bluuebunny/crossref_metadata_2025 huggingface dataset:
Image Quality in Mammography with Special Reference to Anti-Scatter Grids and the Magnification Technique
Authors: Nielsen B. , Fagerberg G.
Published: June 2015

Some of the parameters determining image quality in mammography are analyzed: the effects of primary photon spectra, focal spot size and screen-film systems on spatial resolution are discussed as are scattered radiation, development temperature and absorbed dose. The parameters limiting spatial resolution and contrast are evaluated for the standard and magnification techniques. Methods of reducing scattered radiation to improve contrast are evaluated. Scatter to primary ratios for different scatter reducing methods are compared, using the physical quantity energy imparted. For the standard technique the spatial resolution has been found to be limited by the fluorescent screen. With magnification technique the focal spot is the weakest link for the spatial resolution. The contrast is mainly set by the amount of scatter using the standard technique considering the use of a low tube potential (∼25 kVp). Using the magnification technique the amount of scatter is so small, that the tube potential is the limiting factor. We have found the optimized standard mammographic technique to be achieved under the following conditions: 25 kVp, 0.3 to 0.6 mm focal spot, film-focus distance 500 mm, anti-scatter grid, developing temperature 36 to 38°C and 4 minutes total processing time with the screen-film system we have used. In magnification technique an air gap of at least 20 mm is desired. With an FFD of about 500 mm this will give a magnification ratio of 1.8 to 2.0 and a 0.1 mm × 0.1 mm focus spot is mandatory. With this technique, it is necessary to use a faster screen-film system than that used in standard mammography.
Dimension of the Pharyngo-Esophageal Segment in Dysfunction of the Cricopharyngeal Muscle
Authors: Ekberg O.
Published: June 2015

Defective relaxation of the cricopharyngeal muscle (cricopharyngeal dysfunction) is radiographically demonstrated as a posterior impression into the pharyngo-esophageal segment of the gullet in patients with dysphagia. It has been assumed that this impression implies a mechanical obstacle to the swallowed bolus. Therefore, the width of the pharyngo-esophageal segment was measured in three groups of individuals; 139 non-dysphagic volunteers, 25 dysphagic patients with a normal relaxation of the cricopharyngeus and 25 dysphagic patients with cricopharyngeal dysfunction. Compared with the other two groups of patients studied the patients with cricopharyngeal dysfunction were found to have a slightly wider gullet above and below the cricopharyngeal muscle. However, at the level of the cricopharyngeal muscle they had an equal sized or slightly narrower lumen than the patients in the two control groups. The results obtained suggest that the posterior impression due to cricopharyngeal dysfunction does not cause a substantial mechanical obstacle to swallowing in the majority of patients.
Magnetic Resonance Imaging of Hematomas in a 0.02 T Magnetic Field
Authors: Alanen A.
Published: June 2015

One intramuscular calf hematoma, 2 ankle hematomas and 4 cephalhematomas were imaged at various ages in a low magnetic field (0.02 T). At least one spin echo (SE) multislice image and a series of inversion recovery images (IR) were made varying the inversion time for estimation of the relaxation time T1. T1 tended to shorten and T2 to stay unchanged. With an unsuitable pulse sequence the hematomas were not visible. They were best seen with short TIs. The images of one of the ankle hematomas and the calf hematoma were compared with sonographic findings. The appearances of the hematomas varied during aging with both imaging modalities. The hematomas were easier to detect with magnetic resonance imaging than with ultrasound, also when aging.
Eye Lens Dose in Cranial Computed Tomography with Reference to the Technical Development of CT Scanners
Authors: Moström U. , Ytterbergh C. , Bergström K.
Published: June 2015

The continuous technical development of cranial CT and the accumulation of clinical experience with this method, have resulted in the use of an increasing number of scan protocols for different clinical situations. An investigation was undertaken to find out how this change has influenced the dose delivered to the patient. The eye lens dose was measured at CT examinations in 245 patients, with appropriate scan protocols, and also at corresponding examinations in an anthropomorphic head phantom. One CT scanner of early (EMI CT 1010) and one of modern design (Siemens Somatom DR2) were investigated. The range of the eye lens dose was wide, namely 4 to 206 mGy for EMI CT 1010 and 6 to 124 mGy for Somatom DR2. In patient groups with comparable scan protocols the mean eye lens dose was higher with the Somatom DR2, mostly on account of a different spatial distribution of the dose in the scan plane. The dose varied less with this scanner, however, mainly because of the possibilities for more accurate positioning.
Assessment of Bone Mineral Content and Bone Mass by Non-Invasive Radiologic Methods
Authors: Andresen J. , Nielsen H. E.
Published: June 2015

Methods for quantitative determination of bone mineral and bone mass in normal subjects and in patients with metabolic bone disorders can be measured by the Compton scattering technique, the neutron activation analysis, by measurement of metacarpal bone mass, by single and dual photon absorptiometry, and by quantitative computed tomography. Measurement on metacarpal bone (radiogrammetry) seems to be able to distinguish between resorption and/or new bone formation at the periosteal and/or endosteal surface. The intraindividual observer variation on combined cortical thickness (D—d), cortical area (D2–d2), metacarpal bone mass (D2–d2)/D2 varies from 0.7 to 2.5 per cent and the interindividual observer variation from 1.0 to 5.8 per cent. Single photon absorptiometry measures bone mineral content in the forearm with great precision. The reproducibility using repeated measurements and automatic selection of the measuring area is about one per cent and can be used to follow changes in mineral content with time in patients with metabolic bone diseases. The dual photon absorptiometry may be used for measurements of bone mineral content in lumbar spine, in the femoral neck and measurement of total body calcium with an accuracy of less than 6 per cent and a precision below 3 per cent. Quantitative computed tomography has the ability to measure trabecular and cortical bone both centrally and peripherally. Using CT scanning, scanner related changes with time (day-to-day variation ± 4%), patient repositioning (less than 1.5%), and fat concentration (residual uncertainty of approximately 1/6 of the biologic variation) are important factors influencing the accuracy and reproducibility of the values of the measured bone mineral content. The method is very useful in studies of skeleton changes in metabolic bone diseases.
Vascular Enhancement during Incremental Body Computed Tomography
Authors: Nyman U. , Dinnetz G.
Published: June 2015

An initial manual bolus injection of contrast medium to an amount of 15 g iodine immediately followed by a manual infusion of 25 to 35 g iodine during 3 to 5 minutes will provide proper enhancement of vascular structures (110–150 HU) at incremental body computed tomography during that time and for some minutes after the end of the infusion. This technique applied in more than 1000 examinations proved it to be reliable, simple and fast. A computed tomograph allowing 3 scans per minute permits an adequate and even level of vascular enhancement of the entire neck, mediastinum, abdomen or pelvis when continuous or more sparse slices of about 10 mm thickness are used. When the images are reconstructed without delay and presented on a monitor in the scanning suite, it is possible to individually optimize the rate of infusion and thereby also minimize the amount of contrast medium. A prerequisite for a proper vascular enhancement is a high rate of infusion initially.
The Labyrinthine Portion of the Facial Canal
Authors: Wadin K. , Wilbrand H.
Published: June 2015

The variational radiographic anatomy of the labyrinthine portion of the facial canal was investigated in 200 plastic and silicone casts of unselected temporal bone specimens by means of multidirectional and computed tomography in different projections. The labyrinthine portion of the canal varied considerably in shape and size; in some specimens the cross-section was circular, but often the canal was crumpled and flattened in its passage above the cochlea. The medial part of the labyrinthine portion was narrowest, the lowest cross-sectional area being 0.5 mm2. In spite of optimal positioning of the specimen it was not always possible to reproduce the entire labyrinthine portion of the canal completely. Most difficult to reproduce were specimens with extremely small vertical diameters and marked caudal sloping of the canal.
The Labyrinthine Portion of the Facial Canal in Patients with Bell's Palsy Investigated by Computed Tomography
Authors: Wadin K. , Thomander L. , Wilbrand H.
Published: June 2015

The reproducibility of the labyrinthine portion of the facial canal by computed tomography was investigated in 22 patients with Bell's palsy. The CT images were compared with those obtained in 18 temporal bone specimens. Measurements of the diameters of different parts of the facial canal were made on these images and also microscopically in plastic casts of the temporal bone specimens. No marked difference was found between the dimensions of the labyrinthine portion of the facial canal of the involved and healthy temporal bone in the patient, nor did these differ from the dimensions in the specimens. CT of the slender, curved labyrinthine portion was found to be of doubtful value for metric estimation of small differences in width. The anatomic variations of the canal rendered the evaluation more difficult. CT with a slice thickness of 2 mm was of no value for assessment of this part of the canal. Measurement of the diameters of the labyrinthine portion on CT images is an inappropriate and unreliable method for clinical purposes.
Pharyngeal Function in Patients with Rheumatoid Arthritis of the Cervical Spine and Temporomandibular Joint
Authors: Ekberg O. , Redlund-Johnell I. , Sjöblom K. G.
Published: June 2015

Pharyngeal function was studied in 31 patients with rheumatoid arthritis. Eighteen of these patients had dysphagia. Cervical spine abnormalities were present in 14. Destruction of the capitulum and/or ramus of the mandible was registered in 9. Pharyngeal dysfunction was revealed in 20. Patients with a vertical dislocation of the C1–C2 in relation to the occipital bone and patients with destruction of the capitulum and/or ramus of the mandible had an increased frequency of pharyngeal dysfunction. Pharyngeal dysfunction is thought to be due to mechanical factors and caused by derangements of muscular attachments and turning points.
Computed Tomography after Percutaneous Renal Stone Extraction
Authors: Geterud K. , Henriksson Ch. , Pettersson S. , Zachrisson B. F.
Published: June 2015

Eighty patients were examined with computed tomography (CT) of the kidney and the retroperitoneal space after percutaneous stone extraction. Most examinations were done within a week after the operation. The morphologic changes were usually small or none. In 7 patients minor renal or perirenal fluid collections were found. Their operations had been complicated by bleeding or leakage. In 66 patients CT was compared with conventional radiographs. Residual stones were more often detected by CT. They were usually small. Percutaneous renal stone extraction is considered a safe and efficient method.
Artificial Urinary Sphincters
Authors: Lorentzen T. , Dorph S. , Hald T.
Published: June 2015

A small selected group of patients with urinary incontinence can be treated effectively with an artificial urinary sphincter. Since the fluid in the hydraulic system of this device is radiopaque, radiography is useful in its evaluation. An immediate postoperative radiogram should be performed to control the position and integrity of the system. It also serves as a useful baseline study in case of later complications. It should include radiograms both in the deactivated and activated state. A few cases of tube kinking may be overlooked when exposures in only one projection are used. Experience with 110 implanted sphincters is presented.
Contrast-Enhanced Computed Tomography in Carcinoma of the Urinary Bladder
Authors: Sager E. M. , Fosså S. D. , Kaalhus O. , Talle K.
Published: June 2015

Computed tomography (CT) scans of the urinary bladder were taken before and in combination with intravenous contrast medium injection in 30 patients with invasive bladder carcinoma. Three different ways of injecting the same amount of intravenous contrast material were used in three groups, each consisting of ten patients. In the first group the contrast medium was given during 90 seconds, in the second group during 40 seconds and in the third one, the first half during 20 seconds and the second half during 90 seconds. The attenuation in the tumors and in the bladder wall was measured in Hounsfield units. Independent of injection method, all tumors showed significantly higher contrast enhancement than the bladder wall when the injection was terminated. The difference in contrast enhancement was greatest in the group where the shortest injection time was used and greatest immediately after the conclusion of the injection. The difference in contrast enhancement between tumor and bladder wall was visible on the monitor in all cases.
Computed Tomography of Humeral Head Cup Arthroplasties
Authors: Egund N. , Jonsson E. , Lidgren L. , Kelly I. , Pettersson H.
Published: June 2015

Computed tomography (CT) was employed to evaluate resurfacing metal cup arthroplasties, in shoulders affected by rheumatoid arthritis. Reconstruction of the information obtained, with the high frequency filter, resulted in an image of the cement and skeletal structures inside the cup. This new application of CT may prove valuable in assessing the complications and results of cup arthroplasties.
Gadolinium-DTPA Enhancement of Experimental Soft Tissue Carcinoma and Hemorrhage in Magnetic Resonance Imaging
Authors: Pettersson H. , Ackerman N. , Kaude J. , Googe R. E. , Mancuso A. A. , Scott K. N. , Hackett R. H. , Hager D. A. , Caballero S.
Published: June 2015

An experimental series in the rabbit was performed to test gadolinium-DTPA (Gd-DTPA) enhancement of VX-2 carcinoma and hemorrhages induced in the soft tissues. The recognition of both malignant and benign lesions was greatly facilitated on T1 weighted images after intravenous administration of 0.3 mmol Gd-DTPA/kg body weight because of reduced T1 relaxation times. Gd-DTPA enhancement reached its maximum after 10–15 minutes and was most apparent in tumor tissue, connective tissue surrounding the tumor and in the area of fresh hemorrhage.
Effect of Ionic and Non-Ionic Contrast Media on Aggregation of Red Blood Cells in Vitro
Authors: Raininko R. , Ylinen S.-L.
Published: June 2015

Fresh human blood without additives, and contrast medium were mixed and examined immediately by light microscopy in a non-flowing state. Sodium meglumine diatrizoate, meglumine diatrizoate, meglumine iodamide, sodium meglumine ioxaglate, iopromide, iopamidol, iohexol, and metrizamide were tested in concentrations of 300 mg I/ml. Physiologic saline and 5% glucose were used as controls. All media were tested in a randomized order with blood samples from 23 volunteers. No aggregation was detected in physiologic saline, and few rouleaux were found in ionic contrast media. Irregular red cell aggregates were found in all low-osmolal contrast media: in 17 per cent of the specimens in ioxaglate, in 52 per cent in metrizamide, and in 78 to 100 per cent in other non-ionic media. Irregular aggregates were seen in all specimens with glucose. It remains to be demonstrated whether or not the irregular aggregation of human red cells in non-ionic contrast media has clinical significance. Iohexol was also tested with blood samples from several laboratory animals, but in nearly every case no aggregates were found. Results of animal experiments or tests with animal blood seem to be poorly applicable to man.
Cytotoxic Effects of Six Angiographic Contrast Media on Human Endothelium in Culture
Authors: Laerum F.
Published: June 2015

Human endothelial cells in cultures derived from the veins of fresh umbilical cords were incubated for 24 hours with angiographic contrast media added to the cell culture medium. The cells were preincubated with Na2(51Cr)O4 for subsequent 51Cr-release test. Four different concentrations of the contrast media were used. Cell toxicity as judged by measuring the release of 51Cr was, in decreasing order, as follows: Sodium/meglumine diatrizoate, meglumine metrizoate, ioxaglate, iopamidol, metrizamide, iohexol. The highest concentration of sodium/meglumine diatrizoate (Urografin) led to 99 per cent cell death after 24 hours, while the same concentration of iohexol (Omnipaque) induced about 40 per cent cell lysis. The assay system with human endothelial cells thus seems to be useful for evaluation of the toxicity of contrast media. The osmolality was measured in all the solutions. Hyperosmolality accounted for a major part of the cell toxicity, but additional toxic effects of the substances were observed. The strongest osmolality-independent toxic effect was caused by ioxaglate.
Ultrasound Diagnosis of Liver Hydatid Disease
Authors: Gürses N. , Sungur R. , Gürses N. , Özkan K.
Published: June 2015

A clinical study of 42 patients with hydatid disease was carried out using a real-time gray scale B-scanner. All cases were confirmed surgically. The ultrasound characteristics of the hydatid cysts were classified into three groups: Type I, simple hydatid cyst (19 of the 42 cases), type II, hydatid cyst with a disrupted wall and septa (14 cases), and type III, hydatid cyst with a heterogeneous echo pattern (9 cases). It was concluded that ultrasound classification of the cysts increases diagnostic accuracy. However, if a hydatid cyst becomes secondarily infected these typical changes are lost and the ultrasound diagnosis may then become more difficult. Periodic examinations should be performed with ultrasound after surgery.
Influence of Section Spacing on Reliability of Abdominal Computed Tomography in Early Stage Non-Seminomatous Testicular Tumor
Authors: Lien H. H. , Stenwig A. E. , Ous S. , Fosså S. D.
Published: June 2015

Comparison of reliability of CT with contiguous and non-contiguous scan reading was performed in 100 consecutive patients with a non-seminomatous testicular tumor and lymph nodes less than 20 mm at CT. The patients underwent primary lymphadenectomy and histologic examination of removed nodes. Ten mm thick slices at adjacent 10 mm intervals were used and non-contiguous reading was based on sections with uneven numbers. Reading of non-contiguous scans led to drop in sensitivity from 71% to 66% compared with contiguous scans when 5 mm was used as criterion for abnormal node size. Corresponding decrease was from 47% to 39% with the 10 mm criterion and from 37% to 26% with the 15 mm criterion. Other parameters were only slightly influenced by the scan reading technique. The benefit of contiguous as opposed to non-contiguous scanning was small in the present series.
Addition of Local Anesthetics to Contrast Media
Authors: Nilsson P. , Almén T. , Golman K. , Jonsson K. , Nyman U.
Published: June 2015

Effects of equiosmolar solutions (osmolality 1.35 mol/kg) of the ratio 1.5 contrast medium metrizoate (250 mg I/ml) containing either the local anesthetic mepivacaine or saline were evaluated on subjective discomfort, aortic blood pressure and heart rate in 17 patients referred for aortofemoral angiography due to intermittent claudication. Each patient was injected with 30 ml (15 ml/s) of each solution in random double-blind order. Each patient was then injected with 45 ml (12 ml/s) of the ratio 3 medium ioxaglate (320 mg I/ml, osmolality 0.58 ml/kg). Ioxaglate caused significantly less total discomfort, pain, heat, vocal reactions, involuntary movements and hemodynamic effects than metrizoate-mepiva-caine and metrizoate-saline. The effects of the two metrizoate solutions did not differ significantly. Previous contradictory reports on the effects of anesthetics in contrast media were reviewed with regard to experimental design, different osmolality of the test and control solutions, premedication, and pH dependence of local anesthetics. Ratio 3 media are recommended because they produce a more reliable relief of patient discomfort and fewer hemodynamic changes than the addition of local anesthetics to ratio 1.5 media.
Computed Tomography of the Cerebellopontine Cistern in Normal and Acoustic Tumor Patients
Authors: Fagerlund M.
Published: June 2015

Air computed tomography of the cerebellopontine cistern was performed in 15 consecutive patients. The series comprised 7 patients with a normal cistern and 8 patients with tumor, including one with bilateral tumors. Two tumors were of small size (<10 mm i diameter), 3 were medium sized (10–20 mm in diameter), and 4 were large (>20 mm in diameter). In the normal group, the jugular foramen nerve bundle (the 9th, 10th and 11th nerves), the trigeminal nerve, or the brain stem margin were clearly defined by air. In the tumor group, the possible extension of the tumor to these structures could be defined. Differentiation between a compression or attachment of the trigeminal nerve to the tumor was not always possible. The importance of using reconstruction views is stressed.
Shape of Retroperitoneal Lymph Nodes at Computed Tomography Does Not Correlate to Metastatic Disease in Early Stage Non-Seminomatous Testicular Tumors
Authors: Lien H. H. , Lindsköld L. , Stenwig A. E. , Ous S. , Fosså S. D.
Published: June 2015

Variety Range (difference between the maximum and minimum transverse diameters in percentage of the minimum diameter) was calculated for 86 lumbar lymph nodes with maximum diameter ranging between 5 mm and 19 mm at CT. The nodes were located within a group (pre- and paracaval, interaortico-caval, pre- and paraaortic) which was removed during primary lymphadenectomy for non-seminomatous testicular tumor. Most nodes were fairly rounded with a Variety Range less than 20%. There was no difference between the largest node in a metastasis group (Variety Range less than 20% in 29 out of 36) and tumor free nodes (Variety Range less than 20% in 39 out of 50). A rounded shape of lymph nodes measuring less than 20 mm on transverse CT sections was not a reliable sign of metastasis in patients with ***non-seminomatous testicular tumor.
Radiologic Diagnosis of Gastro-Oesophageal Reflux
Authors: Fransson S.-G. , Sökjer H. , Johansson K.-E. , Tibbling L.
Published: June 2015

It has been proposed that the high density of ordinary barium suspensions may complicate the radiologic diagnosis of gastro-oesophageal reflux. For this reason P-contrast was developed (Ferring AB); a contrast medium with the same density as water (1 g/cm3). A comparison of P-contrast and barium (Mixobar Ventrikel 400 mg/ml) was performed in 82 patients. All patients were examined with both contrast media and the findings were compared with those at reflux test at manometry, endoscopy and 24-hour pH monitoring. Another 40 patients and 15 symptom-free controls were examined with two different amounts of barium, 100 ml and 200 ml, to study if the radiologic diagnosis of reflux varied with the volume of contrast medium administered. P-contrast was found to have no advantages over barium for the diagnosis of gastro-oesophageal reflux. The outcome of the radiologic examination was not influenced by the different volumes of barium used.
Angiography in Non-Functioning Renal Allografts Receiving Cyclosporin A
Authors: Thomsen H. S. , Rygaard H. , Nielsen S. L. , Larsen S. , Løkkegaard H.
Published: June 2015

During a two-year period angiography was performed in 10 out of 40 initially perfused kidney allografts within the first 3 postoperative weeks. Immunosuppression was in all cases performed with cyclosporin A. The indication for angiography was mainly deterioration in the graft function as judged from the renograms or inadequate demonstration of the graft during intravenous radionuclide angiography. At angiography, neither arterial nor venous occlusion was found, and it was normal in 5 patients. It is concluded that during cyclosporin A treatment angiography cannot be recommended on the above mentioned indications in the early postoperative period. A graft biopsy seems sufficient.
Light and Electron Microscopic Observations in Atherosclerotic Rabbits following Experimental Transluminal Angioplasty
Authors: Korogi Y. , Takahashi M.
Published: June 2015

Light and scanning electron microscopy were used to assess the morphologic changes in atherosclerotic lesions in rabbits following percutaneous transluminal angioplasty. Histologic changes observed by light microscopy, i.e. fracture or separation of the plaque and overdistension of the media, were correlated with different balloon sizes. In atherosclerotic rabbits, progressive changes were observed in the vessel wall with increasing size of the balloon. Scanning electron microscopy showed denudation of the endothelial cells, exposure of the subintimal layer, and adhesion of the platelets. In addition, compression of the atheroma, circumferential endothelial rupture, flattening of the intimal fold, and undulation of the intimal fold were observed. Morphometric analysis of histologic sections of the dilated and non-dilated aortas disclosed significant differences in the thickness to width ratio of the plaque. These findings demonstrated that compression of the atherosclerotic plaque could occur.
Magnetic Resonance Imaging of Intracranial Neoplasms at 0.02 Tesla
Authors: Kormano M. , Raininko R. , Katevuo K.
Published: June 2015

Sixty-five patients with single or multiple intracranial neoplasms were examined with an MR imager operating at 0.02 tesla. In 56 patients the diagnosis was histologically confirmed. All patients had an abnormal CT finding. MR images were positive in 59 cases, while the lesion remained undetected or equivocal in 6 cases (2 pituitary adenomas and 4 meningiomas). The MR signal intensity of several meningiomas was equal to that of normal brain tissue. Some astrocytomas were better delineated on MRI than on CT. For the study of pituitary lesions, the spatial resolution was unsatisfactory. The ultralow field MR imager was found to be sensitive for the detection of other intracranial neoplasms.
Technical Aspects on Magnetic Resonance Imaging of the Spine at 1.5 Tesla
Authors: Holtås S. L. , Plewes D. B. , Simon J. H. , Ekholm S. , Kido D. K. , Utz R.
Published: June 2015

Technical aspects on surface coil magnetic resonance imaging of the spine using a superconducting system with a field strength of 1.5 tesla are described. By using a flat surface coil instead of the body coil the image quality was markedly improved and the signal-to-noise ratio (S/N) was increased approximately 2.6 times. Small voxels resulted in low S/N. The best image quality was achieved with a slice thickness of 5 mm, a field of view of 20 to 24 cm and a matrix of 256×256. Interleaved slices provided superior image quality compared with contiguous slices at the expense of acquisition time. For sagittal images the phase encoding gradient should be in the cranio-caudal direction to minimize motion artifacts. To obtain T1 and T2 images of high quality, spin echo pulse sequences with TR 600/TE 20 ms and TR 2000/TE 40 to 80 ms are useful.
Spinal Pseudarthrosis in Ankylosing Spondylitis
Authors: Chan F. L. , Ho E. K. W. , Fang D. , Hsu L. C. S. , Leong J. C. Y. , Ngan H.
Published: June 2015

Spinal pseudarthrosis is an important mechanical complication in longstanding ankylosing spondylitis. Thirty-five patients with 40 lesions were studied. Three lesions through vertebral bodies resulted from complete fractures. The rest occurred at interspaces, more common at the lower thoracic and upper lumbar segments. Double pseudarthrotic lesions were observed in 5 patients. Progressive osteolysis of the anterior elements was prominent, with variable sclerosis, osteophytes, vacuum phenomenon, subluxation and fragmentation. A posterior element weak link, as a bony break or facet joint non-fusion, was an essential component in every lesion, playing an initiating or perpetuating role in its pathogenesis. Mechanical derangement from trauma, severe round kyphosis, spondylodiscitis, hip disease, spinal operation and unusual activities may be contributing factors. Initial treatment is conservative, but 16 patients required operative stabilisation.
Radiologic Observations in Severe Neonatal Respiratory Distress Syndrome Treated with the Isolated Phospholipid Fraction of Natural Surfactant
Authors: Mortensson W. , Noack G. , Curstedt T. , Herin P. , Robertson B.
Published: June 2015

Ten newborn babies with severe respiratory distress syndrome, all dependent on artificial ventilation, were treated via the airways with the isolated phospholipid fraction of bovine or porcine surfactant. After treatment with surfactant at a median age of 10.5h, there was in all patients a striking improvement of lung aeration in chest films, with a decrease in parenchymal fluid retention and in distension of bronchioli. These radiologic findings were associated with a dramatic improvement of oxygenation and a significant reduction of the right-to-left shunt. In spite of the rapid therapeutic response, four patients died from cerebral hemorrhage. One of the surviving patients developed bronchopulmonary dysplasia. Our findings document efficacy of this new surfactant preparation in the neonatal respiratory distress syndrome, but the long-term effects need to be further tested in randomized clinical trials.
Transcatheter Embolization for Treatment of Acute Lower Gastrointestinal Bleeding
Authors: Uflacker R.
Published: June 2015

Treatment of lower gastrointestinal bleeding was attempted in 13 patients by selective embolization of branches of the mesenteric arteries with Gelfoam. Bleeding was adequately controlled in 11 patients with active bleeding during the examination. One patient improved after embolization but bleeding recurred within 24 hours and in another patient the catheterization was unsuccessful. Five patients with diverticular hemorrhage were embolized in the right colic artery four times, and once in the middle colic artery. Three patients had embolization of the ileocolic artery because of hemorrhage from cecal angiodysplasia, post appendectomy, and leukemia infiltration. Three patients had the superior hemorrhoidal artery embolized because of bleeding from unspecific proctitis, infiltration of the rectum from a carcinoma of the bladder, and transendoscopic polypectomy. One patient was septic and bled from jejunal ulcers. Ischemic changes with infarction of the large bowel developed in two patients and were treated by partial semi-elective colectomy, three and four days after embolization. Four other patients developed pain and fever after embolization. Transcatheter embolization of branches of mesenteric arteries is an effective way to control acute lower gastrointestinal bleeding, but still has a significant rate of complications that must be seriously weighed against the advantages of operation.
Digital Subtraction Angiography with Bandpass Filtration during By-Pass Operation
Authors: Kehler M. , Svahn G. , Alwmark A. , Norgren L.
Published: June 2015

Experience is reported on a simple, inexpensive video processor for angiographic control during operation. In 6 patients with graft complications instant operative corrections could be performed.
Application of a Kinetic Model on the Methionine Accumulation in Intracranial Tumours Studied with Positron Emission Tomography
Authors: Ericson K. , Blomqvist G. , Bergström M. , Eriksson L. , Stone-Elander S.
Published: June 2015

Eleven patients were studied with positron emission tomography (PET) using 11C-methionine. They all had low-grade astrocytomas (Kernohan grade II). The PET studies were analyzed with a metabolic model to obtain values for the influx, the accumulation rate and the partition coefficient of methionine in normal and tumourous tissue. Seven of the tumours showed an increased accumulation of methionine as compared with normal tissue on the static PET scans and also had higher values as to the kinetic parameters. Four tumours had a methionine accumulation equal to or lower than that of normal tissue and the kinetic parameters were also lower. Application of the kinetic model did not aid significantly in the delineation of the tumours. There was a correlation between the three parameters indicating an adaption of the transport of methionine to the regional metabolic demand. The accumulation rate for normal cortical tissue was 0.49 nmol/g/min, the influx 0.97 nmol/ml and the partition coefficient 0.45 ml/g. These values are considerably higher than those previously reported. The differences might be attributed to differences in the corrections introduced for i.a. the occurrence of labelled metabolites in serum. With the use of a kinetic model, more information about the tracer is utilized and gained compared with the previously used graphic approach.
Breast Necrosis Associated with Thromboembolic Disorders
Authors: Andersson I. , Adler D. D. , Ljungberg O.
Published: June 2015

Two obese women with thrombotic disease complicated by necrosis of the breast are described. In one patient the reaction started after a few days of coumarin treatment and progressed to severe necrosis requiring mastectomy. The other patient was not on anticoagulant therapy when the breast reaction started and the clinical course was less severe. The radiographic appearance was characterized by thickening of the breast trabeculae, increased density of the breast and skin thickening. Although the radiographic findings are non-specific, the correct diagnosis can be suggested if combined with appropriate clinical information. The disease process may mimic breast cancer of the inflammatory type, clinically as well as radiographically.
Radiographic Findings after Cricopharyngeal Myotomy
Authors: Ekberg O. , Besjakov J. , Lindgren S.
Published: June 2015

Single film examinations (iodine and/or barium) were reviewed in 28 patients who had undergone surgery on the cricopharyngeal muscle due to Zenker diverticula (24 patients), cricopharyngeal muscle incoordination (3 patients) and pharyngoesophageal web (one patient). All patients had had a myotomy which included the cricopharyngeal muscle and up to 3 cm of the cervical esophagus. Lateral and anterior deviation of the pharynx and cervical esophagus occurred regularly. A pharyngocutaneous fistula developed in 2 patients which healed within 3 weeks. In 5 patients there was a posterior leak of contrast medium during the first postoperative week which healed within 2 weeks. Six of these seven patients with a fistula or a leak had had either a diverticulum removed or sustained an accidental mucosal perforation. No patient had recurrence of diverticula, although, 9 patients developed a cricopharyngeal muscle impression. Iodine and barium examinations are important for monitoring early and late postoperative changes after cricopharyngeus myotomy.
Magnetic Resonance Imaging in Hemophilic Arthropathy of the Knee
Authors: Pettersson H. , Gillespy T. , Kitchens C. , Kentro T. , Scott K. N.
Published: June 2015

The MR findings at the examination of 16 knees in 9 hemophilic patients were reviewed. The hemophilic arthropathy was demonstrated in great detail. The state of the joint cartilage, menisci, posterior cruciate ligaments and synovial tissue could be assessed. The presence of intraarticular hemorrhage and cyst fluid in bone cavities was recorded. MRI may become a valuable tool for assessment of early treatment of hemophilic arthropathy.
Anatomic Variations of the Accessory Soleus Muscle
Authors: Lorentzon R. , Wirell S.
Published: June 2015

Four cases of accessory soleus muscle are presented. By means of soft tissue radiography and computed tomography the course of the accessory muscle as well as its exact site and mode of insertion could be determined. It was found that the accessory muscle in these four cases showed four different varieties of insertion, i.e. along the tendon of Achilles, fleshy to the upper surface of the calcaneus, by a separate tendon to the upper surface of the calcaneus and fleshy to the medial surface of the calcaneus. These variations may be of importance in the planning of operative treatment. Therefore, meticulous radiologic examinations as depicted in this study are recommended before surgery.
Combination of DMSA-Scintigraphy and Hippuran Renography in Unilateral Obstructive Nephropathy
Authors: Thomsen H. S. , Hvid-Jacobsen K. , Meyhoff H.-H. , Nielsen S. L.
Published: June 2015

The renal handling of dimercaptosuccinic acid and hippuran differs. This might be used in unilateral obstructive nephropathy in order to predict potential functional recovery following intervention. The theory was evaluated on a retrospective basis in 17 patients, who primarily had a nephrostomy. If the DMSA-uptake rate in the diseased kidney was more than 10 per cent higher than that of hippuran, the uptake rate of hippuran increased following relief of obstruction. Use of the two radiopharmaceuticals, thus, may have great impact on the clinical decision, since in case of a difference some function may be saved by immediate intervention.
Contrast Enhanced Magnetic Resonance Imaging of the Brain Using Gadolinium-DTPA
Authors: Valk J. , de Slegte R. G. M. , Crezee F. C. , Hazenberg G. J. , Thjaha S. I. , Nauta J. J. P.
Published: June 2015

This report concerns a clinical trial with gadolinium-DTPA (Gd-DTPA) as an intravenous contrast medium for magnetic resonance imaging (MRI) in patients with disorders of the central nervous system. Fifty patients, 30 females and 20 males, were examined without and with Gd-DTPA. The contrast medium was well tolerated by all patients. The results of MRI scanning without and with Gd-DTPA and those obtained with computed tomography (CT) using intravenous contrast enhancement were compared. This investigation comprised mainly patients with intracranial tumors, multiple sclerosis, and nasopharyngeal tumors. The results may be summarized as follows: 1) MRI with Gd-DTPA (MRI+) gave better results than MRI without Gd as regards delineation of the lesion, blood vessels and edema in cerebral tumors, pituitary adenomas and acute forms of multiple sclerosis (MS). 2) MRI+ was better than CT in 32 of the 50 cases examined; with intracerebral tumors it was better in 15 out of 18 cases. 3) MRI+ was always better than CT in patients with MS. In 3 out of 7 cases MRI demonstrated the acute MS lesions. 4) MRI+ seemed to have advantages also in nasopharyngeal tumors as ascertained from this limited experience.
Positron Emission Tomography with11C-Methionine and Computed Tomography of Intracranial Tumours Compared with Histopathologic Examination of Multiple Biopsies
Authors: Mosskin M. , von Holst H. , Bergström M. , Collins V. P. , Eriksson L. , Johnström P. , Norén G.
Published: June 2015

A selected group of 36 patients with suspected supratentorial gliomas were investigated with positron emission tomography (PET) using11C-methionine and transmission computed tomography (CT) before and after intravenous injection of contrast medium. Every examination was performed with the head fixed in a plastic helmet and a baseplate to guarantee that the slice orientation was the same at examinations with the two modalities and over time. Guided by the examinations, multiple stereotactic biopsies were performed with the biopsy instrument mounted on the baseplate. Regional accumulation of methionine was compared with histology of the corresponding samples and with attenuation before and after injection of contrast medium as well as mass effect on CT. Typically, there was a low attenuating lesion with a slight mass effect on CT. There was an increased accumulation compared with normal brain tissue in 31 cases of tumours and ordinary or decreased accumulation in 3 cases of tumours. In 22 cases with increased accumulation of methionine the extension of the tumour judged by PET corresponded with that of histology. In 4 cases tumour cells were found outside the area with pathologic methionine uptake. In 5 patients there were areas with increased methionine accumulation where no tumour cells were found. In 22 cases PET using methionine was more accurate than CT in defining the tumour boundaries as determined from the histologic findings. Four groups of biopsy specimens with different amounts of methionine accumulation are described. The uptake in a single biopsy gives good but not exact information about the histology of the specimen.
Radiologic and Endoscopic Diagnosis of Duodenal Angioma
Authors: Plavšić B. , Jereb-Prović B.
Published: June 2015

Two patients with lymphangioma and one with hemangioma of the duodenum are described. The radiologic presentation of duodenal angiomas is that of multiple submucous, soft, polypoid, non-infiltrating tumors. During propagation of peristalsis, on compression, or gas distension of the duodenum, they change in shape and dimensions. Deep peristaltic waves could cause apparent vanishing of the angiomas. Possible mechanisms of such behaviour of angiomas are discussed. Listed characteristics enabled the radiologic distinction of angiomas from solid submucous duodenal tumors. Duodenoscopy allows differentiation of duodenal lymphangiomas from hemangiomas and duodenal varices. Final diagnoses were based on histologic analysis of surgical specimens.
Blast Injuries
Authors: Adler O. B. , Rosenberger A.
Published: June 2015

Blast injuries cause specific lesions with which the radiologist should be familiar. The mechanism of injury and the pathophysiology of this form of trauma are discussed. The clinical effects as well as the radiologic observations in various organs are presented. Most dramatic effects are observed in the thorax.
Water-Soluble Contrast Media in Radiography of Small Bowel Obstruction
Authors: Stordahl A. , Laerum F. , Gjølberg T. , Enge I.
Published: June 2015

Fifty patients with possible gastrointestinal obstruction, referred for enteric follow-through examination, were randomized for a double-blind, parallel comparison of the hyperosmolar contrast medium Gastrografin and the low-osmolar Omnipaque. The result was that Omnipaque retained its radiographic density in the small bowel better than Gastrografin. Omnipaque was thus a better alternative than Gastrografin in follow-through examinations of intestinal obstruction. Also, 23 patients out of 28 with small bowel obstruction due to peritoneal adhesions, had spontaneous relief of symptoms during the observation period following contrast medium ingestion with no significant difference between the two media. This indicated that enteric follow-through procedures may have a therapeutic efficacy similar to the treatment of small bowel obstruction using nasogastric suction and gastrointestinal rest. Possible mechanisms for this action of the contrast media are discussed.
Magnetic Resonance Imaging of Renal Masses at 0.02 Tesla
Authors: Ekelund L. , Hietala S.-O. , Ljungberg B. , Lotz H. , Wickman G.
Published: June 2015

To determine the usefulness of extremely low field magnetic resonance imaging (MRI) in the evaluation of renal masses 19 patients with 15 tumors (13 renal and 2 renal pelvic carcinomas) and 8 cysts were examined in a 0.02 tesla MRI unit. The findings were compared with results of computed tomography (CT) and ultrasound. Cavography was performed in 6 patients. MRI enabled differentiation between cysts and solid tumors. Tumor extension into the inferior vena cava could be demonstrated in one case and liver metastases in two patients. The image quality was inferior to that reported at higher field strengths and the tumors were more precisely staged by CT and ultrasound. At present, it is unlikely that low field MRI will play any substantial role in the evaluation of renal masses.
Effect of Training and Experience on Radiologic Diagnostic Performance in Midfacial Trauma
Authors: Kinnunen J. , Göthlin J. H. , Tötterman S.
Published: June 2015

In a retrospective approach the medical records and radiographs of 618 patients with midfacial trauma were reviewed by radiologists who were classified into four groups according to the length of their training and experience. Initially reported diagnoses were compared with discharge diagnoses, and the impact of training and experience on diagnostic performance was assessed. The same parameters were also investigated in a prospective study. Neither of the investigations revealed any statistically significant improvement in diagnostic performance with increased training and experience. After the basic radiologic education, innate perceptive and cognitive abilities seem to have a larger influence on radiologic diagnostic preformance than training and experience.
Computed Tomography in the Diagnosis and Treatment of Mediastinal Abnormalities in Children
Authors: Ivancev K. , Halldorsdottir A. , Laurin S. , Sandström S. , Békássy A. , Garwics S. , Wiebe T.
Published: June 2015

Thirty-one children with mediastinal abnormalities—14 malignant lymphomas, 4 other primary malignancies, one metastatic and 12 benign lesions—were examined one or several times using CT, which proved to be effective especially for cysts (5 patients), ductus arteriosus aneurysm (2 patients), and intrathoracic liver (one patient). It also supplied important diagnostic information regarding the extent of disease in malignant thymoma (one patient), in neurinoma (one patient), and in Hodgkin's lymphoma (5 patients). It was found to be useful in the monitoring of treatment of patients with lymphomas, in which a small residue, probably a fibrotic remnant, was invariably seen after completion of chemotherapy and irradiation. It was concluded that when the residue was enlarged, the possibility of relapse and even thymic hyperplasia should be considered. However, if CT was performed under general anaesthesia pseudo-widening of the anterior mediastinum could simulate recurrence. Surgical biopsy was found to be necessary in these cases because fine-needle aspiration biopsy was unsuccessful.
False Negative Sonographic Finding in Emphysematous Cholecystitis
Authors: Hawass N. D.
Published: June 2015

Two patients presented with fever and acute abdominal pain. Acute cholecystitis was diagnosed when ultrasound examination showed a double-contour gallbladder wall. Radiography showed gas in the gallbladder wall in both cases, indicating emphysematous cholecystitis. This demonstrated that gas in the gallbladder wall may go undetected by ultrasound at the time when it could still be detected by conventional radiography of the abdomen. Awareness of the value of conventional radiography in these cases has an important diagnostic significance which may affect patient management.
Current Trends in the Management of Urinary Stones
Authors: Smith T. P. , Castaneda-Zuniga W. R. , Darcy M. D. , Cragg A. H. , Hunter D. W. , Amplatz K.
Published: June 2015

The treatment of renal and ureteral stones has undergone rapid and major changes over the past ten years. Extracorporeal Shockwave lithotripsy has become the most commonly used modality for the treatment of renal and upper ureteral stones. Lower ureteral stones are more commonly being approached by retrograde techniques. Percutaneous nephrolithotomy, medical therapy, and open surgical nephrolithotomy offer viable alternatives in given situations. Presented here is the current application of each of these techniques, both alone and in combination, for the treatment of urinary stones.