bluuebunny/crossref_metadata_2025 huggingface dataset:
Emergency CT in Blunt Abdominal Trauma of Multiple Injury Patients
Authors: Kinnunen J. , Kivioja A. , Poussa K. , Laasonen E. M.
Published: June 2015

Multiple injury patients with blunt abdominal trauma (n = 110) were examined by abdominal CT. An i.v., but not peroral, contrast medium was used, thereby eliminating the delay caused by administering peroral contrast medium and any subsequent delay in making the diagnoses and beginning operative treatment. Eighteen patients underwent emergency laparotomy after the initial CT examination. The preoperative CT findings were compared to the laparotomy findings. CT revealed all but one of the severe parenchymal organ lesions requiring surgery. The one liver laceration that went undetected had caused hemoperitoneum, which was diagnosed by CT. The bowel and mesenteric lesions presented as intra-abdominal blood, and the hemoperitoneum was discovered in every patient with these lesions. Fourteen patients also initially had positive abdominal CT findings; 10 of them underwent an additional abdominal CT within 3 days, but the repeat studies did not reveal any lesions in need of surgery. Omission of the oral contrast medium did not jeopardize making the essential diagnoses, but it did save time.
Prediction of Recurrence after HCC Resection
Authors: Yamamoto M. , Iimuro Y. , Mogaki M. , Kachi K. , Fujii H. , Matsumoto Y.
Published: June 2015

In trying to clarify the high recurrence rate after removal of small hepatocellular carcinoma (HCC), we assessed the postoperative evolution of minute hepatic Lipiodol deposits which had been diagnosed as artifacts on the preoperative Lipiodol-CT. Of 27 patients with solitary HCC less than 5 cm in diameter, 14 had such Lipiodol deposits in the preoperative CT and 9 of them (64%) developed recurrent tumors. On the other hand, 6 of the 13 patients without deposits (46%) suffered recurrence, but in 5 of these 6 patients the HCC was metachronous multicentric. The cumulative survival rate of the non-deposit group was better than that of the deposit group (p < 0.1). The present study suggested that, even in patients with small HCC, minute concomitant tumors invisible by conventional imaging techniques may exist at the time of surgery. Some of these lesions without sufficient tumor vasculature showing a hypervascular blush on angiography appear to retain small, vague Lipiodol deposits.
CT Changes after Conservative Treatment for Lumbar Disk Herniation
Authors: Dullerud R. , Nakstad P. H.
Published: June 2015

In order to assess changes occurring to lumbar disk herniations and bulges and to the disk spaces after conservative treatment, a follow-up CT was carried out of 106 pathologic disks in 92 patients at a mean interval of 14 months after the initial examination. There was a strong association between the evolution of the hernias and clinical results, with a decrease in size of the majority of hernias in successfully treated patients, whereas the others essentially remained unchanged (p < 0.0001). A significantly higher proportion of large hernias diminished as compared to the smaller ones (p < 0.0001). Diffuse disk bulges were associated with a poor outcome and never regressed. There was a lower incidence of diminution of the central hernias compared to other locations. Patients with normal disk space at the initial examination had a better outcome than those with disk space narrowing. Only occasionally was a reduction of the disk space observed at follow-up.
Pelvic Fractures
Authors: Albrechtsen J. , Hede J. , Jurik A. G.
Published: June 2015

Sixty-two patients with pelvic fractures were evaluated by conventional radiography and CT. A correct pathoanatomic classification of the fractures was most often obtained by conventional radiography, but CT added information regarding acetabular fractures and involvement of the posterior part of the pelvic ring. Besides, CT was essential in the detection of intraarticular fragments and lesions of the femoral head. Classification of pelvic ring fractures by the pattern of traumatic forces was easily obtainable by conventional radiography, but often difficult to achieve by CT.
Hyperplastic Callus Formation in Osteogenesis Imperfecta
Authors: Burchardt A.-J. , Wagner AA , Basse P.
Published: June 2015

We report a case of bilateral hyperplastic callus formation as a complication of fracture in a patient with osteogenesis imperfecta. The clinical and radiographic findings and the differential diagnosis are discussed.
Primary Angiosarcoma of the Spleen
Authors: Ha H. K. , Kim H. H. , Kim B. K. , Han J. K. , Choi B. I.
Published: June 2015

The CT and MR findings in 2 patients with surgically proven splenic angiosarcoma are presented. Two distinctive radiologic and pathologic patterns were observed: total tumor replacement of the spleen with preservation of normal contour or multiple nodular masses in the spleen. The various findings on CT and MR imaging reflected the hemorrhagic nature of the lesions with increased iron content. MR imaging appeared to be superior to CT in demonstrating these features. In the case of focal lesions, radiologic differentiation from lymphoma or metastasis was impossible.
MR Imaging in Cerebral Gliomas
Authors: Tovi M. , Hartman M. , Lilja A. , Ericsson A.
Published: June 2015

A comparative analysis between MR examinations and histopathologic whole-brain sections regarding tumour components was performed in 5 brain specimens from patients with malignant glial brain tumours. All cases were examined with MR imaging in vitro and in 2 cases a close comparison with the MR examinations in vivo was also possible. The most homogeneous hypercellular area in malignant gliomas, giving the highest tumour grade, was not visualised on MR imaging as an isolated entity, either in vitro or in vivo. The most conspicuous tumour component, reflecting the heterogeneity of malignant gliomas, was necrosis. This feature was best depicted in the T2WI. In 4 of 5 cases, distant tumour spread of benign-looking tumour cells was found in areas visualised as normal on T2WI, outside the margins of the peritumoural oedema. In 2 cases, estimation of water content was performed immunohistochemically and a close correlation was found in each case between peritumoural and periventricular hyperintensity on T2WI and areas of pallor on the haematoxylin-eosin-stained whole-brain sections. These areas corresponded to microscopical oedema. MR imaging reflects underlying heterogeneous histopathology in malignant gliomas. The degree of malignancy of the lesion as a whole can thus be assessed by MR imaging. However, the method does not allow malignant gliomas to be correctly delineated.
Percutaneous Transhepatic External Biliary Drainage Utilizing a Pig Tail Balloon Catheter
Authors: Karstrup S. , Mygind T. , Hennild V.
Published: June 2015

A 2.3-mm soft pig tail balloon catheter was developed to be used for percutaneous transhepatic biliary drainage. A small balloon (OD 10 mm) secures an optimal internal fixation and side holes behind the balloon secure drainage of the cannulated bile duct peripheral to the balloon. Successful transhepatic biliary drainage with the pig tail balloon catheter was achieved in 11 of 12 patients for a period of 3 to 67 days (median 6 days). In one patient the catheter clogged after 55 days of drainage. No case of catheter dislodgement or other complications related to the external drainage was seen.
Increased Self-Diffusion of Brain Water in Hydrocephalus Measured MR Imaging
Authors: Gideon P. , Thomsen C. , Gjerris F. , Sørensen P. S. , Henriksen O.
Published: June 2015

We used MR imaging to measure the apparent brain water self-diffusion in 5 patients with normal pressure hydrocephalus (NPH), in 2 patients with high pressure hydrocephalus (HPH), and in 8 age-matched controls. In all patients with NPH significant elevations of the apparent diffusion coefficients (ADC) of brain water were found within periventricular white matter, in the corpus callosum, in the internal capsule, within cortical gray matter, and in cerebrospinal fluid, whereas normal ADCs were found within the basal ganglia. In 2 patients with HPH elevated ADCs were found most prominently within white matter, and in one patient reexamined one year after surgery, ADCs were unchanged in nearly all brain regions. The increased ADC values in hydrocephalus patients may be caused by factors such as changes in myelin-associated bound water, increased Virchow-Robin spaces, and increased extracellular brain water fraction. For further studies of brain water diffusion in hydrocephalus patients, echo-planar imaging techniques with imaging times of a few seconds may be valuable.
Time-of-Flight MR Angiography of Portal System and Collaterals in Portal Hypertension Using a 2-DFT Fast Spoiled Gradient Recalled Steady-State Precession Technique
Authors: Murakami T. , Igarashi H. , Oi H. , Matsushita M. , Kim T. , Kishimoto H. , Nakamura H. , Okamura J. , Kozuka T.
Published: June 2015

MR angiographic examinations were performed in 26 patients. Approximately 30 contiguous fast spoiled GRASS images (8.1/3.1/30°, TR/TE/flip angle) were acquired during single breath-holding for about 35 s, and then new images were reconstructed with maximum intensity projection technique. Spoiled GRASS images (40/12/40) of 2 to 3 slices were taken during breath-holding for about 13 s, and these processes were repeated to obtain about 30 individual images for conventional MR angiography. The new MR angiograms were compared quantitatively and qualitatively with conventional MR angiograms with arterial portography as the gold standard. The new MR angiograms could visualize blood vessels with smooth margins, and provided almost the same anatomic information about the portal vein and collateral vessels as the conventional MR angiograms. Contrast-to-noise ratios between the portal or hepatic vein and liver parenchyma were significantly higher with fast spoiled GRASS images. The new MR angiograms using fast spoiled GRASS images provided useful diagnostic mapping of the collateral venous pathways within a shorter examination time.
Doppler Ultrasound in the Diagnosis of Renal Transplant Artery Stenosis — Value of Resistive Index
Authors: Saarinen O. , Salmela K. , Edgren J.
Published: June 2015

Doppler ultrasound (DU) with angiographic correlation was performed in 19 hypertensive renal transplant recipients suspected for transplant artery stenosis. DU included calculation of the intrarenal resistive index (RI) and measurement of the maximum systolic velocity in the transplant artery. All 10 cases having a pathologically low RI (≤0.6) had a ≥ 50% stenosis; specificity and positive predictive values were thus 100%. There were 5 false-negative diagnoses, sensitivity 67%. The measurement of maximum systolic velocity was feasible in only 15 cases (79%). Using a cut-off point of 2 m/s the sensitivity was 91% and there were 4 false-positive cases and one false-negative case. Balloon percutaneous transluminal angioplasty (PTA) was performed in 13 cases, of which 9 were successful. In all successful cases RI was <0.6 after PTA. We conclude that low RI (<0.6) is highly suggestive for transplant artery stenosis. RI may serve as an indicator of the hemodynamic success of PTA.
Low-Field MR Imaging (0.1 T) in Patients with Clinically Suspected Acute Spinal Block
Authors: Heldmann U. , Thomsen H. S. , Mygind T.
Published: June 2015

The diagnostic usefulness of a 0.1 T MR unit in patients with clinical suspicion of acute spinal block was studied in 59 patients who were referred to acute MR investigation. The records were reviewed retrospectively 1 month after the MR for assessing the clinical impact of the examination. Ninety-eight per cent had a true-positive examination confirmed by surgery (21%) or observation (77%). In 60% of the patients the MR imaging had a therapeutic consequence. In only one patient did the level of visualised pathology at the MR examination not correlate with the clinical findings; the patient subsequently refused surgical treatment. We conclude that a low-field MR unit is excellent for acute examination of patients clinically suspected of acute spinal block.
Combination of Gadolinium and Dysprosium Chelates as a Cellular Integrity Marker in MR Imaging
Authors: Ericsson A. , Bach-Gansmo T. , Niklasson F. , Hemmingsson A.
Published: June 2015

A combination of gadolinium (Gd) and dysprosium (Dy) chelates was investigated as a potential marker of cell-membrane integrity by means of a double-contrast effect in MR imaging. Blood samples with varying hematocrit (Hct) levels containing intact or lysed cells were used as model systems. With intact cells, the agents were assumed to be distributed solely extracellularly and the highest Hct studied (69%) was assumed to mimic the ratio of extracellular to intracellular water in tissue. The combined effect on image intensity of Gd (in a concentration corresponding to 0.2 mmol/kg b.w. in humans) and Dy (0.6 mmol/kg b.w.) applied simultaneously was a marked difference in signal intensity between samples with intact and lysed cells in both the T1- and T2-weighted spin-echo images with a corresponding increase in the contrast-to-noise ratio. This was the result of a T1 reduction caused by Gd with a negligible Dy susceptibility effect in areas with lysed cells. On the other hand, the Dy susceptibility effect (i.e. reduced apparent T2) dominated in areas with intact cells. Thus, the combination of Gd and Dy may serve as a marker of cell-membrane integrity in MR examinations.
Cardiac Effects of Adding Electrolytes and Oxygen to Iohexol in a Dog Model of Contrast Media-Induced Ventricular Fibrillation
Authors: Jacobsen E. A. , Pedersen H. K. , Kløw N.-E. , Refsum H.
Published: June 2015

We investigated whether addition of a balanced electrolyte supplement and oxygen to the nonionic contrast medium iohexol reduces the risk of ventricular fibrillation (VF), and studied regional electrophysiology prior to the VF event. Twenty ml of each test solution were infused at a rate of 0.5 ml/s into the left anterior descending coronary artery (LAD) in 8 anesthetized dogs. LAD was externally occluded during infusion, to simulate a wedged catheter situation. ECG, hemodynamics, regional epicardial monophasic action potential duration (MAPD) and ventricular activation times (VAT) were calculated. All infusions with iohexol caused VF within 27 s. Five of 12 infusions with iohexol + 30 mmol NaCl, 3 of 11 infusions with iohexol + electrolytes (IPE) (NaCl, KCl, CaCl2 and MgCl2) and 4 of 11 infusions with IPE with oxygen addition (IPE + O2) caused VF after 45 s. Iohexol did not change MAPD prior to the VF event. Iohexol + 30 mmol NaCl and the IPE solutions lengthened MAPD initially, but at the time of the VF event MAPD were normalized or shortened. We conclude that electrolyte supplement to iohexol may prevent VF, probably by lengthening MAPD.
Effect of Iopentol on Renal Function and its Use for Calculation of Glomerular Filtration Rate in Children
Authors: Stake G. , Monclair T. , Berg K. J. , Rootwelt K. , Brekke O.
Published: June 2015

Nineteen children received 99mTc-DTPA for renography. The next day they received a simultaneous injection of the non-ionic contrast medium iopentol for urography and another injection of 99mTc-DTPA. The glomerular filtration rate (GFR) was estimated from the plasma elimination of 99mTc-DTPA as well as iopentol. Serum concentrations of creatinine and β2-microglobulin, and urine concentrations of creatinine, β2-microglobulin, alkaline phosphatase, N-acetyl-glucosaminidase, and albumin were determined. A significant reduction (12 ± 3%) of GFR was observed after the injection of iopentol, without a subsequent rise in serum creatinine or β2-microglobulin. The urinary excretion of albumin and β2-microglobulin remained unchanged, while the excretion of alkaline phosphatase and N-acetyl-glucosaminidase was significantly increased after the urography, indicating some tubular effects of iopentol. Iopentol caused few and mild adverse events, the diagnostic yield was high, and the small changes in the renal tubular function parameters are presumed to be without clinical importance. The observed depressive effect on the GFR demands further investigations before iopentol can be recommended as a GFR-marker in children.
Artifacts in MR Imaging Caused by Small Quantities of Powdered Iron
Authors: Alanen A. , Bondestam S. , Komu M.
Published: June 2015

The MR image artifacts caused by minute metallic particles were investigated by imaging small powdered iron quantities from 0.01 mg to 1.7 mg in water phantoms. Images with T1-weighted GRE 3-D and T2-weighted SE 2-D sequences were reconstructed with 5 MR imagers: at 0.04 T., 0.1 T (2 scanners), 1.0 T and 1.5 T. In GRE 3-D images the artifacts were round, clearly demarcated black areas, whereas in SE 2-D images artifact areas were elliptic and surrounded by a bright irregular rim with ghost veils in the direction of frequency encoding. The area of the artifact increased slightly up to 0.1 mg of iron, but grew clearly with larger samples. It appeared to behave independently on the MR imager system for all iron samples. This study shows that even microscopic magnetic particles cause a notable distortion in the MR image independently of the MR equipment used.
Pleuro-Pulmonary Aspergillosis
Authors: Tikkakoski T. , Lohela P. , Päivänsalo M. , Kerola T.
Published: June 2015

We reviewed the US findings and the diagnostic yield of fine-needle aspiration biopsy (FNAB) for cytologic and microbiologic samples in 4 patients with pulmonary or pleural aspergillosis. All 3 apical Aspergillus abscesses were round, hypoechoic with irregular margins and one contained echo-densities with shadowing consistent with air. One pleural empyema was oval and hypoechoic. Cytology suggested inflammation in all cases and Aspergillus hyphae were detected in 2 of 4 aspirates. Culture of the aspirate was positive for Aspergillus in 3 of 4 cases, while one diagnosis was made after surgery. No complications occurred. Apico-pleural Aspergillus lesions are suitable targets for US-guided FNAB, thus avoiding more invasive methods. Our results suggest wider use of this procedure.
Dynamic High-Field MR Imaging in Experimental Porcine Acute Pancreatitis
Authors: Piironen A. , Kivisaari R. , Pitkäranta P. , Poutanen V.-P. , Laippala P. , Laurila P. , Kivisaari L.
Published: June 2015

The effects of acute pancreatitis on MR imaging signal intensities (SIs) were determined in an experimental study at 1.0 T. Oedematous pancreatitis was induced in 9 piglets and haemorrhagic pancreatitis in 11 piglets. Each animal served as its own control for MR imaging before and after induction of pancreatitis. T1-weighted spin echo (450/15 ms) and dynamic turbo FLASH (flip angle 8°) sequences were used without contrast medium in testing the stability of the SI measurements. There was no significant difference in the SI-versus-time curves of the pancreas in piglets with oedematous and haemorrhagic pancreatitis. However, the difference in mean SIs between healthy and diseased piglets was significant. Thus, although non-contrast MR may be useful in the diagnosis of acute pancreatitis, it does not distinguish between oedematous and haemorrhagic pancreatitis.
Contrast-Enhanced Dynamic MR Imaging of Postmolar Gestational Trophoblastic Disease
Authors: Yamashita Y. , Torashima M. , Takahashi M. , Mizutani H. , Miyazaki K. , Matsuura K. , Okamura H.
Published: June 2015

Conventional spin-echo (SE) and contrast-enhanced dynamic MR imaging were performed on a 1.5 T superconductive unit for evaluation of myometrial lesions in postmolar gestational trophoblastic disease (GTD) in 10 women. MR imaging was done at the time of the initial examination (n=10), during (n=6), and after repeated courses of chemotherapy (n=10). The T2-weighted SE image revealed an enlarged uterus (n=7), disappearance of zonal anatomy (n=6), and heterogeneous signal intensities (n=8) with prominent flow voids (n=7). However, these abnormalities remained after repeated courses of chemotherapy, when the S-β-HCG level returned to the normal range. Myometrial lesions characteristically had marked enhancement with areas of unenhancement on dynamic MR images in patients with highly elevated S-β-HCG. Areas of contrast enhancement correlated with changes in S-β-HCG level. The enhancement was reduced with decrease in S-β-HCG level after repeated courses of chemotherapy. Six of 8 masses seen on T2-weighted images proved to be active trophoblastic lesions and 2 masses proved to be hematoma or necrosis. In 2 patients, abnormal myometrial lesions were detected only on contrast-enhanced dynamic MR imaging. These preliminary data indicate that contrast-enhanced dynamic MR imaging more clearly demonstrates myometrial involvement of postmolar GTD than conventional SE imaging.
Simple and Safe Device for Pneumatic Reduction of Intussusception
Authors: Stenström H.
Published: June 2015

An apparatus for gas enema technique at intussusception in children has been constructed.
Computed VS. Film-Screen Magnification Radiography of Fingers in Hyperparathyroidism
Authors: Jónsson Á. , Hannesson P. , Herrlin K. , Jonsson K. , Andersen R. , Pettersson H.
Published: June 2015

One hundred randomly selected patients with suspected or known hyperparathyroidism were examined in a prospective study of the 2nd and 3rd fingers with film-screen and digital luminescence radiographs using magnification technique. The digital images were displayed on a work-station and printed as hard-copies. Two radiologists evaluated the film-screen images regarding subperiosteal and intracortical resorption and their results were defined as “gold standard” regarding the absence or presence of these changes. Four radiologists evaluated these changes in the 3 image forms and an ROC analysis was performed. Comparing the areas under the ROC curves no significant difference was found between the film-screen images and the 2 digital display forms. These results suggest that currently available digital systems provide adequate diagnostic accuracy for evaluation of subtle skeletal changes.
Artefacts Caused by Dental Filling Materials in MR Imaging
Authors: Vikhoff B. , Ribbelin S. , Köhler B. , Ekholm S. , Borrman H.
Published: June 2015

An investigation regarding possible artefacts from dental filling materials in MR imaging is presented including 9 types of such materials from various manufacturers. Freshly extracted teeth were prepared and the filling materials were handled according to manufacturers' instructions. The teeth were encapsulated into a gel phantom based on de-ionized water, Ni (NO3)2 and polysaccharide agarose powder. The investigation was performed with a standard head coil and a 1.5 T MR unit. Images acquired with various combinations of parameters from different sequences were visually analysed regarding possible artefacts. The investigation showed that only one of the materials caused significant artefacts. The gel phantom was found to be a valuable means for examination of artefacts from small samples, and can be recommended as a standard technique for this purpose.
Ultrasonographic and Endoscopic Ultrasonographic Angiography in Pancreatic Mass Lesions
Authors: Kato Tadeshi , Tsukamoto Yoshihisa , Naitoh Yasuo , Hirooka Yoshiki , Furukawa Tsuyoshi , Hayakawa Tetsuo
Published: June 2015

Extracorporeal ultrasonographic (US) angiography and endoscopic ultrasonographic (EUS) angiography were performed in 40 lesions on 39 patients with various pancreatic diseases to evaluate characteristic findings. Pancreatic cancer (duct cell carcinoma) showed negative or slight enhancement. Islet cell tumor, serous cystadenoma composed of microcysts, and intraductal papillary adenoma showed strong enhancement. Solid and papillary tumor showed enhancement in the central lesion. Four of 6 cases with pseudotumorous pancreatitis had iso-enhancement which disappeared earlier than that in the pancreatic parenchyma. However, 2 cases showed slight or negative enhancement similar to pancreatic duct cell carcinoma. US angiography is useful in evaluating the vascularity of various pancreatic lesions, especially small lesions, in dynamic real-time images. EUS angiography is also useful in evaluating the vascularity in lesions that cannot be detected by US.
Oral Contrast Media in CT of the Abdomen
Authors: Lönnemark Maria , Magnusson Anders
Published: June 2015

In a double blind randomised study 3 different concentrations of iohexol for bowel opacification at CT of the abdomen were compared. Iohexol in a concentration of 4.5 mg I/ml, 6.75 mg I/ml and 9 mg I/ml was used. No significant differences between the 3 preparations of contrast media were found regarding the contrast effect, the distribution or patient tolerance. When using iohexol as a bowel contrast medium at CT the concentration of 4.5 mg I/ml is sufficient for bowel opacification.
MR Imaging and Radiography of Patients with Cervical Hyperextension—Flexion Injuries after Car Accidents
Authors: Borchgrevink Grethe E. , Smevik Olaug , Nordby Asbjön , Rinck Peter A. , Stiles T. C. , Lereim I.
Published: June 2015

Fifty-two patients underwent MR imaging and conventional radiography of the neck within 4 days after a hyperextension—flexion injury. The patients also had follow-up investigations during the first 2 years. The images did not reveal any serious lesions in any of them. Based on the main MR and radio-graphical findings the patients were divided into 4 groups; no findings, posture abnormalities, spondylosis and disc pathology (from MR images) or reduced intervertebral space (from the radiographs). The outcomes of the different groups were compared with reference to neck stiffness, neck pain and headache during a 2-year follow-up period. The patient groups did not correspond completely when diagnosed from MR imaging and radiography. However, patients with pre-existing spondylosis had more symptoms when examined by both modalities. Based on the radiographs, the group with posture abnormalities had significant fewer symptoms than the other groups.
Computed Radiography in Scoliosis
Authors: Jønsson Ásbjörn , Jonsson Kjell , Eklund Karin , Holje Gunnila , Pettersson Holger
Published: June 2015

The diagnostic information and radiation dose in scoliosis examinations performed with air-gap technique using stimulable phosphor imaging plates were determined in a prospective study. Overlapping p.a. images of the thoracic and lumbar spine in 9 patients were obtained with 4 different exposure settings according to patient size. Equal exposure settings were used for the 2 images. Two images of 18 were judged inferior in depicting the landmarks of scoliosis measurement, requiring re-exposure. Sixteen images were judged of adequate or good quality. The mean entrance doses in the central beam for the 4 patient groups were in the interval of 0.05 to 0.12 mGy for both images. The skin doses on the breasts were in the range of 0.00 to 0.03 mGy. The presented technique thus results in a low radiation dose with sufficient diagnostic information in radiography of scoliosis.
Comparative Study of the Dialysability of Iobitridol and Iohexol in the Rat with Impaired Renal Function
Authors: Dencausse A. , Chambon C. , Violas X. , Bonnemain B.
Published: June 2015

Purpose:

To assess the dialysability of iobitridol, a comparative study with iohexol was conducted in the rat over 4 hours.

Material and Methods:

After ligature of the renal veins and arteries, a group of animals was submitted to continuous peritoneal dialysis, while the remainder were not.

Results:

In the event of total renal failure, biliary excretion rose from 0.4 to 9% for iobitridol and from 2 to 16% for iohexol. In the rats submitted to peritoneal dialysis, biliary excretion decreased to 5% in the iobitridol group and to 13% in the iohexol group. Further, 18% of the test substances were eliminated in the dialysis liquid.

Conclusions:

As their physicochemical characteristics are very similar, the differences between the biliary excretion levels of these 2 media may be caused by a factor related to their respective molecular conformations.
Contrast Enhancement of the Upper Abdomen Evaluated BY CT
Authors: Thorstensen Ö. , Isberg B. , Aspelin P.
Published: June 2015

The non-ionic monomeric contrast media iopamidol and iohexol were compared concerning enhancement in the organs of the upper abdomen in CT. The average peak enhancement above the base line for the 2 contrast media in the liver, vena cava, aorta and spleen was calculated. No difference between the contrast media was found with regard to increase in contrast enhancement. No correlation between the peak enhancement and body weight and body surface was found with either of the 2 contrast media.
CT-Diskography, Diskomanometry and MR Imaging as Predictors of the Outcome of Lumbar Percutaneous Automated Nucleotomy
Authors: Dullerud R. , Amundsen T. , Lie H. , Juel N. G. , Magnæs B.
Published: June 2015

Purpose:

This prospective study was performed to assess whether CT-diskography (CT-D), diskomanometry (DMM) including recording of the pain response, or the MR signal intensity of the disks are reliable predictors of the outcome of nucleotomy.

Material and Methods:

Ninety-one patients, 44 females and 47 males aged 18–68 years (mean 37.4) treated at 99 disk levels were included. All had plain CT, MR imaging, CT-D and DMM performed prior to automated percutaneous nucleotomy with the Nucleotome R system.

Results:

Sixty-nine (76%) of the patients responded well to treatment within 3 months. Due to recurrences, the success rate at 1 year was reduced to 65%. Except for better results following nucleotomy in patients with similar and identical pain as the presenting complaint provoked at diskography, no association was demonstrated between diskographic parameters, or loss of signal on MR, and the outcome. Better results were also seen in patients with a short history of disk disease, but not in patients with predominantly sciatica and focal hernias compared to those with predominantly low-back pain and diffuse posterior bulges.

Conclusion:

The results do not justify routine use of diskography prior to nucleotomy in patients with pathologic disks demonstrated by noninvasive methods and localizing sciatic pain.
CT-Assessment of Dependent Lung Densities in Man during General Anaesthesia
Authors: Lundquist H. , Hedenstierna G. , Strandberg Å. , Tokics L. , Brismar B.
Published: June 2015

Purpose:

We aimed to describe the frequency of atelectasis occurring during anaesthesia, to describe the size and pattern of the atelectasis, and to standardise the method of identifying the atelectasis and calculate its area.

Material and Methods:

Patients (n=109) scheduled for elective abdominal surgery were examined with CT of the thorax during anaesthesia.

Results:

In 95 patients (87%) dependent pulmonary densities were seen, interpreted as atelectasis. Two different types of atelectasis were found — Homogeneous (78%) and non-homogeneous (9%). Attenuation values in histograms of the lung and atelectasis were studied using 2 methods of calculating the atelectatic area.

Conclusion:

On the basis of the present findings, we defined atelectasis as pulmonary dependent densities with attenuation values of —100 to +100 HU.
Neural Tolerance of the Non-Ionic Dimers Iodixanol and Iotrolan and the Non-Ionic Monomer Iopamidol during Myelography in Non-Anaesthetised Rabbits
Authors: Maly P. , Sundgren P. , Bååth L. , Walday P.
Published: June 2015

Purpose:

The neural tolerance of the recently introduced dimer iodixanol (320 g I/l) was compared with that of the dimer iotrolan (300 g I/l) and of the monomer iopamidol (300 g I/l), both used in clinical myelography.

Material and Methods:

Non-anaesthetised rabbits were injected into the cisterna magna with Ringer's solution (control) or contrast media (CM) at doses of 1.0 or 0.5 ml/kg b.w. The behaviour of the animals (10 in each of 7 groups) was evaluated for signs of excitation and depression during the first 3 hours after injection.

Results:

At the dose level of 1.0 ml/kg b.w., iodixanol produced no seizures but did cause focal twitching in 4/10 rabbits. Iopamidol produced grand mal seizures in 2/10 and hyperexcitability in 4/10 rabbits. Iotrolan produced generalised grand mal seizures in 8/10 rabbits, an incidence of excitation significantly greater than that of iodixanol (p<0.01) and iopamidol (p<0.05). The excitative effects of iodixanol were not significantly different from those of iopamidol and Ringer's solution. All 3 CM produced similar depressive effects on rabbit behaviour. Ringer's solution caused no depressive effects (p<0.01). A clear dose response was produced with all 3 CM after treatment with a lower dose of 0.5 ml/kg b.w.

Conclusion:

The results indicate that the neural tolerance in the rabbit of iodixanol is higher than that of iotrolan, and is at least equal to that of iopamidol.
Percutaneous Pancreatography under Ultrasonographic Guidance
Authors: Opačić M. , Rustemović N. , Pulanić R. , Vucelić B. , Frković M. , Mandić A.
Published: June 2015

Purpose:

The aim of the study was to evaluate percutaneous pancreatography as an alternative method for pancreatic duct visualisation in patients with pancreatic disease.

Material and Methods:

In 21 patients with pancreatic disease and previously unsuccessful ERCP, puncture of the pancreatic duct was carried out under ultrasonographic guidance with an 0.7-mm Chiba needle, and contrast injection was made under fluoroscopic control in the pancreatic duct.

Results:

The procedure was successful in 18 patients (86%). In 10 patients, chronic pancreatitis was found, and in 8 patients, pancreatic carcinoma.

Conclusion:

Percutaneous pancreatography is a good alternative method for visualisation of the pancreatic duct in patients with pancreatic disease and previously unsuccessful ERCP.
Effect of Bone Density of the Head on Total Body Dexa Measurements in 100 Healthy Swedish Women
Authors: Brismar T. B. , Ringertz H.
Published: June 2015

Purpose:

The aims of this study were to examine the bone areal density of the head and how it varied in relation to the density of the rest of the skeleton, and with age, and body mass index (BMI). Our intention was to study the feasibility of excluding the head from the rest of the body, a method which might improve the fracture prediction power of bone mineral measurements.

Material and Methods:

Bone mineral per area (BMA) and bone mineral content (BMC) (g) were determined in 100 consecutive female volunteers, aged 17 to 78 years, with total and partial body measurements.

Results:

BMC of the head was found to be 20.2±2.2% of that for the total body. The BMA of the head was 2.38±0.21 times higher than that of the rest of the body. The correlation between the BMA of the head and the rest of the body was significant (r=0.73). The average change in z-score (referred to the same age group in our material) was 0.20 when the head was excluded from total body BMA. The BMA of a) total body, b) total body, head excluded, and c) head decreased with age. The BMA of the head was correlated to BMI in the older age groups (p<0.01). The relative statistical uncertainty for repeated measurement of head BMA was 1.8%.

Conclusion:

The change of the bone density of the head with age and BMI, in comparison to that of the rest of the skeleton, suggests that when the head is excluded from total body BMA better predictive value for fracture risk is obtained.
In Vitro Study of the Accuracy of Bone Mineral Measuring Devices in Norway and Sweden
Authors: Kullenberg R. J.
Published: June 2015

Purpose:

The aim of the study was to investigate the performance of different types of equipment for bone mineral assessment in Sweden and Norway with standardised phantoms.

Material and Methods:

Measurements of the bone mineral content of 2 semi-anthropomorphic phantoms, one simulating the human torso and one the lower arm, at 21 hospitals in Norway and Sweden, were undertaken. The phantoms had inserts of hydroxyapatite in different concentrations and were measured together with additions of stearic acid simulating fat. The phantoms were repeatedly measured on 14 dual X-ray absorptiometry, 5 single X-ray absorptiometry, and 3 single photon absorptiometry devices and 1 quantitative CT device.

Results:

The measurements showed a large spread in the measured hydroxyapatite concentrations among different devices. The inaccuracy was slightly lower than 10% without fat present when the results were expressed as bone mineral areal mass (BMA, g/cm2). With fat included the inaccuracy was at worst 50%.

Conclusion:

The large inaccuracy found in this study gives rise to a large overlap between healthy and osteoporotic cases and makes the diagnosis of osteoporosis difficult in the individual patient.
Measurement of Blood Flow in the Superior Sagittal Sinus in Healthy Volunteers, and in Patients with Normal Pressure Hydrocephalus and Idiopathic Intracranial Hypertension with Phase-Contrast Cine MR Imaging
Authors: Gideon P. , Thomsen C. , Gjerris F. , Sørensen P. S. , Ståhlberg F. , Henriksen O.
Published: June 2015

Purpose:

To measure blood flow and velocity in the superior sagittal sinus.

Material and Methods:

MR velocity mapping was used to examine 14 healthy volunteers, 15 patients with normal pressure hydrocephalus (NPH), 3 patients with high pressure hydrocephalus (HPH), and 11 patients with idiopathic intracranial hypertension (IIH).

Results:

Mean blood flow was 443 ml/min in healthy volunteers with a tendency towards reduced blood flow with increasing age. In NPH patients significantly lower superior sagittal sinus blood flow values were found, but this difference was no longer significant when patients and controls were matched for age. In HPH and IIH patients blood flow and velocity were within the normal range. In one patient with thrombosis of the superior sagittal sinus the blood flow was reduced to 40 ml/min.

Conclusion:

MR velocity mapping methods may be of value in the assessment of blood flow in the dural sinuses in various pathologies resulting in dural sinus occlusion, such as dural sinus thrombosis, and for following the progress of these patients while undergoing treatment.
Conventional Radiography and Ultrasonography in the Diagnosis of Small Bowel Obstruction and Strangulation
Authors: Czechowski J.
Published: June 2015

Ninety-six patients, 45 men and 51 women (mean age 39 years, range 13–90 years), with clinically acute abdomen were examined by conventional abdominal radiography and ultrasonography during a period of one year. Ultrasonography was performed with a linear transducer, which permitted study of morphology and motility of small bowel loops: distention, paralysis, intramural thickening, and extraluminal fluid. Nineteen cases of mechanical obstruction (9 simple and 10 of strangulation type) were observed. In the strangulation group ultrasonographic findings were positive in 91% whereas conventional radiography solely was positive in 30%. In the simple obstruction, 89% and 78%, respectively, were correctly diagnosed by the 2 techniques. Ultrasonography is recommended as a routine examination beside conventional abdominal films in acute abdomen.
3DFT-Flash MR Imaging of Pancreatic Cancer with Gadopentetate Dimeglumine
Authors: Murakami T. , Tsuda K. , Nakamura H. , Osuga K. , Tomoda K. , Hori S. , Miyata M. , Monden M. , Wakasa K.
Published: June 2015

Purpose:

We evaluated the usefulness of dynamic 3-dimensional Fourier transformation (3DFT) fast low angle shot (FLASH) MR imaging using gadopentetate dimeglumine (Gd-DTPA) to assess the extent of pancreatic cancer.

Material and Methods:

Breath-hold 3DFT-FLASH MR images (20/4; 25° flip angle; 7 partitions; 3–5-mm slice thickness) were obtained before the administration of 0.1 mmol/kg of Gd-DTPA, just after (early phase), and 1 and 2 min (late phases) after in 14 patients with pancreatic cancer. All patients underwent surgical removal or laparotomy. We compared the findings of T1-, T2-, and postcontrast T1-weighted spin-echo (conventional SE) and 3DFT-FLASH imaging with histologic or surgical findings.

Results:

Dynamic MR images could delineate the pancreatic tumors more clearly than the conventional SE images, and were useful for diagnosing vessel invasion. The contrast-to-noise ratio between the pancreatic cancer and the surrounding pancreatic parenchyma was significantly higher with the dynamic 3DFT-FLASH image than with the conventional SE images (p<0.01).

Conclusion:

Dynamic 3DFT-FLASH MR imaging with Gd-DTPA is useful in delineating and evaluating the extent of pancreatic cancer.
Percutaneous Drainage of Intrasplenic Pancreatic Pseudocyst
Authors: Tennøe B. , Bay D. , Rosales R.
Published: June 2015

The intrasplenic pancreatic pseudocyst is very rare and surgical treatment has been recommended. We report on a patient with this condition who was successfully treated with percutaneous drainage. Special considerations apply when the drainage catheter is inserted intercostally.
Phantom Gastric Mucosa for Evaluating Computed Radiography in Double-Contrast Upper Gastrointestinal Examinations
Authors: Murakami M. , Watanabe H. , Nakata H.
Published: June 2015

Purpose:

To test the clinical usefulness of computed radiography (CR) with a storage phosphor plate in upper gastrointestinal radiographic examinations, a newly devised phantom gastric mucosa was used.

Material and Methods:

Simulated small elevated and depressed lesions were created on a phantom gastric mucosa made from a styrofoam “plate”. Twenty-four sets of each CR and screen-film radiographs (SR) were obtained using phototimed exposures. Receiver operating characteristic (ROC) study and visual ranking using these images were performed.

Results:

There was no significant difference between the ROC curves of CR and SR. By visual ranking, CR was equal to or better than SR in most cases. In no case was SR definitely superior to CR.

Conclusion:

CR can be safely applied in upper gastrointestinal roentgenologic examinations.
Detection of Hepatocellular Carcinoma by Intraarterially Enhanced Ultrasonography with Co2 Microbubbles
Authors: Arakawa A. , Nishiharu T. , Matsukawa T. , Urata J. , Hatanaka Y. , Yamashita Y. , Takahashi M. , Kanemitsu K. , Mihara M.
Published: June 2015

Purpose:

To evaluate the diagnostic value of contrast-enhanced US with CO2 microbubbles (EU) for HCCs. Detectability was compared with DSA, dynamic CT, and Lipiodol CT.

Material and Methods:

Forty-seven histologically proven HCCs detected with US were evaluated with EU, DSA, and dynamic CT. In 23 patients (35 lesions), Lipiodol CT was also performed. The size of the tumors ranged from 8 to 71 mm (average 28.1 mm); 24 lesions were smaller than 20 mm and 23 lesions were larger than 20 mm.

Results:

Overall detection was possible in 40 of 47 lesions (85%) by EU, in 32 of 47 (68%) by DSA, in 33 of 47 (74%) by dynamic CT, and in 27 of 35 (77%) by Lipiodol CT. In tumors smaller than 20 mm, detection was possible in 21 of 24 lesions (88%) by EU, 14 of 24 (58%) by DSA, 14 of 24 (58%) by dynamic CT, and 11 of 17 (65%) by Lipiodol CT.

Conclusion:

EU has significant diagnostic value for detection of HCCs, particularly tumors smaller than 20 mm.
Factors Predicting the Outcome of Intraarterial Thrombolysis in Peripheral Arterial and Graft Occlusions
Authors: Sandbæk G. , Staxrud L. E. , Rosen L. , Bay D. , Stiris M. , Gjølberg T.
Published: June 2015

Purpose:

To determine the association between successful intraarterial thrombolysis and the following factors: sex, age, symptoms, duration of symptoms, length of occlusion, conduit type, runoff, and catheter localization.

Material and Methods:

Forty-six patients with acute or subacute occlusions of peripheral native arteries and grafts were treated with continuous intraarterial infusion of streptokinase or urokinase. A univariate chi-square test and logistic regression analysis were used.

Results:

Successful lysis was achieved in 27 of 46 patients (59%). The logistic regression analysis revealed a significant association between successful thrombolysis and good runoff (p<0.01). A catheter position above the occlusion resulted in lysis in only one of 11 patients. The variables rest pain and claudication were slightly significant (p=0.07). None of the other variables were significant, but a trend toward a separate effect of duration of occlusion was found.

Conclusion:

Good runoff and intrathrombotic infusion are virtual necessities in obtaining a positive immediate outcome in peripheral arterial and graft occlusions. In our study, other factors were less important.
Phantom Study of Chest Radiography with Storage Phosphor, Selenium, and Film-Screen Systems
Authors: Kehler M. , Lyttkens K. , Andersson B. , Hochbergs P. , Lindberg C.-G. , Medin J. , Nordström A.-J. , Sanfridsson J. , Vojciechowski J.
Published: June 2015

Purpose:

Chest radiographs from 3 digital systems − 2 based on luminescent phosphors and one on selenium — and a conventional film-screen system were evaluated and compared.

Material and Methods:

Computed radiography (CR) has for the past years been dominated by a single manufacturer, but now several systems have been marketed. Using a chest phantom and, as test objects, 2 simulated tumours for the lung and mediastinum, respectively, and one object simulating pulmonary lines, a total of 400 exposures were made, 100 on each system. The test objects were placed randomly with a ratio of presence/absence of each object of about 50. Six radiologists participated, 2 residents and 4 staff members. A receiver operating characteristics (ROC) analysis was performed with construction of curves, and the difference between the curves was estimated with a 2-tailed paired t-test.

Results and Conclusion:

The selenium-based system performed significantly better for pulmonary line detection than all the other systems, and better than one storage phosphor system for the lung “tumour” (p<0.05), while one storage phosphor system was slightly better than the other in diagnosing all 3 test objects. The score for the film-screen system was only average.
Postoperative Lumbar MR Imaging with Contrast Enhancement
Authors: Grane P. , Tullberg T. , Rydberg J. , Lindgren L.
Published: June 2015

Purpose and Material:

Contrast-enhanced MR imaging of the spine after surgery for lumbar disk herniation almost always shows pathologic changes. To investigate to what extent these changes are correlated to patients' actual clinical symptoms, we compared the postoperative MR findings in 19 asymptomatic patients with 42 symptomatic patients (43 levels).

Methods:

The asymptomatic patients underwent MR examination one year after surgery. Twenty-six of the symptomatic patients underwent MR one year or less after surgery, and in 16 patients (17 levels) MR was performed more than one year after surgery.

Results:

Sixteen percent of the asymptomatic and 42% of the symptomatic patients had disk herniation at the level of previous surgery. Most of the herniated disks were found in the symptomatic patients less than one year after surgery. The amount of epidural scar tissue, displacement and thickening of nerve roots, and compression of the dural sac were also studied. Disk herniation as a probable cause of recurrent sciatica was a common finding among symptomatic patients examined one year or less after surgery. In comparing asymptomatic patients and symptomatic patients with more than one year between surgery and MR examination, no significant radiologic differences, including disk herniation, were found.
Diagnostic Radiology in Denmark
Authors: Andersen P. E. , Langfeldt B.
Published: June 2015

The development of diagnostic radiology in Denmark is described with reference to the persons and organizations involved.