose: The reproductive toxicology of mangafodipir trisodium (MnDPDP, Teslascan), a new hepatobiliary MR contrast agent, was evaluated in rats and rabbits.

Material and Methods: Male and female fertility and post-natal development were examined in rats after repeated i.v. injections of MnDPDP. The developmental toxicity in rats was investigated after repeated daily i.v. injections during organogenesis with MnDPDP, MnCl2, or DPDP, as well as with MnCl2, administered orally. The developmental toxicity of i.v. injected MnDPDP was also investigated in rabbits.

Results: MnDPDP (100 μmol/kg) had no adverse effects on rat fertility. However, both MnDPDP (10–40 μmol/kg) and MnCl2 (30 μmol/kg) caused skeletal abnormalities in the rat, but not in the rabbit given 20 μmol MnDPDP/kg. Maternal treatment of rats with MnDPDP (40 μmol/kg) reduced survival and body weights of neonates, and adversely affected their functional, but not physical development. No skeletal abnormalities were seen in the rat after i.v. administered DPDP (40 μmol/kg) or MnCl2 (6 μmol/kg), or after MnCl2 (400 μmol/kg) given by oral gavage. Maternal toxicity was not seen in rats or rabbits given these doses.

Conclusion: MnDPDP caused skeletal abnormalities in foetal rats, but not rabbits, and had no effects on rat fertility. Manganese appears to be the causative agent for inducing bone abnormalities in the rat.
Angiography in non-traumatic brain haematoma
Authors: Griffiths P. D. , Beveridge C. J. , Gholkar A.
Published: January 2010

Purpose: The primary purpose of this project was to study the anatomical characteristics of intracerebral haematoma (ICH) in order to determine features that may negate the need for angiography in some patients.

Material and Methods: The study was prospective and designed to investigate the underlying cause of non-traumatic ICH in 100 cases assessed by conventional angiography. Patients were excluded if there was a history of trauma or known pre-existing brain abnormality. All patients were examined with CT and angiography within 4 days of the ictus.

Results: Ruptured aneurysms or arteriovenous malformations (AVMs) were diagnosed on the initial angiogram in 49% of cases: 27 AVMs and 22 aneurysms. One case of superior sagittal sinus thrombosis was also detected. Vascular abnormalities were found most frequently in the under-40 age group and in cases in which subarachnoid haemorrhage, intraventricular haemorrhage or extracerebral haematoma accompanied the ICH. The temporal lobe was the most frequent anatomical location (37%). When a temporal lobe haematoma extended into the Sylvian fissure from the inferior pole of the temporal lobe or when it was associated with subarachnoid haemorrhage, structural abnormalities were found in over 90% of cases

Conclusions: There are groups of patients with ICH in whom the CT features are highly suggestive of AVM or aneurysm rupture. If the initial angiography is negative in these cases, careful follow up by repeat angiography and/or MR imaging is essential. However, potentially treatable abnormalities cannot be excluded with certainty by the distribution of the haematoma on CT alone, even if there is a history of pre-existing hypertension.
Craniocaudal motion velocity in the cervical spinal cord in degenerative disease as shown by MR imaging
Authors: Tanaka H. , Sakurai K. , Iwasaki M. , Harada K. , Inaba F. , Hirabuki N. , Nakamura H.
Published: January 2010

Purpose: To investigate, by means of MR phase imaging, the effects of compression on the velocity of craniocaudal motion in the spinal cord.

Material and Methods: Spin-echo pulse sequences with velocity encoding gradients were used to examine 12 patients with cervical spondylosis and 6 normal volunteers. Oblique-axial phase images at 3 levels (cranial, middle and caudal), were obtained with prospective electrocardiogram gating. The middle level was set at the site where the spinal cord was most severely compressed, and the cranial and caudal sections were set where it was not compressed. Time-velocity curves were generated at these 3 levels and focal velocity change was correlated with motor function in the lower extremities.

Results and Conclusion: The cord showed a higher motion velocity at the compression level than at noncompression levels. This paradoxical increase in velocity was observed in 7 out of 8 patients whose lower extremity motor function was impaired. Four patients with normal lower extremity motor function did not demonstrate this increase in velocity. An increase in motion velocity was therefore found to correlate with impaired lower extremity motor function.
Transcutaneous needle biopsy of the lung
Authors: Komiya T. , Kusunoki Y. , Kobayashi M. , Hirashima T. , Yana T. , Masuda N. , Matsui K. , Takada M. , Nakagawa K. , Kotake Y. , Yasumitsu T. , Kikui M. , Kawase I.
Published: January 2010

Purpose: To evaluate the usefulness of transcutaneous needle biopsy (TCNB).

Material and Methods: From May 1988 to December 1994, we performed TCNB under fluoroscopic control in 408 patients with mass lesions of the peripheral lung. The Surecut needle (1.5 mm) was selected mainly because of its ability to obtain specimens large enough for histological examination. Of the 408 patients, 286 had had previous bronchofiberscopic examinations but no definite diagnosis had been reached.

Results: A definite diagnosis was obtained by TCNB in 305 (74.7%) of 408 cases (251 malignant neoplasms, 54 benign lesions). In malignant neoplasms, the pathological diagnosis based on cytology and histology together was more reliable than that based on cytology alone. Although the complications of this procedure (such as pneumothorax) were within the range of acceptability, care should be taken to avoid air embolism and the seeding of cancer cells along the needle tract.

Conclusion: TCNB with the Surecut needle is a useful procedure with relatively low risk.
Progress of emphysema in severe α1-Antitrypsin Deficiency as Assessed by Annual CT
Authors: Dirksen A. , Friis M. , Olesen K. P. , Skovgaard L. T. , Sørensen K.
Published: January 2010

Purpose: To assess serial CT as a measure of the progress of emphysema in patients with severe α1,-antitrpsin deficiency (phenotype PiZ).

Material and Methods: In a randomized placebo-controlled study of α1,-antitrypsin augmentation therapy, 22 patients with moderate emphysema were followed for 2–4 years with an annual lung CT. The images were analysed by means of semiautomatic lung detection, and the degree of emphysema was quantitated by the density-mask and the percentile methods. The influence of lung volume was standardised by a regression model.

Results: A highly significant decline in Hounsfield units (HU) was found in low-density areas, corresponding to a mean (SE) annual loss of lung tissue of 2.1 (0.4) g/l lung volume. Analysis of a single slice at 5 cm below the level of the carina gave comparable results: 2.4 (0.4) g/l.

Conclusion: Serial CT is a sensitive measure of the progress of emphysema in patients with severe α1-antitrypsin deficiency.
Compulsory superselective arterial embolization in hypovascular local hepatic tumor ablation
Authors: Ishizaka H. , Ishijima H. , Katsuya T. , Horikoshi H. , Koyama Y.
Published: January 2010

We performed compulsory superselective transcatheter arterial embolization on local hypovascular liver metastases under balloon occlusion using a 1-mm (3 F) coaxial microballoon catheter in 2 cases. One case was a metastasis from breast cancer (maximum diameter 5.5 cm) at segment 7. The other case comprised metastases from rectal cancer (maximum diameter 8 cm) at segments 7 and 8. Absolute ethanol (50%) mixed with Lipiodol (50%) was used for embolization. No major treatment-related complications occurred. No local recurrence was observed in either case in follow-up CT and MR studies of up to 16 and 9 months respectively. This technique may thus be applied as an alternative to surgical resection in the treatment of local hypovascular liver tumors.
Renal vascular resistance in autosomal dominant polycystic kidney disease
Authors: Brkljacic B. , Sabljar-Matovinovic M. , Putarek K. , Soldo D. , Morovic-Vergles J. , Hauser M.
Published: January 2010

Purpose: The purpose of this study was to evaluate the performance of color duplex Doppler ultrasonography in the assessment of renal vascular resistance (RVR) by measuring resistive indices (RIs) and pulsatility indices (PIs) in patients with autosomal dominant polycystic kidney disease (ADPKD), and to correlate the measured values with renal function and the presence of arterial hypertension.

Material and Methods: In 42 patients with ADPKD and 65 control subjects, RIs and PIs were measured by means of color duplex Doppler sonography and correlated with clinical and laboratory findings and with morphological abnormalities at B-mode ultrasonography.

Results: Mean RI in the control subjects was 0.59 ± 0.03 (± SD) and in the patients 0.71 ± 0.11, (p < 0.01). Mean PI in the controls was 1.00 ± 0.11 and in the patients 1.69 ± 0.21, (p < 0.01). Elevated RIs and PIs heralded a progression of ADPKD. Doppler indices correlated significantly with renal function tests and morphological changes in the affected kidneys at ultrasound. Significantly higher RIs (p < 0.01) and PIs (p < 0.04) were measured in hypertensive ADPKD patients as compared to normotensive patients. Correlation of patient age and Doppler indices did not reach statistical significance.

Conclusion: Doppler indices do reflect the increased RVR in patients with ADPKD and they correlate with renal function disturbance, with the development of systemic arterial hypertension, and with ultrasonographic abnormality of the kidney in these subjects.
Radiological findings in serous surface papillary carcinoma of the ovary
Authors: Kim S. H. , Cho J. Y. , Park I. A. , Kang S. B. , Lee H. P. , Han M. C.
Published: January 2010

Serous surface papillary carcinoma (SSPC) is a malignant tumor originating from the surface epithelium of the ovary, and is characterized by macroscopic normal ovaries accompanied by diffuse peritoneal dissemination. Therefore diagnosis of SSPC cannot usually be made preoperatively. We report on two cases of SSPC in which US, CT, and MR demonstrated nodularities along the surface of the normal-sized ovaries, adjacent organs and pelvic peritoneum in addition to findings of peritoneal seeding. These imaging findings may suggest the correct preoperative diagnosis of SSPC.
Epiphyseal bone-marrow abnormalities and restitution in legg-calvé-perthes disease
Authors: Hochbergs P. , Eckervall G. , Wingstrand H. , Egund N. , Jonsson K.
Published: January 2010

Purpose: By means of MR imaging, to determine signal abnormalities in the femoral epiphysis; to determine their location, extent and restitution over time; and to correlate these findings to the Catterall radiological classification.

Material and Methods: A total of 247 MR images in 86 patients (101 hips) with Legg-CalvC-Perthes disease were examined. The MR images were taken in the coronal plane, and the images through the center of the femoral head were used for this study.

Results: T1-weighted images proved as good as T2-weighted images for the MR evaluation of the extent of the necrosis. In almost every case, the central-cranial part of the epiphysis showed a low initial signal. In Catterall group I, the medial part was never involved. In Catterall III and IV, almost the entire epiphysis showed signal changes. In the period 3–6 years after diagnosis, we still found signal changes in the epiphysis in some hips but there was no correlation with the Catterall classification. After 6 years, the epiphysis showed normal signal intensity in MR imaging. In T1-weighted images, Gd-enhancement occurred in the peripheral regions in the early stages of the disease. The central part of the epiphysis became more enhanced over time and peaked in the period 1–3 years after diagnosis.

Conclusion: MR is a valuable modality for monitoring changes in the femoral epiphysis. We propose a new classification of the extent and pattern of epiphyseal bone-marrow abnormalities based on the 4 zones most commonly observed in MR imaging.
Ct of the sacroiliac joints
Authors: Damilakis J. , Prassopoulos P. , Perisinakis K. , Faflia C. , Gourtsoyiannis N.
Published: January 2010

Purpose: The aim was to select an optimal technique for low-dose high-resolution CT of the sacroiliac joints (SJ).

Material and Methods: Dose measurements were performed on a Rando anthropomorphic phantom using thermoluminescence dosimeters for 4 CT protocols and 2 conventional radiography protocols used for SJ evaluation. Six available reconstruction algorithms were tested on CT protocols using 285–665 mAs and 120 or 130 kVp settings and noncontiguous 1.5-mm-thin sections with 3.5-mm intervals. Settings with optimum performance on phantom tests were also applied in a series of 10 patients with SJ arthropathies.

Results: A CT protocol using 120 kVp/175 mA2.9 s/1.5-mm slice thicknessb-mm table increment implied the lower radiation dose among all examination protocols tested and provided high image quality of the SJ. A reconstruction algorithm yielding images of improved spatial resolution with acceptable noise was selected.

Conclusion: A high spatial frequency reconstruction algorithm, and 120 kVp and 508 mAs were considered optimal for a low-dose CT examination of the SJ that employed narrow (1.5 mm) slice images with interspacing.
MR imaging of meniscal subluxation in the knee
Authors: Breitenseher M. J. , Trattni S. , Dobrocky I. , Kukla C. , Nehrer S. , Steiner E. , Imhof H.
Published: January 2010

Purpose: The aim of this study was to establish diagnostic criteria for meniscal subluxation, and to determine whether there was any connection between meniscal subluxation and other common meniscal and knee-joint abnormalities.

Material and Methods: The normal position of the meniscal body was assessed in 10 asymptomatic volunteers. MR signs of meniscal subluxation were evaluated retrospectively in 60 symptomatic patients with pain in the knee, impaired mobility, and/or joint swelling who had no clear diagnosis after the evaluation of case history, clinical examination, and radiography. The criterion for subluxation of the meniscus was defined as a distance of ≥3 mm between the peripheral border of the meniscus and the edge of the tibial plateau.

Results: In the volunteers, the mean distance from the medial meniscus to the edge of the tibial plateau was 0.07 mm, and that from the lateral meniscus was 0 mm. In 55 symptomatic patients without meniscal subluxation, the mean distance from.the meniscus to the edge of the tibial plateau was 0.27 mm. Five patients (8%) had evidence of meniscal subluxation, 4 in the medial meniscus and one in the lateral meniscus. The most commonly associated knee abnormality was joint effusion in 5 knees and osteoarthritis in 2 knees.

Conclusion: Meniscal subluxation was not a rare finding with MR imaging in patients with painful knees. Meniscal subluxation was associated with other knee abnormalities such as joint effusion or osteoarthritis.
Kinematic MR imaging of the ankle — initial results with ultra-fast sequence imaging
Authors: Muhle C. , Brinkmann G. , Brossmann J. , Wesner F. , Heller M.
Published: January 2010

Purpose: In order to evaluate the advantages of ultra-fast MR sequences, kinematic MR imaging studies were performed in 4 patients with osteochondritis dissecans of the talus and in 12 healthy volunteers.

Material and Methods: The patients and volunteers were placed inside a custom-made positioning device. Sagittal ultra-fast T2-weighted turbo gradient-echo sequences and HASTE sequences were obtained during active joint motion from dorsiflexion to plantar flexion. Eight sagittal slices were scanned separately to cover this ankle motion. In each slice, 8 to 10 images were obtained in 12-s or 18-s periods.

Results: Adequate image quality for analyzing the normal kinematics of the ankle was obtained in all subjects. At surgery, the osteochondral fragment was found to be mobile in 3 of the 4 of the patients. In none of these cases was fragment mobility observed on kinematic MR imaging. No motion of the fragments was observed in the fourth patient, neither at surgery nor on kinematic MR imaging.

Conclusion: Ultra-fast MR imaging sequences made it possible to produce kinematic MR imaging studies of active joint motion. The positioning device was useful for guiding joint motion in patients and for obtaining adequate image quality.
Assessment of suspected bone metastases
Authors: Çiray I. , Åström G. , Sundström C. , Hagberg H. , Ahlström H.
Published: January 2010

Purpose: To evaluate the role of CT with and without clinical information as compared to CT-guided bone biopsy in the assessment of suspected bone metastases.

Material and Methods: The study comprised 51 consecutive patients with suspected bone metastases who had undergone CT-guided bone biopsies with an eccentric drill system. CT of the targets, clinical information, and histopathology were scored separately as malignant, uncertain or benign. The results of CT alone and CT in combination with clinical information were compared to the results of histopathology.

Results: Histopathology diagnosed 45/51 lesions (88%), 23 as malignant and 22 as benign. CT correctly depicted 17 of these 23 malignant lesions. The remaining 6 malignant lesions were CT-scored as uncertain (n=5) or benign (n=l). CT correctly depicted only 3 of the 22 benign lesions. The remaining 19 benign lesions were CT-scored as malignant (n=2) or uncertain (n=17). When uncertain CT scores were combined with clinical scores, the true-positive and true-negative results for malignancy increased from 44% to 82%.

Conclusion: In most cases, CT in combination with clinical information gives enough information about the nature — malignant or benign — of a skeletal lesion. In uncertain cases, diagnostic accuracy can be improved by means of CT-guided bone biopsy.
Bone-marrow MR imaging before and after autologous marrow transplantation in lymphoma patients without known bone-marrow involvement
Authors: Lien H. H. , Blomlie V. , Blystad A. K. , Holte H. , Langholm R. , Kvaløy S.
Published: January 2010

Purpose: To study lumbar bone marrow by means of MR imaging before and after bone-marrow transplantation in lymphoma patients. Particular emphasis was paid to heterogeneity and to focal manifestations, i.e. appearances that could simulate tumor.

Material and Methods: Twenty-two patients who were disease-free for a minimum of 30 months after transplantation were studied in 107 MR examinations. Two radiologists visually evaluated coronal T1-weighted and short inversion time inversion-recovery (STIR) images.

Results: T1-weighted images demonstrated a more heterogeneous marrow after transplantation than before it. Sharply defined focal low signal intensity areas appeared on this sequence in 5 (23%) of the 22 patients at between 21 and 60 weeks after transplantation. The mean age of these 5 patients was 48.4 years (range 42–54 years). The difference in age between these 5 patients and the remaining 17 patients, who had a mean age of 33.4 years (range 14–51 years), was statistically significant (p < 0.01, Student's t-test, 2-sided test).

Conclusion: Sharply defined focal low signal intensity areas may be seen on T1-weighted images of bone marrow in patients who are in complete remission after transplantation, particularly in those aged over 40–45 years.
CT, MR imaging and muscle biopsy in severe crush injury
Authors: Nakanishi K. , Shimamoto S. , Kishi M. , Yoshioka T. , Ishida T. , Tomoda K. , Nakamura H.
Published: January 2010

Purpose: We reviewed CT and MR findings in crush injuries in muscles and compared them with findings at muscle biopsy.

Material and Methods: CT and MR examinations were made of the lower extremities in 6 adult patients whose muscles were crushed in the big earthquake in Kobe, Japan, on 17 January 1995. All CT examinations were performed twice and within 60 days of the earthquake. In 5 of the 6 patients, biopsies were taken of the injured muscle after the CT and MR examinations.

Results: At CT investigation, the images in 5 patients showed calcification in the muscles, and the crushed muscle appeared atrophic. In 3 of these 5, the degree of calcification decreased with time. At MR investigation, T1-weighted images of the crushed muscle showed isointensity in 4 of the 6 patients and high intensity in the remaining 2. T2-weighted images of the crushed muscle showed inhomogeneous high intensity in all patients. After Gd injection, all the crushed muscles were enhanced, either slightly or markedly. At muscle biospy, in 5 of the 6 cases, the findings showed calcification in the muscle cells and the total destruction of the normal muscle structure.

Conclusion: CT and MR findings in crush injury correlated well with the findings at histopathology.
Role of MR venography in the evaluation of deep venous thrombosis
Authors: Catalano C. , Pavone P. , Laghi A. , Scipioni A. , Fanelli F. , Assael F. G. , Grossi A. , Venosi S. , Passariello R.
Published: January 2010

Purpose: MR venography has been recommended for the evaluation of deep venous thrombosis. The purpose of our study was to determine the role of MR venography, in particular at the level of the pelvis where other diagnostic modalities show major limitations.

Materials and Methods: Forty-three patients with clinical suspicion of deep venous thrombosis were examined by means of pelvic MR venography. In all cases, a 2D-TOF sequence was used with cranial arterial presaturation. In selected cases, i.e. when a small intraluminal filling defect was present, a cine-PC sequence was used in addition in order to exclude the presence of a pulsatility artifact as causing the filling defect. In all cases, contrast venography was also performed and considered to be the standard of reference.

Results: MR venography showed 26 patients to be positive for deep venous thrombosis at the pelvic level. These positive results were correct in 25 cases. The analysis of the results provided values of sensitivity and specificity of respectively 100% and 94%, with an overall accuracy of 97.6%.

Conclusion: Our results indicate that MR can provide highly accurate images, similar to those of contrast venography, in a noninvasive fashion. It is particularly useful in the pelvic region where the limitations of other imaging modalities are more evident.
Optimising imaging parameters in experimental spiral CT
Authors: Tiitola M. , Vehmas T. , Kivisaari R. P. , Kivisaari L.
Published: January 2010

Purpose: This in vitro study was conducted to analyse lesion detection and relative radiation exposure in different CT techniques.

Material and Methods: We used a plastic phantom (12x8x2 cm) containing holes filled with air or fluid of varying densities to simulate lesions. This was imaged with Siemens Somatom Plus S and GE High Speed Advantage units. We varied table feeds (3 and 6 mm/s in Siemens and 3 and 4.5 mm/s in GE) and increments (2 mm and 4 mm) while keeping collimation at 3 mm. The Smartscan program of GE and the reformatting algorithm of Siemens were also analysed. To evaluate the different methods, the phantom lesions were counted by 3 observers. Radiation exposures associated with each technique were also measured.

Results: The images reformatted to a coronal direction were significantly inferior (p < 0.01) to those in other techniques. The use of Smartscan did not influence lesion detection, nor did changes in pitch or increment. Spiral and non-spiral techniques proved to be equal. Radiation exposure was lowest when a greater pitch or the Smartscan program was used.

Conclusion: Radiation exposure in CT can be limited without significantly impairing the image quality by using low-dose techniques. Reformatting to a coronal direction should be used with care as it debases the image quality.
Permeability of contrast media through hemodialysis membrane
Authors: Furukawa T. , Ueda J. , Higashino K. , Takahashi S. , Sakaguchi K. , Imai T.
Published: January 2010

Purpose: To compare the permeability of 10 contrast media (CM) through the hemodialysis membrane.

Material and Methods: An experimental model was constructed from clinical hemodialysis equipment. The 10 CM that were used were: diatrizoate, iothalamate, iopami-dol, iohexol, iopromide, ioversol, iomeprol, ioxaglate, iodixanol and iotrolan. They were dissolved into the dialysate. Each solution ran into the blood circuit of the dialyzer at a rate of 200 ml/min and into the dialysate circuit of the dialysis machine at a rate of 500 ml/min. Permeability was expressed as clearance, calculated from the iodine concentration at the afferent and efferent lines of the dialyzer, and from the blood-flow rate.

Results: The clearance of all the monomeric CM was superior to that of all the dimeric CM. Values of clearance and molecular weight correlated well.

Conclusion: The molecular weight of a contrast medium is the main factor that influences the efficiency of CM removal by hemodialysis.
Ultrasound Diagnosis of Soft-Tissue Tumours in the Hand and Forearm
Authors: Höglund M.
Published: January 2010

Purpose: The aim of this prospective investigation was to evaluate the accuracy of certain ultrasound characteristics in diagnosing 5 common types of soft-tissue tumour in the hand and forearm.

Material and Methods: The study comprised 50 soft-tissue tumours, diagnosed by ultrasonography or histopathology as belonging to one of 5 soft-tissue tumour groups. The reported ultrasound diagnoses and the histopathological results were compared, and their sensitivity was calculated. A statistical model was applied to the prospective material. The first and second diagnostic alternatives were calculated for each specific tumour and for the whole prospective material. In the second part of this study, the prospective material was combined with a retrospective material of 96 tumours from a previous study. The combined material was analysed and the accuracy of the first and second diagnostic alternatives for each tumour and for the whole material was calculated.

Results: The sensitivity for the prospective material was 84%. The correct diagnosis predicted by the model for the combined material was 56% for the first alternative and 79% when the second alternative was included.

Conclusion: Ultrasonography is useful in the diagnosis of soft-tissue tumours of the hand.
Diagnosis of Hill-Sachs Lesion of the Shoulder
Authors: Pancione L. , Gatti G. , Mecozzi B.
Published: January 2010

Aim: The Hill-Sachs lesion is a compression fracture caused by impact on the trabeculae of the humeral head during anterior glenohumeral dislocation. The early and accurate identification of patients who risk recurrence of shoulder dislocation requires a suitable screening method. This should be characterized by high sensitivity and specificity, low cost, and repeatability.

Material and Methods: The results of ultrasound examination as a screening method were evaluated, the indicator being the identification of the Hill-Sachs lesion. Using ultrasonography and conventional radiological techniques, and double contrast CT (arthro-CT), we studied 60 patients with posttraumatic instability of the shoulder.

Results: Against arthro-CT as the true standard, ultrasonography showed a sensitivity of 95.6%, specificity of 92.8%, and diagnostic accuracy of 95%.

Conclusion: Ultrasonography is an acceptable screening examination for recurrent scapulohumeral dislocation and should be applied prior to other techniques of investigation such as arthro-CT or MR imaging.
CT Measurement of Anteversion in the Femoral Neck
Authors: Hermann K. L. , Egund N.
Published: January 2010

Purpose: To evaluate CT methods of measuring anteversion in the femoral neck with respect to measurement accuracy and with respect to the influence exerted by different femoral shaft positions; and to describe a new CT measurement concept that introduces a mathematical adjustment for different femoral shaft positions. The new technique facilitates the taking of measurements in patients who cannot be correctly positioned in traditional methods.

Material and Methods: CT examinations of previously measured anteversions in the femoral neck were reviewed in retrospect in 30 patients with fractures of the femoral neck. The position of the femoral shaft was assessed. A reference angle was compared with direct traditional measurements and with measurements adjusted for the actual position of the femoral shaft by means of a 3D mathematical reconstruction. Reproducibility and inter— and intraobserver variability were assessed in 10 cases.

Results: All femurs varied in position within the gantry. The mean difference between the direct CT measurement and the adjusted CT measurement compared to the reference angle were -8.8° (range -35.0-16.3°) and -0.1° (range -1.4-1.4°), respectively. For the adjusted CT method, reproducibility and inter- and intraobserver variability were 1.4 intraobserver variability were 1.4, 1.6 intraobserver variability were 1.4 and 1.4° (SD of difference), respectively.

Conclusion: CT measurement of femoral anteversion in clinical practice can only be accurate when corrected for variation in the position of the femoral shaft.
Endoscopically Inserted Stent as Treatment for Pancreatic Ascites
Authors: Hämäläinen K.-P. , Halme L. , Tierala E.
Published: January 2010

After 3 weeks of unsuccessful conservative treatment, a pancreatic fistula with peritoneal fluid collection was managed with the endoscopic insertion of a stent from the duodenum into the pancreatic duct beyond the origin of the fistula. The patient who presented contraindications at surgery, made a remarkable recovery. At stent-retrieval, however, a stricture formation was seen in the main pancreatic duct.
Characterization of Sonographically Indeterminate Ovarian Tumors with MR Imaging
Authors: Yamashita Y. , Hatanaka Y. , Torashima M. , Takahashi M. , Miyazaki K. , Okamura H.
Published: January 2010

Purpose: The goal of this study was to maximize the discrimination between benign and malignant masses in patients with sonographically indeterminate ovarian lesions by means of unenhanced and contrast-enhanced MR imaging, and to develop a computer-assisted diagnosis system.

Material and Methods: Findings in precontrast and Gd-DTPA contrast-enhanced MR images of 104 patients with 115 sonographically indeterminate ovarian masses were analyzed, and the results were correlated with histopathological findings. of 115 lesions, 65 were benign (23 cystadenomas, 13 complex cysts, 11 teratomas, 6 fibro-thecomas, 12 others) and 50 were malignant (32 ovarian carcinomas, 7 metastatic tumors of the ovary, 4 carcinomas of the fallopian tubes, 7 others). A logistic regression analysis was performed to discriminate between benign and malignant lesions, and a model of a computer-assisted diagnosis was developed. This model was pro-spectively tested in 75 cases of ovarian tumors found at other institutions.

Results: From the univariate analysis, the following parameters were selected as significant for predicting malignancy (p<0.05): a solid or cystic mass with a large solid component or wall thickness greater than 3 mm; complex internal architecture; ascites; and bilaterality. Based on these parameters, a model of a computer-assisted diagnosis system was developed with the logistic regression analysis. To distinguish benign from malignant lesions, the maximum cut-off point was obtained between 0.47 and 0.51. In a prospective application of this model, 87% of the lesions were accurately identified as benign or malignant.

Conclusion: Benign and malignant ovarian lesions can be distinguished in most sonographically indeterminate lesions by means of parameters obtained from contrast-enhanced MR imaging.