bluuebunny/crossref_metadata_2025 huggingface dataset:
Computed Tomography in Early Stages of Testicular Carcinoma
Authors: Forsberg L. , Dale L. , Høiem L. , Magnusson A. , Mikulowski P. , Olsson A. M. , Ous S. , Stenwig A. E.
Published: June 2015

From the SWENOTECA Project, the CT findings in 156 patients treated by bilateral retroperitoneal lymphadenectomy were reviewed. Of these, 112 were in stage I (no metastases) and 44 in stage II A (metastases in normal-sized lymph nodes and in nodes with a maximum diameter in the transverse plane of ≤ 20 mm). The normal size of lymph nodes in young Scandinavian men was found to be less than 10 mm × 8 mm above the bifurcation, except in the area below the left renal vein to the left of the aortic midline where the normal size was found to be maximally 14 mm × 10 mm. The addition of a lymphangiographic contrast medium did not change the size of the lymph nodes significantly above the bifurcation, while changes of importance were noticed in the pelvic area. Normal size without contrast medium was found to be at the most 15 mm × 10 mm and after addition of contrast medium to the nodes 28 mm × 12 mm. The results of the CT findings in the stage II A group were not impressive but changed somewhat for the better using the new limits concerning size of retroperitoneal lymph nodes. The impact of using different limits is discussed and it is concluded that metastases in normal-sized or almost normal-sized lymph nodes will continue to be a diagnostic problem, at least when using CT.
Chest Radiography in the Carcinoid Syndrome
Authors: Thorvinger B. , Lundstedt C. , Mårtensson H.
Published: June 2015

The chest films of 44 patients with liver metastases from intestinal carcinoid tumors were reviewed in order to evaluate the frequency of significant carcinoid heart disease. Only two patients had obvious signs of cardiac involvement, which is contradictory to most other studies.
Alternating Use of 123I and 131I Hippuran for Routine Postoperative Monitoring of Transplanted Kidneys is Impracticable
Authors: Thomsen H. S. , Hvid-Jacobsen K. , Nielsen S. L.
Published: June 2015

During a 7-week period 123I hippuran was used instead of 131I hippuran for all renographies of transplanted kidneys on Wednesdays. Only in well functioning grafts with a diuresis above 2 ml/min during the examination a scintigraphic improvement of renal and upper urinary visualization was obtained. It is concluded that alternating routine use of the expensive 123I hippuran in control of renal grafts cannot be recommended.
99Tcm-MDP and 99Tcm-DPD in Pathologic Bone Lesions
Authors: Lantto T. , Vorne M. , Mokka R. , Vähätalo S.
Published: June 2015

The efficiency of 99Tcm-methylene diphosphonate (MDP) and 99Tcm-dicarboxypropane diphosphonate (DPD) to detect pathologically increased bone uptake was evaluated both by computed quantitative intra-individual and visual inter-individual comparison. Twelve patients with altogether 44 metastases in ribs and lumbar vertebrae were evaluated quantitatively. The lesion to normal bone ratio (mean ± SD) was, with MDP, 2.9 ± 1.6 and with DPD 2.4 ± 1.2 (p<0.001), and the normal bone to soft tissue ratios with MDP 8.5 ± 5.0 and with DPD 9.4±6.1 (NS). Visual analysis of 162 patients with 334 focal lesions showed no significant difference between two MDP preparations and one DPD preparation. Visual and quantitative comparison in the three most common malignancies studied (breast, prostatic, and lung carcinoma) gave the same result. Because the lesion to normal bone ratios were high with both agents, and there was no significant difference on visual analysis, both radiopharmaceuticals are considered to be relevant bone seeking agents and the difference between MDP and DPD is only academic and not of practical value.
Magnetic Resonance Imaging in Small Lesions of the Central Nervous System
Authors: Schroth G. , Grodd W. , Guhl L. , Grauer M. , Klose U. , Niendorf H.-P.
Published: June 2015

T1 values and T2 values (CPGM-sequence) of neurinomas and meningiomas were determined, and showed values close to those of white and grey matter or, in regressive cystic neurinomas, near the cerebrospinal fluid (CSF). By this overlapping in relaxation times, as well as by crossover and boundary effects, small tumors may be obscured. The application of gadolinium-DTPA allows easier identification even of small lesions, by the high contrast achieved on the T1 weighted imaging sequences, which also avoids crossover and boundary effects with the adjacent parenchyma and CSF. This is demonstrated in intrameatal acoustic neurinomas, vascular tumors, small and en plaque growing meningiomas, and tumors of the spinal canal.
Wegener's Granulomatosis in North India
Authors: Bambery P. , Katariya S. , Sakhuja V. , Kaur U. , Behera D. , Malik S. K. , Deodhar S. D.
Published: June 2015

The chest radiograph in Wegener's granulomatosis reveals several striking, but not pathognomonic abnormalities. Nine (82%) of eleven patients with Wegener's granulomatosis had abnormal chest radiographs. Infiltrates were seen in all patients and were nodular in seven (77%). Six patients had cavities which were most often unilateral and thick walled. Serial radiographs showed the simultaneous appearance and resolution of infiltrates in 4 of 7 instances. Bilateral pulmonary involvement (67%), pleural effusion (33%), and pericardial effusion (22%) were also seen. Paranasal sinus involvement was seen in 4 of 5 studies. The chest radiograph was interpreted as tuberculosis in eight patients, resulting in delayed diagnosis and incorrect treatment.
Increased Arterial Wall Stiffness and Thickness in Medium-Sized Arteries in Patients with Insulin-Dependent Diabetes Mellitus
Authors: Christensen T. , Neubauer B.
Published: June 2015

By means of ultrasonography, arterial wall stiffness, arterial wall thickness, and the elastic modulus of the common femoral artery were estimated in a group of 19 young insulin-dependent diabetics. The ultrasound technique for determination of these parameters is described as well as the echo-anatomy of the arterial wall. In accordance with a previous investigation a significant rise in arterial wall stiffness was found. Furthermore, there was a highly significant correlation between the stiffness and the thickness of the arterial wall. The elastic modulus also correlated to the stiffness. It is concluded that the diabetic macroangiopathy is characterized by an increased stiffness of the arterial wall caused by increased thickness as well as by progressive alterations of the elastic characteristics of the wall tissue. Possible pathogenetic reasons are discussed.
Comparison of Two- and Three-Dimensional Methods for Assessment of Orientation of the Total Hip Prosthesis
Authors: Herrlin K. , Pettersson H. , Selvik G.
Published: June 2015

A comparison of two- and three-dimensional methods for the determination of the orientation of total hip prostheses was made in a group of 57 patients. The acetabular inclination and the collum-diaphyseal angle measured on a.p. projections (2-D) were adequate in most cases for assessing how vertically the prosthetic component was inserted, but in individual cases with a high degree of version these measurements could be misleading. Anteversion measured in the transverse plane (2-D) was more sensitive to errors than planar anteversion measured as a rotation around the longest diameter of the ellipsoid projection of the acetabular opening, but it gave a rough estimate of the relation of the prosthetic components. Determination of the spatial (3-D) orientation of the components provides a precise estimate of the component relations.
The Percentage of Migration as Indicator of Femoral Head Position
Authors: Eklöf O. , Ringertz H. , Samuelsson L.
Published: June 2015

In childhood subluxation of one or both hips may develop rather insidiously. For lack of generally accepted objective methods of assessment, ambiguous interpretations of findings in serial examinations are common. Many subluxations are overlooked during the early stages. In order to overcome such disadvantages, determination of the percentage of migration seems to be a reasonably easy and reliable technique facilitating evaluation of impending dislocation. This investigation was carried out in order to establish norms applicable to patients in the pediatric age interval. The 98th percentile of migration increases with age from 16 per cent in patients <4 years of age to 24 per cent in patients ≥12 years. Higher figures represent subluxation. If the migration exceeds 80 per cent a manifest luxation is present. A difference in migration between the two hips larger than 12 per cent indicates abnormality calling for clinical and radiologic follow-up.
Nine Pheochromocytomas in the Same Patient
Authors: Nolsøe C. P. , Jensen L. T. , Torp-Pedersen S. , Rasmussen M. , Christensen N. Juel , Holm H. H.
Published: June 2015

A 37-year-old man presented with hypertension and elevated urine catecholamine. Ultrasound scanning revealed a solid tumour of the right adrenal gland and two solid tumours in the retroperitoneum. The findings were confirmed with computed tomography and abdominal angiography. At surgery only the tumour of the right adrenal gland was removed. The histopathologic diagnosis was pheochromocytoma. Postoperatively the symptoms and biochemistry were unchanged and the patient was referred for further treatment. At ultrasonography and abdominal aortography 6 remaining tumours were demonstrated. Surgery was performed and 8 pheochromocytomas were extirpated (3 were closely spaced small tumours in a conglomerate corresponding to one of the visualized tumour sites). On histopathologic examination no signs of invasive growth were found. The patient recovered completely. The blood pressure was still normal 2 1/2 years later. Angiography and non-invasive examination of the entire abdomen and pelvis should be routine when pheochromocytomas are searched for.
Effect of Contrast Media on Whole Blood Filtrability
Authors: Le Mignon M. M. , Ducret M. Nain Dit , Bonnemain B. , Donadieu A. M.
Published: June 2015

The effects of three contrast media, iohexol, iopamidol and ioxaglate, on rat erythrocytes were compared. Three parameters representative of the rheologic properties of blood were investigated: whole blood filtrability, red cell filtrability and morphology. Whole blood and red cell filtrabilities were both measured using an erythrometer and red cell morphology was observed with an optical microscope. Iohexol and iopamidol were found to cause a significant increase in filtrability indices and to modify the shape of red blood cells. Ioxaglate had less effect on these parameters than did the other two contrast media. The chemical structure seems to be a determining factor for red cell integrity. The study of blood rheology parameters in vitro may be useful as a model predictive of observations on human blood and of hemodynamic consequences.
Repeated Computed Tomography in Lacunar Infarcts of the Brain
Authors: Skriver E. B. , Olsen T. S.
Published: June 2015

This prospective and consecutive study of 74 patients with completed stroke elucidates occurrence, localization and evolution of lacunar infarcts on repeated CT examinations. Twenty patients had large infarcts (diameter >3 cm), 25 medium-sized infarcts (diameter ≥1.5 cm – ≤ 3 cm), and 16 had lacunar infarcts (diameter <1.5 cm). In 13 patients no infarct was seen. The lacunar infarcts were characterized by delayed appearance on CT, low incidence of fog effect, and infrequent presence of contrast enhancement. In 9 of the 16 patients (56%) the lacunar infarct could be identified on the first CT, performed approximately 3 days after the stroke. In 2 patients the infarct was first revealed on the second (2 weeks post stroke) and in 5 on the third CT (6 months post stroke). The delayed appearance might be due to a partial volume effect. Early development of fog effect may also be considered. As contrast enhancement was observed in only 8 per cent of the patients with lacunar infarcts on CT, and in 70 per cent of the entire group of patients in our series with ischemic infarcts, contrast enhancement seemed to be a function of lesion size.
Clinical Comparison of 99Tcm-Hmpao Labelled Leucocytes and 99Tcm-Nanocolloid in the Detection of Inflammation
Authors: Vorne M. , Lantto T. , Paakkinen S. , Salo S. , Soini I.
Published: June 2015

Forty-five patients with various inflammatory diseases were imaged with 99Tcm-HMPAO labelled leucocytes and 99Tcm-nanocolloid within 7 days. The overall sensitivity of 99Tcm-leucocytes was 97% and that of 99Tcm-nanocolloid 59% and both agents had a 100% specificity. The 99Tcm-leucocyte method showed reliable results in various inflammatory and infectious conditions, and seems suitable as a primary imaging method. On the contrary, 99Tcm-nanocolloid cannot be recommended for use in inflammatory bowel diseases, soft tissue abscesses or prosthetic vascular graft infections. However, 99Tcm-nanocolloid gave reliable information in inflammatory and infectious bone and joint diseases in which it had a 90% sensitivity and 100% specificity. In those lesions the 99Tcm-nanocolloid method may be useful, because it is simple, fast and cheap. Yet, further evaluation is needed.
Influence of Urography on Renal Function in Children
Authors: Stake G. , Monn E. , Rootwelt K. , Golman K. , Monclair T.
Published: June 2015

Thirty-two children were given either metrizoate or iohexol for urography in a double blind study. Mild to moderate adverse reactions were observed in all patients receiving metrizoate (15/15) and in 4 receiving iohexol (4/17). Alkaline phosphatase in urine was significantly increased 4 hours after the injection of both media, but had returned to pre-injection levels 16 hours later. The excretion of β2-microglobulin and albumin was not altered. In 9 children in the metrizoate group and 11 in the iohexol group the glomerular filtration rate (GFR) was determined before urography by the single injection 99Tcm-DTPA-technique and 3 to 4 hours after urography by measuring the plasma disappearance of the contrast medium with the x-ray fluorescence technique. No reduction of GFR was observed.
Computed Tomographic Arteriography of the Liver Using Balloon Occlusion
Authors: Hosoki T. , Marukawa T. , Hori S. , Tokunaga K. , Kuroda C. , Kozuka T.
Published: June 2015

The article describes a new method for computed tomographic arteriography (CTA) of hepatocellular carcinoma (HCC) using a balloon occlusion catheter in 8 patients. Our dynamic study indicated that: 1) a bolus injection of contrast medium with our method of CTA (CTA-B) produced an attenuation difference between liver and tumor which was about double that obtained with standard methods for CTA, and 2) marked tumor-liver attenuation differences (above 20 HU) persisted for more than 60 s in CTA-B and for not more than 20 s with conventional methods for CTA. The results show that CTA-B is superior to standard methods in enabling multiple scans of the liver during greater and prolonged differential tumor enhancement after administration of a bolus of contrast medium. In conjunction with table incrementation, CTA-B allows scanning of the entire liver at the time of maximal contrast enhancement with two to three injections of contrast medium. Two patients complained of abdominal pain during balloon inflation. No other complications were observed.
Balloon Dilatation of the Ampulla of Vater
Authors: Riesenfeld V. , Hägerstrand I. , Lunderquist A.
Published: June 2015

In order to evaluate possible local tissue injury following balloon dilatation of the ampulla of Vater, the ampullas of 10 rabbits were dilated. The ampullas and the common bile ducts were examined histologically two months afterwards. All the ampullas were found to be normal. In one case aggregations of lymphoid cells were found in the thin wall of the common bile duct. Cholangiography was performed in 8 of the animals two months after dilatation. This was done to evaluate gross signs of local injury, i.e. strictures. All these were normal.
Percutaneous Drainage of Abscess in Psoas Compartment and Epidural Space
Authors: Cwikiel W.
Published: June 2015

The history of a patient with neurological deficit symptoms secondary to a spinal epidural abscess connected with psoas abscess and several fistulas on the buttocks is described. Etiology, diagnosis, and treatment are discussed. Percutaneous drainage of the spinal epidural abscess is suggested as an alternative to surgery.
Muscle Toxicity of Diatrizoate and Iohexol in Rabbits
Authors: Thomsen H. S. , Golman K. , Svendsen O.
Published: June 2015

The potential tissue irritating effect of diatrizoate and iohexol was studied by injecting the contrast media into the right longissimus dorsi muscle of rabbits. The left muscle served as control. The animals were sacrificed 3 days after the injection, at which time muscle tissue was examined for macroscopic changes and loss of the muscle enzyme creatine kinase (CK) from the injection site was determined. An irregular area of necrotic muscle tissue and a hemorrhage was found at the injection site in rabbits given diatrizoate, whereas iohexol only caused hemorrhage. The local loss of CK activity following diatrizoate (0.64 g muscle tissue) was statistically significantly greater than following iohexol (0.18 g muscle tissue). It is concluded that this model seems to be useful for identification of the irritating potential of contrast media. It is also concluded that diatrizoate caused more damage to the local muscle tissue than iohexol.
Radiographic Changes in Cardiac Contours following Heart Transplantation
Authors: Murayama S. , Ikezoe J. , Godwin J. D. , Allen M. D.
Published: June 2015

Chest radiographs of 46 patients who had undergone heart transplantation were reviewed with special attention to abnormalities of the cardiac contours. MR imaging in 3 such patients revealed 3 types of double right cardiac contours: the recipient right atrium combined with the donor right atrium; the donor right atrium combined with the recipient left atrium; and a cardiac fat pad combined with the right atrium. A prominent main pulmonary artery was shown by MR imaging to result from leftward displacement of the main pulmonary artery caused by clockwise rotation and transverse position of the transplanted heart. Recognition of these unique radiographic appearances is of value in assessing transplanted hearts and in avoiding misdiagnosis.
Transcatheter Embolization of Testicular Vein for Varicocele Testis
Authors: Kuroiwa T. , Hasuo K. , Yasumori K. , Mizushima A. , Yoshida K. , Hirakata R. , Komatsu K. , Yamaguchi A. , Masuda K.
Published: June 2015

Percutaneous transcatheter embolization of the testicular vein was performed on 28 patients with angiographically proven varicocele testis. In 2 patients bilateral and in 26 only the left vein was embolized using 3-, 5-, or 8-mm stainless steel coils. All patients had clinically palpable varicoceles and male infertility. The grade of varicoceles improved after embolization in 23 of 28 cases (82%). Effective sperm count increased significantly from 34.5 ± 44.6 to 65.1 ± 71.0 following embolization. However, pregnancy was achieved only in one of 28 cases. Technically, the basilic vein approach was felt to be superior to the femoral vein or jugular vein approach for this procedure.
Peritoneal Mesothelioma
Authors: Ros P. R. , Yuschok T. J. , Buck J. L. , Shekitka K. M. , Kaude J. V.
Published: June 2015

Previous imaging reports of peritoneal mesothelioma have described a variety of radiologic appearances, but have not included its pathologic classification. We retrospectively reviewed 10 cases of peritoneal mesothelioma representing the following histologic categories: 7 epithelial, 2 sarcomatoid, and one biphasic. By imaging, epithelial mesotheliomas demonstrated diffuse thickening of the peritoneum and mesentery and/or multiple small nodules. The sarcomatoid-type appeared as a mass and the biphasic-type had radiologic and gross pathologic features of both sarcomatoid and epithelial types. We conclude that peritoneal mesothelioma presents with a wide spectrum of radiographic appearances and should therefore be included in the differential diagnoses of diffuse as well as localized peritoneal processes.
Clinical and Angiographic Features of Nonspecific Aorto-Arteritis in Children and Adults
Authors: Sharma S. , Rajani M. , Kamalakar T. , Talwar K. K. , Sunderam K. R.
Published: June 2015

We compared clinical and angiographic features of nonspecific aorto-arteritis in children with those of adult patients. Digital subtraction angiography by i.v. and/or i.a. injection was carried out in 104 patients. In group 1, consisting of 32 patients aged 16 years and younger, hypertension (75%) was the most common clinical feature, followed by diminished pulse, bruit (72% each), congestive cardiac failure (38%), and limb claudication (13%). Obstructing arterial lesions were always present and commonly involved the abdominal aorta (75%), descending thoracic aorta (41%), renal (63%) and subclavian (41%)) arteries. In Group 2, consisting of 72 patients more than 16 years of age, arterial bruit (91%), and diminished pulse (82%) were the most common symptoms. Hypertension occurred in 61%, congestive failure in 14%, and limb claudication in 30%. Obstructing lesions were always seen and commonly involved the abdominal aorta (77%) and renal arteries (64%). Involvement of the descending thoracic aorta (26%) was less common but subclavian (57%) and carotid (24%) arteries were more commonly involved than in group 1. Arterial aneurysms and pulmonary involvement were uncommon in both groups. There were some clinical and angiographic differences in nonspecific aorto-arteritis between children and adults but these were statistically insignificant (chi-square test).
Contrast Medium Injected into Juvenile Bone Cysts to Analyze Interior Morphology and Guide Intracavity Corticosteroid Treatment
Authors: Rosenborg M. , Karlsson A. , Hirsch G. , Mortensson W.
Published: June 2015

In connection with treating juvenile bone cysts with intracavital corticosteroid injections, the interior cyst anatomy was analyzed at cystography in 13 children aged 4 to 15 years. Only 4 children had a true unicameral cyst; the others had 2 or more cysts or had compartments with free or restricted communication to the main cyst. Cysts and compartments which had not been reached by steroids may continue to grow. Optimum treatment may therefore require injections at different sites guided by cystography. Neither conventional criteria of cyst activity nor repeated bone scintigraphy 3 months after treatment could predict whether the treatment would lead to final healing.
In Vivo 19F Mr Spectroscopic Study of Metabolism of 5-Fluorotryptophan in Rat Liver
Authors: Harada M. , Nishitani H. , Koga K. , Miura I. , Kido R.
Published: June 2015

The metabolism of 5-fluorotryptophan in rat liver was examined by in vivo 19F MR spectroscopy. After i.v. injection of 200 mg/kg b.w. of 5-fluorotryptophan the substance was noted immediately as a strong peak, which decreased gradually. Another peak appeared about 40 min after the injection. The chemical shift value of this peak was 1.6 ppm from that of 5-fluorotryptophan. Kynurenine is known to be a major metabolite of tryptophan in the liver. We synthesized 5-fluorokynurenine from 5-fluorotryptophan by ozonolysis. The chemical shift value of 5-fluorokynurenine was confirmed to be coincident with that of the metabolite peak. This strongly suggests that the metabolite peak of 5-fluorotryptophan observed in this study was the 5-fluorokyrurenine signal. We also applied this method for the CCl4-injured liver. In the liver injury group, the metabolite peak appeared slowly and the intensity was low compared to that of the normal group, though the peak of 5-fluorotryptophan decreased similarly as in the normal liver. These results suggest that the decrease of 5-fluorotryptophan is due mainly to the renal excretion, as the injured liver could not metabolize 5-fluorotryptophan.
P-31 Mr Spectrum and Histologic Changes after Intrahepatic Arterial Injection of Iodized Oil in Normal and Cirrhotic Rat Liver
Authors: Ohkusa A. , Yoshioka H. , Ishida O.
Published: June 2015

Injection of iodized oil (Lipiodol) into the hepatic artery is widely used in the diagnosis and treatment of hepatocellular carcinoma. However, no reports have yet appeared concerning temporal changes in hepatic metabolism following Lipiodol injection. In the present study, Lipiodol was injected into the hepatic arteries of normal and cirrhotic rats, successive P-31 MR measurements were performed, and temporal changes in metabolism were compared with histologic findings. Both normal and cirrhotic rats displayed minimum levels of β-ATP/PME and β-ATP/Pi 5 days after hepatic arterial injection of Lipiodol. However, 10 days after injection these values had reverted to the preinjection levels. The metabolic dysfunction observed in the liver following hepatic arterial injection of 0.3 ml/kg b.w. Lipiodol was transient. Moreover, no distinct differences were observed between P-31 MR changes in normal and cirrhotic rats. Conversely, histologic impairment assessed on the basis of hepatic necrosis ratios was most severe 2 days after hepatic arterial injection in both normal and cirrhotic rats, and this did not coincide with the time of the most pronounced metabolic impairment as inferred from P-31 MR changes.
Radial Scar and Tubular Carcinoma
Authors: Vega A. , Garijo F.
Published: June 2015

Clinical, mammographic, sonographic and pathologic examinations in 17 patients with nonpalpable stellate lesions showed radiographic findings suggestive of radial scars, with the exception of 2 cases which showed a dense central region. These findings were not sufficiently consistent to differentiate radial scar from carcinoma so that wire localization biopsy was necessary. Four patients had 7 radial scars associated with 6 tubular carcinomas, 2 of them having 3 and 2 radial scars with 2 tubular carcinomas, respectively. No characteristic radiographic findings were made in these cases. Four patients showed radial scar with punctate microcalcifications in the surrounding breast parenchyma as part of benign and premalignant conditions. Ultrasonography in 7 patients showed a hypoechoic area on 4 with acoustic shadow similar to that of carcinoma. Our study suggested that radial scar has a relationship with tubular carcinoma and surgical excision of these stellate lesions is, therefore, required.
Thrombus Imaging with 99mTc-Hmpao-Labeled Platelets and 111In-Labeled Monoclonal Antifibrin Antibodies
Authors: Vorne M. S. , Honkanen T. T. , Lantto T. J. , Laitinen R. O. , Karppinen K. J. , Jauhola S. V.
Published: June 2015

Eighteen patients with suspicion of deep venous thrombosis (DVT) in the lower extremities were imaged both with autologous 99mTc-HMPAO-labeled platelets (Tc-PLT) and 111In-labeled monoclonal antifibrin antibodies (In-MoAbs) on the same day. Presence or absence of thrombosis was verified by venography. Tc-PLT was given i.v. followed after 30 min by In-MoAbs. Anterior and posterior projections of the lower extremities were obtained with a large field-of-view gamma camera at 5 to 25 min, 2 h, 4 to 6 h, and 20 h after administration of the marker. Both Tc-PLT and In-MoAbs detected DVT well but less frequently than venography. Thrombi were visualized at 2 to 4 h after injection. The quality of images was better with Tc-PLT than with In-MoAbs. In the patients treated during the study, heparin significantly (p < 0.01) inhibited the uptake of Tc-PLT but not of In-MoAbs. We conclude that both Tc-PLT and In-MoAbs are suitable agents for the detection of DVT especially in patients without anticoagulation.
Chondroitin Sulfate Iron Colloid as MR Contrast Agent in Differentiation between Hepatocellular Carcinoma and Adenomatous Hyperplasia
Authors: Suto Y. , Kato T. , Matsuo T. , Kamba M. , Shimatani Y. , Ohuchi Y. , Nakamura K. , Ohta Y.
Published: June 2015

Using a 1.5 T MR imaging unit, T1- and T2-weighted images were obtained before and after i.v. administration of chondroitin sulfate iron colloid (CSIC) in order to differentiate hepatocellular carcinoma (n = 20) from adenomatous hyperplasia without atypia (n = 16). Differentiation was made from the tumor-liver contrast to noise ratio (CNR) and visual evaluation of the nodule, with reference to signal intensity relative to that of the surrounding liver. The CNR of adenomatous hyperplasia was on T1-weighted images significantly decreased after CSIC administration (p < 0.01). On T2-weighted images, there was no significant difference in CNR after CSIC administration. On the other hand, the CNR of hepatocellular carcinoma was significantly increased after CSIC administration on both T1- and T2-weighted images (p < 0.01). CSIC reflects intratumor reticuloendothelial cellular functions, and is therefore useful in differentiating hepatocellular carcinoma from adenomatous hyperplasia without atypia.
Dacron-Covered Stent Therapy for Portal Vein Tumor Thrombus in Hepatocellular Carcinoma
Authors: Kishi K. , Mitsuzane K. , Sonomura T. , Nishida N. , Sato M. , Yamada R.
Published: June 2015

A tumor thrombus of the portal vein is refractory to therapy and constitutes a serious prognostic factor in hepatocellular carcinoma. For the purpose of treating portal vein tumor thrombus by restoring the blood flow and preventing recurrent ingrowth of tumor, we devised a metallic stent partially covered with a Dacron mesh sheet, and a coaxial percutaneous delivery system. One half of the wall of a Gianturco Z-stent was covered with a sheet of 0.25-mm-thick Dacron mesh, fixed to the stent wall with nylon threads. The covered stent was implanted in a patient with severe main portal vein stenosis due to tumor thrombus protruding from the left portal vein branch. Immediately after stent placement the tumor stenosis was effectively dilated, the portal blood flow restored, and the portal hypertension relieved. CT and angiography after 8 months still showed complete portal vein patency. Intrahepatic tumor dissemination or other complications were not observed. Intraportal placement of a covered metallic stent appears to be an efficacious therapy of major portal tumor thrombi.
Dynamic MR Imaging of Hepatoma Treated by Transcatheter Arterial Embolization Therapy
Authors: Yamashita Y. , Yoshimatsu S. , Sumi M. , Harada M. , Takahashi M.
Published: June 2015

The effect of transcatheter arterial chemo-embolization therapy (TACE) for hepatoma was evaluated with dynamic MR imaging with Gd-DTPA in 37 patients (44 tumors). TACE was performed using Lipiodol/cis-platinum and gelatin sponge (or microspheres) as an embolic material. All patients were examined with dynamic CT and MR imaging before and after treatment. On conventional spin echo images, changes of signal intensity after treatment varied regardless of presence of Lipiodol. Dynamic MR imaging revealed changes of tumor vascularity before and after treatment. On histologic correlation, areas of persistent tumor enhancement on dynamic MR imaging corresponded to areas of viable tumor cells while areas of nonenhancement corresponded to areas of necrosis. Dynamic MR imaging was superior in contrast resolution and was not influenced by the presence of Lipiodol compared with dynamic CT, and therefore residual viable tumors were better defined by dynamic MR imaging.
CT-Diagnosis of Deep-Seated Lipomas with Alarming Symptoms
Authors: Muren C. , Lee M. , Juhlin L.
Published: June 2015

Deep-seated lipomas can present with symptoms very different from those of the common subcutaneous variety. Rapid growth and nerve encroachment may cause suspicion of malignancy. The case histories as well as the clinical and radiographic findings of 2 patients with alarming symptoms from deep-seated lipomas of hand and forearm, respectively, are described. By means of CT an accurate preoperative diagnosis could be made, and surgery planned accordingly.
High-Resolution CT of the Lung in Asbestos-Exposed Subjects
Authors: Majurin M.-L. , Varpula M. , Kurki T. , Pakkala L.
Published: June 2015

The lowest possible mAs settings for high-resolution CT (HRCT) were studied on 45 individuals with suspected asbestos-related lung disease. All patients were investigated with 5 to 6 high-dose HRCT images (120 kVp/160 mA/2 s) at 3-cm intervals. At a selected level 4 additional low-dose images were obtained on each patient with lower mAs settings (100 mA/2 s, 80 mA/2 s, 60 mA/2 s, 30 mA/2 s). Thirty-seven subjects out of 45 had HRCT lesions compatible with asbestosis. HRCT images obtained with as low as 60 mA/2 s settings clearly showed pleural tractions and thickenings, parenchymal bands, honeycombing and subpleural curvilinear shadows, whereas in the evaluation of subpleural short lines and ground glass findings 80 mA/2 s were required. The lowest setting, 30 mA/2 s, was sufficient only in detecting and evaluating pleural tractions and thickenings. We conclude that 160 mAs yield good quality HRCT images, with substantial decrease of radiation dose, for the evaluation of asbestos-related lesions.
Primary Pelvic Bone Tumours in Children and Adolescents — Imaging Correlation
Authors: Hugosson C. , Lindahl S. , Rifai A.
Published: June 2015

Eight children aged 6 to 17 years (mean 13.3 years) were examined using conventional radiography, radionuclide bone scintigraphy, CT and MR imaging for pre-treatment assessment of extensive primary pelvic bone tumours. The tumours evaluated were Ewing's sarcoma (n = 4), osteogenic sarcoma (n = 3), and chondrosarcoma (n= 1). Each imaging modality made a contribution to the evaluation of the primary tumour. Conventional radiography and bone scintigraphy were necessary for the initial diagnosis, with CT playing a complementary role. MR imaging and/or dynamic contrast-enhanced CT were mandatory prior to surgical resection.
Ultrasonographic Angiography in Gallbladder Diseases
Authors: Kato T. , Tsukamoto Y. , Naitoh Y. , Mitake M. , Hirooka Y. , Furukawa T. , Hayakawa T.
Published: June 2015

Ultrasonographic (US) angiography was performed by sonographic examination with injection of carbon dioxide microbubbles through a catheter following conventional angiography in 41 patients with various gallbladder diseases. Three enhancement patterns were found; strong enhancement in the lesion from the periphery to the center was noted in patients with adenocarcinoma and benign polyp (type I), irregular partial enhancement at the margins of the lesion in those with adenosquamous carcinoma (type II), and internal regular enhancement in those with chronic cholecystitis, xanthogranulomatous cholecystitis and adenomyomatosis (type III). Pseudopolypoid lesion such as gallbladder debris showed no enhancement. US angiography may be useful in the differential diagnosis of gallbladder diseases, especially to differentiate the wall thickening type of gallbladder carcinoma from chronic cholecystitis or adenomyomatosis, and the pseudopolypoid lesion and fundal type of adenomyomatosis from benign polyp or polypoid-type carcinoma.
Intraarterial Occlusion by Radiofrequency
Authors: Tanigawa N. , Sawada S. , Morioka N. , Iwamiya T. , Senda T. , Kobayashi M. , Okuda Y. , Ohta Y.
Published: June 2015

Arterial occlusion using radiofrequency energy was performed. The length of the noninsulated part of the guidewire was 10 mm and the duration of radiofrequency supply was 20 s. Animal experiments were carried out in 17 canine arteries; 4 out of 6 arteries less than 2.3 mm in diameter were completely occluded during the 20 s radiofrequency supply. A clinical application was also successfully performed without any complications. Arterial occlusion with radiofrequency can be applied to vessels less than about 2 mm in diameter.
Ultrasonography in Arthritis of the Knee
Authors: Østergaard M. , Court-Payen M. , Gideon P. , Wieslander S. , Cortsen M. , Lorenzen I. , Henriksen O.
Published: June 2015

Ultrasonography (US) of the knee in gonarthritis was evaluated with gadolinium-DTPA-enhanced MR imaging as a reference. The study included 13 patients with gonarthritis, 2 patients with osteoarthritis and 5 healthy controls. Compared to MR, US identified 100% (12/12) of joint effusions, 100% (5/5) of Baker's cysts, 57% (8/14) of the synovial membranes of the suprapatellar recess and 38% (3/8) of bone erosions. No MR or clinical findings characterized the patients with ultrasonographically identifiable synovial membranes. Quantitative MR- and US-estimates of effusion, synovial membrane and cartilage thicknesses were correlated. The Spearman correlation coefficients were 0.87, 0.86 and 0.82, respectively. US reliably demonstrated joint effusions and Baker's cysts but showed lack of sensitivity for demonstration of the synovial membrane and bone erosions. When the synovial membrane was identifiable, the measurements of synovial thickness by US appeared precise. Cartilage evaluation by US seemed dependable. The clinical value was limited, because the weight-bearing areas were inaccessible.
Deuterium MR Spectroscopy at 4.7 T
Authors: Wirestam R. , Larsen V. Andrée , Stubgaard M. , Thomsen C. , Vikhoff B. , Larsson H. B. W. , Ståhlberg F. , Henriksen O.
Published: June 2015

Deuterium MR spectroscopy was used for the determination of tissue blood flow (TBF). The tracer D2O was injected into the tissue of interest, and tracer washout was followed using a 4.7 T spectroscopy/imaging unit. Normal subcutaneous tissue in rats was studied, as well as tissue influenced by vasoactive agents (papaverine and adrenaline). The vasoactive agents introduced changes of 40% in TBF, compared with normal tissue. Normal tissue measurements were repeated using various D2O injection volumes (5–400 μl). The injection volume 5 μl gave TBF 11.7 ± 2.0 ml/100 g·min (mean ± 1 SD). This value was 40% higher than corresponding values observed at larger injection volumes (200–400 μl). This injection volume effect is probably partly due to a capillary dilution caused by tracer administration, and partly related to the non-physiological deuterium signal decrease observed in dead rats. Blood flow measurements in human colon tumours implanted in nude mice showed a rather poor reproducibility, not improved by the use of a multiple site injection technique.
Low-Field MR Imaging for the Assessment of Therapy Response in Musculoskeletal Infections
Authors: Hovi I. , Valtonen M. , Korhola O. , Hekali P.
Published: June 2015

Fifty-one patients with musculoskeletal infection were imaged by repeated MR imaging at ultra low-field and low-field strength. Soft-tissue infection, osteomyelitis, septic arthritis, and spondylitis were studied. The MR finding was scored according to the signal intensity (SI) on T2-weighted images (T2WI), and correlated with the values of serum C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and peripheral white blood cell (WBC) count. There was a positive correlation between the MR score and both CRP and ESR, but no correlation between MR score and WBC. The MR score between the follow-up studies decreased significantly in accordance with clinical reconstitution. The MR finding according to the SI on T2WIs corresponded better to disease activity than did the CRP or ESR.
Noninvasive Assessment of Renal Artery Stenosis
Authors: Strotzer M. , Fellner C. M. , Geissler A. , Gmeinwieser J. , Kohler S. M. , Krämer B. K. , Kromer E. P.
Published: June 2015

The purpose of this study was to evaluate MR angiography (MRA) and color Doppler sonography as noninvasive screening methods in suspected renovascular hypertension. Fifty-five consecutive patients with arterial hypertension were examined prospectively using high resolution 3-D TOF MRA and color Doppler sonography. Intraarterial angiography was the standard of reference. Stenoses of 60% or more were regarded as significant. MR angiograms were evaluated by 3 independent observers who studied 110 main renal arteries. All 8 significant stenoses and 2 occlusions were correctly classified with MRA while one 60% stenosis was underestimated by color Doppler sonography. Mild stenoses were overestimated by MRA in 4 and by color Doppler sonography in 6 cases. A drawback of both methods was the large number of not evaluable arteries (6 in MRA, 11 in color Doppler sonography). These arteries were regarded as pathologic because stenosis could not be excluded. Due to this fact specificities of MRA and color Doppler sonography were 90% and 85% respectively. Accessory vessels were detected in 47% (8/17) by MRA and in 0% (0/17) by color Doppler sonography.
Vasoconstriction of Isolated Arteries Induced by Angiographic Contrast Media
Authors: Karstoft J. , Bååth L. , Jansen I. , Edvinsson L.
Published: June 2015

Angiographic contrast media (CM) may cause both vasodilatation and vasoconstriction, effects that can only be partly be explained by the media's hyperosmolality. The present study describes a CM-induced vasoconstriction of isolated rabbit coronary arteries that depends on chemotoxicity and ion content of the CM. Rings of arteries were mounted in tissue baths and the constrictions induced by different CM were measured. Iotrolan and iodixanol (nonionic dimers) caused the most powerful constrictions followed by iohexol (non-ionic monomer) and mannitol. Ioxaglate (ionic dimer) and diatrizoate (ionic monomer) caused no or weak constrictions. By comparing these findings with previous studies, it is concluded that non-ionic media cause vasoconstriction due to depolarization of the smooth muscle cells, an effect that for iohexol can be counteracted by addition of 30 mM NaCl. The ionic media seem to cause hyperpolarization of the cells. This difference between non-ionic and ionic CM might be one of the reasons for the lower tendency of non-ionic CM to cause vasodilatation clinically.
Contrast Media Leakage to the Cerebrospinal Fluid after Intravenous Injection
Authors: Larsen John L. , Skouen Jan S. , Vik Hogne
Published: June 2015

We have tested a method to evaluate leakage of i.v. injected contrast media (CM) through the 3 partitions between blood and cerebrospinal fluid (CSF) in controls and in patients with acute cerebrovascular disease (ACBVD) to detect differences between normal brains and brains with ischemic lesions. High-osmolar (HOCM) and low-osmolar (LOCM) CM were used. In 55 patients and in 41 controls who underwent CT after i.v. contrast administration, lumbar CSF was collected 1 hour after injection and the iodine content in the CSF was measured. The concentration of iodine in CSF was very low, between 0.57 and 11.20 ng/l, and no significant difference could be found between patients and controls or between HOCM and LOCM. We conclude that under the conditions mentioned above, iodine detected in the human lumbar CSF does not reflect the true leakage of contrast agent through the blood-brain barrier.
Digital Optical Card
Authors: Langer M. , Buitrago-Téllez C. H. , Schulze C. , Gufler H. , Mundinger A. , Kommos F.
Published: June 2015

Purpose:

To assess a patient-oriented digital optical card (OC) for documentation and communication of images using the analysis of breast microcalcifications to illustrate its resolution power.

Methods:

Fifty film mammograms with histologically proved clustered microcalcifications were digitized using a 5 lp/mm CCD-scanner. A region of interest containing the cluster was selected for documentation on an OC as an overview OC-image and as a magnified OC-image (5 lp/mm). The shape (spherical/nonspherical) as well as the total number of microcalcifications were quantitatively analyzed by 2 radiologists.

Results:

The detection rate for total number of overall and spherical microcalcifications using digital media was significantly reduced (p<0.01) compared to analog mammography. There were no significant differences in the detection rate of nonspherical microcalcifications between film mammograms (100%) and magnified section OC-images (92.7%). The overview OC-image revealed 72% of those calcifications (p<0.01).

Conclusion:

According to our results, this technology is not appropriate for diagnosis of breast microcalcifications, but may be a promising communication digital medium for transmitting an image/report unit to referring physicians.
Duplex US of the External Carotid Artery
Authors: Päivänsalo M. J. , Siniluoto T. M. J. , Tikkakoski T. A. , Myllylä V. , Suramo I. J. I.
Published: June 2015

The ratio between the systolic peak velocities of the internal and common carotid arteries (vpICA/vpCCA), vpICA and grey-scale imaging measurement are generally used to evaluate internal carotid stenosis against known flow criteria in order to differentiate non-significant from significant stenosis. The same criteria are also used for evaluating the external carotid artery (ECA). Our data on 707 normal or stenotic ECA nevertheless showed that the systolic peak velocity of the normal ECA (vpECA) and its ratio to the systolic velocity of the CCA (vpECA/vpCCA) are higher than vpICA and vpICA/vpCCA. vpECA/vpCCA is about 2 in >0–49% ECA stenosis. Only in severe stenosis are the peak velocities almost comparable. The ratio between the peak end diastolic velocities (edvECA/edvCCA) and edvECA proved to be unreliable, as did grey-scale imaging measurement of the external carotid stenosis. In addition, ipsilateral internal carotid stenosis greatly affects the non-stenotic external carotid flow values, and probably has the same effect on the flow values of a stenotic external artery. Thus, external carotid flow values must be considered carefully.
MR Velocity Mapping Measurement of Renal Artery Blood Flow in Patients with Impaired Kidney Function
Authors: Cortsen M. , Petersen L. J. , Ståhlberg F. , Thomsen C. , Søndergaard L. , Petersen J. R. , Ladefoged S. D. , Henriksen O.
Published: June 2015

Renal blood flow (RBF) was measured in 9 patients with chronic impaired kidney function using MR velocity mapping and compared to PAH clearance and 99mTc-DTPA scintigraphy. An image plane suitable for flow measurement perpendicular to the renal arteries was chosen from 2-dimensional MR angiography. MR velocity mapping was performed in both renal arteries using an ECG-triggered gradient echo pulse sequence previously validated in normal volunteers. Effective renal plasma flow was calculated from the clearance rate of PAH during constant infusion and the split of renal function was evaluated by 99mTc-DTPA scintigraphy. A reduction of RBF was found, and there was a significant correlation between PAH clearance multiplied by 1/(1-hematocrit) and RBF determined by MR velocity mapping. Furthermore a significant correlation between the distribution of renal function and the percent distribution of RBF was found.
Rater Agreement in Lung Scintigraphy
Authors: Christiansen F. , Andersson T. , Rydman H. , Qvarner N. , Måre K.
Published: June 2015

Purpose:

The PIOPED criteria in their original and revised forms are today's standards in the interpretation of ventilation-perfusion scintigraphy. When the PIOPED criteria are used by experienced raters with training in consensus interpretation, the agreement rates have been demonstrated to be excellent. Our purpose was to investigate the rates of agreement between 2 experienced raters from different hospitals who had no training in consensus interpretation.

Material and Methods:

The 2 raters investigated a population of 195 patients. This group included 72 patients from a previous study who had an intermediate probability of pulmonary embolism and who had also been examined by pulmonary angiography.

Results:

The results demonstrated moderate agreement rates with a kappa value of 0.54 (0.45–0.63 in a 95% confidence interval), which is similar to the kappa value of the PIOPED study but significantly lower than the kappa values of agreement rates among consensus-trained raters. There was a low consistency in the intermediate probability category, with a proportional agreement rate of 0.39 between the experienced raters.

Conclusion:

The moderate agreement rates between raters from different hospitals make it difficult to compare study populations of a certain scintigraphic category in different hospitals. Further investigations are mandatory for accurate diagnosis when the scintigrams are in the category of intermediate probability of pulmonary embolism.