bluuebunny/crossref_metadata_2025 huggingface dataset:
White matter abnormalities in tuberous sclerosis complex
Authors: Griffiths P. D. , Bolton P. , Verity C
Published: January 2010

Purpose: the aim of this study was to investigate and describe the range of white matter abnormalities in children with tuberous sclerosis complex by means of MR imaging

Material and Methods: A retrospective cross-sectional study was performed on the basis of MR imaging findings in 20 cases of tuberous sclerosis complex in children aged 17 years or younger

Results: White matter abnormalities were present in 19/20 (95%) cases of tuberous sclerosis complex. These were most frequently (19/20 cases) found in relation to cortical tubers in the supratentorial compartment. White matter abnormalities related to tubers were found in the cerebellum in 3/20 (15%) cases. White matter abnormalities described as radial migration lines were found in relation to 5 tubers in 3 (15%) children. in 4/20 (20%) cases, white matter abnormalities were found that were not related to cortical tubers. These areas had the appearance of white matter cysts in 3 cases and infarction in the fourth. in the latter case there was a definable event in the clinical history, supporting the diagnosis of stroke

Conclusion: A range of white matter abnormalities were found by MR imaging in tuberous sclerosis complex, the commonest being gliosis and hypomy-elination related to cortical tubers. Radial migration lines were seen infrequently in relation to cortical tubers and these are thought to represent heterotopic glia and neurons along the expected path of cortical migration
MR findings in three pituitary abscesses
Authors: Kashiwagi N. , Fujita N. , Hirabuki N. , Tanaka H. , Sato T. , Sato M. , Nakamura H.
Published: January 2010

We present MR findings in 3 surgically proved cases of pituitary abscess. All lesions were seen as a sellar cystic mass with a thin rim of enhancement. in addition, the pituitary stalk was thickened in 2 cases in which central diabetes insipidus developed. These findings may be suggestive of pituitary abscess
Mechanism of contrast enhancement in breast lesions at MR imaging
Authors: Boné B. , Wiberg M. Kristoffersen , Parrado C. , Falkmer U. , Aspelin P. , Gad A.
Published: January 2010

Purpose: the aim of the study was to explain why breast lesions are enhanced by contrast medium at MR imaging and to elucidate the histopathological basis for the overlap in the enhancement patterns of benign and malignant breast lesions

Material and Methods: Ten invasive breast carcinomas and 10 benign breast lesions were selected for the study. of the 10 carcinomas, 5 showed a strong and early contrast enhancement, and 5 did not. of the 10 benign lesions, 5 showed a strong and early contrast enhancement, and 5 showed no enhancement. the following morphometric variables were evaluated: proliferation cell index of neoplastic parenchymal cells, S-phase fraction, nuclear ploidy analysed by image DNA-cytometry, microvessel density, and the percentage proportion of the interstitial area

Results: Contrast enhancement was related to the proliferating activity of the hyperplastic or neoplastic parenchymal cells and was inversely correlated with the interstitial area in carcinomas as well as in benign tumours and non-neo-plastic lesions of the breast

Conclusion: Morphometric variables play an important role in the general mechanism of MR contrast enhancement in examinations of the breast and explain the histopathological basis for the overlap in the enhancement patterns of benign and malignant breast lesions
Assessment of image quality and total performance in norwegian mammography laboratories
Authors: Olsen J. B. , Skretting A. , Widmark A.
Published: January 2010

Purpose: to assess the image quality at different mammography laboratories

Material and Methods: Two commercial mammographic test phantoms and one phantom based on excised mammary tissue were used in an assessment of the imaging chain and total performance at 45 Norwegian mammography laboratories. the breast-tissue phantom was used for a receiver operating characteristics (ROC) analysis. This was carried out by putting overlays with identifiable regions (some of which contained a cluster of simulated calcifications) on top of the mammary tissue, and then having a radiologist report the confidence of a finding for each region

Results and Conclusion: the areas under the ROC curves were in general high. in nearly all the laboratories, performance was improved when a magnification technique was applied. There were wide variations among the laboratories in total performance as measured by the area under the ROC curve, and also in the physical parameters derived by means of the commercial phantoms. in general, a good ROC performance was associated with a good physical performance in the imaging chain
Dose reduction in thorax radiography in simulated neonates with additional filtration and digital luminescence radiography
Authors: Seifert H. , Jesberger H.-J. , Schneider G. , Rein L. , Blass G. , Limbach H.-G. , Niewald M. , Sitzmann F. C. , Kramann B.
Published: January 2010

Purpose: to determine the minimum acceptable radiation dose for an adequate image quality in thorax a.p. radiographs of neonates using mobile X-ray equipment

Material and Methods: the influence of additional filtration (1.0 mm Al+0.1 mm Cu) on image quality and radiation dose was determined for the speed class 400 screen-film system (SFS) and digital luminescence radiography (DLR) by making radiographs of a test phantom. Conventional and digital thorax a.p. radiographs of a rabbit were produced using various tube current-time products. the quality of the rabbit radiographs was judged by eight radiologists applying image quality criteria according to the German guidelines and the recommendations of the European Community

Results: the added filter resulted in a dose reduction of 39% at 66 kV. DLR gave a further dose reduction of 25% in comparison to the speed class 400 SFS while maintaining adequate image quality, i. e. the radiographs were clinically acceptable with regard to quality criteria

Conclusion: the radiation dose resulting from thorax a.p. radiographs of neonates can be reduced by approximately 50% with the use of additional filtration and DLR
Functional MR imaging of the cervical spine in patients with rheumatoid arthritis
Authors: Allmann K.-H. , Uhl M. , Uhrmeister P. , Neumann K. , von Kempis J. , Lange M.
Published: January 2010

Purpose: to evaluate functional MR imaging in patients with rheumatoid arthritis (RA) involving the cervical spine

Material and Methods: We used a device that allows MR examination to be made of the cervical spine in infinitely variable degrees of flexion and extension. Dynamic functional MR imaging was performed on 25 patients with RA

Results: Functional MR imaging was able to show the degree of vertebral instability of the occipito-atlantal or atlanto-axial level as well as the subaxial level. by performing functional MR imaging, we were able to demonstrate the extent of synovial tissue around the dens, and the impingement and displacement of the spinal cord during flexion and extension. the basilar impression, the cord impingement into the foramen magnum, the cord compression, the slipping of vertebrae, and the angulation of the cord were all much more evident in functional than in static MR imaging

Conclusion: Functional MR imaging provided additional information in patients with RA, and is valuable in patients who have a normal MR study in the neutral position and yet have signs of a neurological deficit. Functional MR imaging is important in the planning of stabilizing operations of the cervical spine
High-resolution MR imaging of the cutis and subcutis
Authors: Krug B. , Kugel H. , Schulze H.-J. , Krahe T. , Gieseke J. , Lackner K.
Published: January 2010

Objective: to determine whether the spatial resolution that can be achieved with currently available MR devices is adequate for the evaluation of skin disease

Material and Methods: We correlated high-resolution MR images of the skin with dermatohistopathology in 26 patients. the examinations were carried out on a 1.0 T imager using a commercially available surface coil (ID 7.5 cm) and optimized SE and GE sequences. Image quality was assessed by four readers on a questionnaire

Results: the visualization of the dermis, subcutaneous tissue, and muscle fascia allowed a pattern analysis that gave findings identical to those at dermatohistopathology. It was possible to distinguish septal from lobular panniculitis, and lipatrophia from sclerodermia. Images with contrast media infusion were useful in the differential diagnosis

Conclusion: High-resolution MR imaging may narrow down the differential diagnosis of various skin diseases and may help to reduce the number of skin biopsies on certain indications
MR and CT cholangiography in evaluation of the biliary tract
Authors: Masui T. , Takehara Y. , Fujiwara T. , Ichijo K. , Imaoka I. , Naito M. , Yamamoto H. , Watahiki H. , Kaneko M.
Published: January 2010

Objective: to compare MR and CT cholangiography (MRC and CTC) in evaluating the anatomy of the extrahepatic biliary tract and the pathology related to the gallbladder

Material and Methods: Twenty-three patients underwent MRC and CTC with a biliary contrast medium for investigation of biliary disease. 3D displays of both were also obtained. Endoscopic retrograde cholangiography was performed in 17 patients, and the pathology of all 23 was evaluated

Results: Overall, the image quality was higher with CTC than with MRC (4.7 vs 3.9, p<0.05). the cystic duct was demonstrated better by CTC than MRC (p<0.05). Multiplanar reformation (MPR) and source images provided additional information to that obtained from 3D MRC and CTC images. Gallstones were revealed in 6 patients by CTC and in 5 of these 6 by MRC. in 2 patients with cholecystitis, CTC demonstrated gallbladder wall thickening but MRC did not. in 3 patients with adenomyomatosis, MRC demonstrated Roki-tansky-Aschoff sinuses (RAS) while CTC demonstrated focal gallbladder wall thickening in all 3 and RAS in 1 of them

Conclusion: Both MRC and CTC provided anatomical and pathological information about the biliary system. with both techniques, however, either MPR or source images proved necessary in addition for evaluating the biliary system anatomy and pathology. the gallbladder wall was depicted clearly in source CTC, but MRC is recommended for the evaluation of adenomyomatosis because it depicts RAS clearly
The efficacy of fp 736-04 in experimental liver cirrhosis
Authors: Bergman A. , Magnusson A. , Moore K. , Sundin A. , Davies S. , Harry D. , Öhagen P.
Published: January 2010

Purpose: to determine whether the uptake of FP 736-04, a hepatocyte-specific CT contrast agent, is influenced by cirrhotic changes in the liver

Material and Methods: Liver cirrhosis was induced by bile duct ligation (BDL) in Sprague-Dawley rats. Seventy-four animals were divided into three groups comprising: rats with acute BDL; rats with chronic BDL; and normal controls. CT was performed after i.v. infusion of FP 736-04 or saline at a dose of 2 ml/kg b.w., and the mean attenuation in the liver and spleen was measured. the livers from the chronic BDL group were taken for histopathological examination and the extent of the disease was graded according to an arbitrary scale

Results and Conclusion: There was a significant reduction of the native liver attenuation in both chronic and acute BDL groups as compared with the normal controls. FP 736-04 was taken up by the liver parenchyma with a similar degree of enhancement in all three groups
Thrombotic complications in coronary angioplasty — ionic versus non-ionic lowosmolar contrast media
Authors: Husted S. E. , Kanstrup H.
Published: January 2010

It has been suggested that the potential for thrombo-embolic complications is greater with the use of non-ionic contrast agents than with ionic contrast agents.

The increasing use of interventional therapy in patients with acute coronary disease makes the discussion of a possible relationship between thrombo-embolic complications and use of non-ionic contrast media pertinent.

It has been shown that ionic contrast media have a marked effect on the coagulation system and platelet function. The non-ionic contrast media have a less pronounced effect on the coagulation system and platelet function although there is no evidence of a thrombogenic effect.

The anticoagulant effect observed with ionic contrast media in connection with coronary angiography or angioplasty (PTCA) is short and disappears as soon as the medium is excreted. Therefore an effective antithrombotic treatment in relation to the procedure is necessary.

Larger randomized clinical studies need to be performed with effective antithrombotic regimens in order to clarify any difference in thrombo-embolic complications from the different contrast media. Until then, the non-ionic contrast media should be preferred to the ionic contrast media in high-risk PTCA, owing to their overall lower toxicity and fewer adverse reactions.
Late allergy-like reactions following vascular administration of radiography contrast media
Authors: Pedersen S. H. , Svaland M. G. , Reiss A.-L. , Andrew E.
Published: January 2010

Purpose: To compare the frequency of allergy-like reactions in adults following vascular injection of iohexol and iopentol versus other contrast media (CMs), with emphasis on late reactions.

Material and Methods: Thirty-two trials involving a total of 2656 patients in the European clinical development programmes for iohexol and iopentol were retrospectively evaluated. The number of patients experiencing late allergy-like reactions, immediate allergy-like reactions, and both types of reaction were pooled separately. Late was defined as time of onset being 60 min or more after the first injection of CM.

Results and Conclusion: After vascular administration of iohexol and iopentol, 0.52% (0.44% and 0.68% respectively) of the patients experienced a late allergy-like reaction. The same frequency was reported for immediate allergy-like reactions. After administration of ionic CMs, the frequency of late allergy-like reactions was in the same range (0.42%) as for non-ionic CMs, but the frequency of immediate allergy-like reactions was much higher (6.99% vs 0.52%). Our results are in the same range as those reported by other authors. No serious adverse reactions were reported in the 32-trial series.
Iohexol, platelet activation and thrombosis
Authors: Sakariassen K. S. , Barstad R. M. , Hamers M. J. A. G. , Stormorken H.
Published: January 2010

Background: The nonionic monomer iohexol triggers in vitro platelet secretion of β-thromboglobulin (β-TG). This iohexol platelet activation may promote intravascular thrombosis. We studied this relationship by employing a human model of collagen-induced platelet thrombus formation at arterial flow. The ionic dimer ioxaglate, the nonionic dimer iodixanol, and glucose were included.

Methods and Results: In vitro platelet activation as measured by β-TG secretion following a 1-min incubation of native blood with 50 vol% of iohexol was significant. Glucose solutions of 300, 580 and 825 mosmol, corresponding to the osmolalities of respectively iodixanol, ioxaglate and iohexol, increased the β-TG secretion in parallel with the osmolalities. Ioxaglate and iodixanol were virtually inert. Continuous infusion of iohexol or 580 or 825 mosmol glucose (40 vol%) into flowing native blood at an arterial wall shear rate of 2600 s−1 in an ex vivo collagen-induced platelet thrombus formation device triggered pronounced secretion of β-TG. However, the platelet thrombus formation in blood mixed with iohexol was within the same range as that observed with ioxaglate or iodixanol. Increasing glucose osmolality induced increasing β-TG secretion, which paralleled gradually decreasing platelet thrombus formation.

Conclusion: Iohexol and 580 or 825 mosmol glucose trigger platelet secretion of β-TG. This secretion is not associated with enhanced collagen-induced platelet thrombus formation at high arterial shear.
Iohexol, platelet activation and thrombosis
Authors: Sakariassen K. S. , Buchmann M. , Hamers M. J. A. G. , Stormorken H.
Published: January 2010

Background: There is a dispute about the potential effects of radiographic contrast media (CM) on thrombogenesis. The nonionic CM iohexol triggers platelet β-thromboglobulin (β-TG) secretion, and thus may activate the platelets and promote thrombosis. We addressed this topic in a study employing a human model of arterial thrombus formation in the presence of aspirin and heparin. This was a follow-up to our initial study (on thrombus formation in native blood) which did not include antithrombotic drugs. The nonionic CM iohexol (monomer) and iodixanol (dimer) and the ionic CM ioxaglate (dimer) were compared.

Methods and Results: Thrombus formation was triggered by a surface rich in either collagen or tissue factor, positioned in a parallel-plate perfusion chamber device at an arterial wall shear rate of 2600 s−1. Blood from healthy volunteers, following ingestion of 1 g aspirin, was mixed with 40 vol% CM and 2.0 IU/ml heparin and passed over the surfaces. Thrombus formation in the presence of either CM showed no difference, despite the fact that iohexol triggered a pronounced platelet β-TG secretion; iodixanol or ioxaglate were virtually inert.

Conclusion: There was no association between iohexol-induced β-TG secretion and thrombus formation on collagen (platelet-driven) or on tissue factor (thrombin-driven) in the presence of a standard antithrombotic regimen of aspirin and heparin as used in the clinic. The notion of a thrombotic risk due to platelet activation by iohexol was thus not substantiated by this study.
Assessment of possible nephrotoxicity from iohexol in patients with normal and impaired renal function
Authors: Lundqvist S. , Holmberg G. , Jakobsson G. , Lithner F. , Skinningsrud K. , Stegmayr B. , Hietala S.-O.
Published: January 2010

Purpose: To evaluate the possible nephrotoxic effects of iohexol in patients with normal and impaired renal function.

Material and Methods: A prospective urographic study using iohexol (50 ml, 300 mg I/ml) was performed in 100 patients, 63 with impaired renal function (IRF) and 37 with normal renal function (NRF). The group included 24 patients with diabetes mellitus, 17 of them with IRF. Renal function parameters and adverse events were recorded for one week after the urography.

Results: There were no significant changes in serum creatinine, creatinine clearance, or β-2-microglobulin. The 24-h urine protein excretion showed a statistically significant increase in patients with NRF as well as in patients with IRF. Nine patients experienced adverse events but none of them required any treatment.

Conclusion: Iohexol was tolerated well in patients with NRF and in patients with IRF without significant overall nephrotoxic effects. Some minor adverse events were recorded.
Effect of iodixanol on renal function immediately after abdominal angiography
Authors: Murakami R. , Tajima H. , Kumazaki T. , Yamamoto K.
Published: January 2010

Purpose: To investigate the acute renal effects of three contrast media in a double-blind randomized parallel-group study. The contrast media investigated were: the nonionic dimeric iso-osmolality medium iodixanol; the nonionic monomeric medium iomeprol; and the ionic dimeric medium ioxaglate.

Material and Methods: A total of 30 patients were given the following doses of contrast medium: 10 patients received iodixanol 320 mg I/ml; 10 received iomeprol 300 mg I/ml; and 10 received ioxaglate 320 mg I/ml. The doses were given intra-arterially at routine abdominal angiography and the renal effects of these three contrast media were studied for up to 120 min after injection.

Results: The urinary minute volume increased immediately after angiography but tended to return to baseline values after 120 min; these changes were more pronounced with iomeprol and ioxaglate than with iodixanol. Creatinine clearance was not reduced by any of the contrast media. Fraction excretion of sodium increased immediately and lasted for 30 min after angiography; these changes were more pronounced with ioxaglate than with iomeprol and iodixanol. Urinary γ-glutamyl transferase increased for 120 min after angiography with iodixanol and iomeprol; these changes were more pronounced with iomeprol than with iodixanol. On the other hand, urinary N-acetyl-β-glucosaminidase increased for 120 min after angiography with iomeprol, but was unchanged with iodixanol.

Conclusion: The use of contrast media induces osmotic diuresis and its acute effects on the proximal tubular function. However, the iso-osmolality medium iodixanol induces fewer changes than the other two media.
Effect of nitrendipine on renal function and on hormonal parameters after intravascular iopromide
Authors: Madsen J. K. , Jensen L. Winther , Sandermann J. , Johannesen N. , Paaske W. P. , Egeblad M. , Pedersen E. Bjerregaard
Published: January 2010

Purpose: To evaluate the effect of the low-molecular nonionic radiographic contrast agent iopromide (Ultravist) on renal function, vasoactive peptides (angiotensin II, aldosterone, arginine vasopressin, and atrial natriuretic factor (ANF)), and blood pressure, and to evaluate the influence of the calcium antagonist nitrendipine on these parameters. The findings were evaluated in a prospective, double-blind and placebo-controlled randomized study.

Material and Methods: Twenty-six patients undergoing routine aortofemoral arteriography for peripheral atherosclerotic disease were treated with nitrendipine tablets (10 mg) or placebo twice daily for a week. Angiography was performed on the fifth day of medication. Efficacy variables were determined on the day before and 2 days after arteriography. The glomerular filtration rate and renal plasma flow were measured by the constant infusion technique. Renal tubular function was estimated from the clearance of lithium. Hormones were measured by radioimmunoassays.

Results: Arteriography with iopromide did not change renal function. No differences between the nitrendipine and placebo groups were found in renal hemodynamics, tubular sodium handling, or blood pressure. Nitrendipine changed ANF (26.1%) compared to placebo (1.5%), whereas the other hormones were not affected.

Conclusion: The use of iopromide for angiography did not affect renal function in normotensive patients with peripheral atherosclerotic disease. Shortterm treatment with nitrendipine may lower the plasma levels of ANF but it had no effect on renal function or blood pressure. Treatment with calcium antagonists prior to arteriography with iopromide is not indicated in these patients.
Detecting experimental liver metastases at CT with the hepatocyte-specific contrast medium FP 736-03
Authors: Bergman A. , Magnusson A. , Sundin A.
Published: January 2010

Purpose: To evaluate the detection of experimental hepatic metastases at CT with the hepatocyte-specific contrast medium FP 736-03.

Material and Methods: A nude-rat model of experimental multiple hepatic metastases from a human colonic cancer was used. Three weeks after intraportal tumour cell injection, the CT examination was performed before and after i.v. injection of FP 736-03 at a dose of 0.5 ml/kg b.w.

Results: The overall detection rate was determined in a lesion-by-lesion analysis of 87 metastases. Irrespective of metastatic size, the mean detection rate for two viewers was significantly higher at the FP-736-03-enhanced examination (59%) than at the unenhanced CT examination (16%).

Conclusion: The detection rate increased with the i.v. administration of FP 736-03 at a dose of 0.5 ml/kg b.w. compared with that at unenhanced examination.
Sensitivity and specificity of computer-assisted breast cancer detection in mammography screening
Authors: Thurfjell E. , Thurfjell M. Gelig , Egge E. , Bjurstam N.
Published: January 2010

Purpose: To evaluate a system of computer-assisted diagnosis (CAD) in mammography.

Material and Methods: A sample of 120 sets of two-view mammograms was examined by an expert screener, a screening radiologist, a clinical radiologist, and a CAD system. The screening and clinical radiologists examined the mammograms twice, first without and then with the help of CAD. The sample consisted of first-round screening films from a two-round population-based screening, and comprised: 32 women in whom breast cancer was detected at the first screening; 10 with cancer detected during the screening interval; 32 with cancer detected at the second screening; and 46 with normal mammograms at both screenings.

Results: The expert screener, the screening radiologist, the clinical radiologist, and the CAD system detected respectively 44, 41, 34 and 37 cancers. Their respective specificities were 80%, 83%, 100% and 22%. With the help of CAD, the screening radiologist detected 1 additional cancer and the clinical radiologist detected 3; their respective specificities were 80% and 100%.

Conclusion: The sensitivity of the CAD system was satisfactory. The two radiologists helped by CAD achieved a modest increase in sensitivity with unaffected specificity. However, the CAD system by itself had a very low specificity and it needs improvement before it can be useful in mammographic screening.
CT-guided transthoracic fine-needle aspiration versus transbronchial fluoroscopy-guided needle aspiration in pulmonary nodules
Authors: Shankar S. , Gulati Madhu , Gupta D. , Rajwanshi A. , Suri S.
Published: January 2010

Purpose: To evaluate the diagnostic yield of CT-guided (CTNAB) and fluoroscopy-guided transbronchial (TBNA) fine-needle aspiration cytology in pulmonary nodules and to compare their complications.

Material and Methods: Thirty patients with pulmonary nodules not abutting upon the chest wall and inaccessible to bronchoscopy were randomised for CTNAB or TBNA. Eighteen patients underwent CTNAB and 16 TBNA. Four patients underwent both procedures.

Results: In the CTNAB group, a definitive diagnosis could be made in 14 (78%) out of 18 patients whereas in the TBNA group, a definitive diagnosis was made in 11 (69%) out of 16 patients. This difference was not statistically significant ( p>0.05). The final diagnosis in 29 out of 30 patients comprised primary bronchogenic carcinoma in 14 patients, metastases in 5 patients, and benign lesions in 10 patients (34%) of which 3 lesions (30%) were of tuberculous aetiology. There were 2 asymptomatic pneumothoraces in the CTNAB group and no complication was observed in the TBNA group.

Conclusion: Both techniques were safe and effective in the diagnosis of peripheral pulmonary lesions. TBNA was best suited for lesions larger than 3 cm and located in the middle and lower lobes while CTNAB could be used for any lesions.
Videomanometry of the pharynx in dysphagic patients with laryngeal barium penetration during swallowing
Authors: Olsson R. , Castell J. , Ekberg O. , Castell D. O.
Published: January 2010

Purpose: This study used simultaneous videomanometry to measure pressure characteristics in a group of patients with evidence of laryngeal and/or tracheal barium penetration, and to compare the results to those of one group of healthy volunteers and one group of patients with dysphagia but a normal barium swallow.

Material and Methods: Videomanometry during barium swallowing was performed in 25 patients who showed penetration of barium into the laryngeal vestibule. Manometric abnormalities were determined by comparing these mean values with those of 25 healthy volunteers, and the frequency of manometric abnormalities was compared to that of 19 patients presenting with oropharyngeal dysphagia with a normal barium swallow.

Results: The frequency of abnormalities for four parameters (pharyngo-eso-phageal segment (PES) resting pressure, PES relaxation duration, pharyngeal peak pressure, pharyngeal contraction duration) differed significantly between the patients with penetration and those with normal barium studies. There was, however, no association between manometric abnormalities and the degree of barium penetration.

Conclusion: The differences in manometric abnormalities between patients with laryngeal penetration and patients with normal barium swallows may be useful in identifying the mechanisms of laryngeal penetration.
Measuring anteversion in the femoral neck from routine radiographs
Authors: Hermann K. L. , Egund N.
Published: January 2010

Purpose: To describe a new method for measuring femoral neck anteversion (FNA) that requires only one lateral radiograph of the knee in addition to routine radiographs of the hip for evaluation of total hip replacement; and to compare the proposed method with FNA measurement by means of 3D CT.

Material and Methods: In 18 femoral specimens, radiographic examinations of the hip and knee, in three different rotational positions, and one CT examination were made, and the measurements of FNA were compared. Similarly, in 38 patients with 40 total hip replacements, measurements from routine radiographic examinations of the hip and knee and from CT examinations were compared. The accuracy and reproducibility of the FNA measurements produced by this proposed method were calculated.

Results: Accuracy and reproducibility were 2° and 2° for the proposed method in the femoral specimen study, and accuracy was 4° in the hip patient study. The proposed method had a minor flaw that was caused almost solely by differences in knee size at inward rotation of the femur.

Conclusion: FNA measurement can be made from a routine radiographic examination of the hip and a lateral view of the knee. This method achieves an acceptable level of accuracy and reproducibility.
Influence of the phosphate balance on the activity distribution of 99mTc-Hydroxymethylene Diphosphonate
Authors: Cronhjort M. , Sääf M. , Sjöberg H. E. , Schnell P. O. , Jacobsson H.
Published: January 2010

Objective: The purpose was to determine whether changes in the phosphate balance have an influence on the distribution of bone-seeking radiopharmaceuticals.

Material and Methods: The biodistribution of 99mTc-HDP in mice, intravenously administered under varying conditions, was assessed by removing different organs and estimating their activity in a scintillation counter. Some experiments were also performed with 99mTc-MDP and 99mTc-DPD.

Results: After 1 h and 18 h on phosphate-enriched drinking water, the mice showed a strongly increased uptake in all organs/tissues representing background activity and a decrease in the bone uptake. This pattern changed with time. After 6–8 days of phosphate load, we saw a more favourable distribution with a reduction of the background and whole-body activity. Administration of hPTH 1–34 gave rise to an activity distribution similar to that after 6–8 days on phosphate-enriched water. Changing the phosphate balance had less obvious effects on the distribution of 99mTc-MDP and 99mTc-DPD.

Conclusion: The activity distribution of bone-seeking radiopharmaceuticals in the mouse is affected by the phosphate balance. The mechanism behind this finding is unknown but it may be partially mediated by PTH. It is possible that changes in the phosphate balance, induced by pharmaceuticals or by dietary changes, may affect the image quality at bone scintigraphy.
MR and magnetisation transfer imaging in cirrhotic and fatty livers
Authors: Alanen A. , Komu M. , Leino R. , Toikkanen S.
Published: January 2010

Purpose: To determine whether low-field MR fat/water separation and magnetisation transfer (MT) techniques are useful in studying the livers of patients with parenchymal liver diseases in vivo.

Material and Methods: MR and MT imaging of the liver in 33 patients (14 with primary biliary cirrhosis, 15 with alcohol-induced liver disease, and 4 with fatty liver) was performed by means of the fat/water separation technique at 0.1 T. The relaxation time T1 and the MT contrast (MTC) parameter of liver and spleen tissue were measured, and the relative proton density fat content N(%) and MTC of the liver were calculated from the separate fat and water images. The value of N(%) was also compared with the percentage of fatty hepatocytes at histology.

Results: The relaxation rate R1 of liver measured from the magnitude image, and the difference in the value of MTC measured from the water image compared with the one measured from the fat and water magnitude image, both depended linearly on the value of N(%). The value of N(%) correlated significantly with the percentage of the fatty hepatocytes. In in vivo fatty tissue, fat infiltration increased both the observed relaxation rate R1 and the measured magnetisation ratio (the steady state magnetisation Ms divided by the equilibrium magnetisation Mo, Ms/Mo) and consequently decreased the MT efficiency measured in a magnitude MR image. The amount of liver fibrosis did not correlate with the value of MTC measured after fat separation.

Conclusion: Our results in studying fatty livers with MR imaging and the MT method show that the fat/water separation gives more reliable parametric results. Characterisation of liver cirrhosis by means of the MTC parameter is not reliable, even after fat separation.
Single-shot diffusion-weighted echo-planar imaging of normal and cirrhotic livers using a phased-array multicoil
Authors: Amano Y. , Kumazaki T. , Ishihara M.
Published: January 2010

Single-shot spin-echo diffusion-weighted echo-planar imaging using a phased-array multicoil was performed to distinguish between normal and cirrhotic livers. Sets of 6 images with different b-values were acquired with breathholding. Significant differences were observed between controls and cirrhosis cases in the signal ratios when the b-value was 383 s/mm2, and apparent diffusion coefficients.
Hepatocellular carcinomas supplied by inferior phrenic arteries
Authors: Tanabe N. , Iwasaki T. , Chida N. , Suzuki S. , Akahane T. , Kobayashi N. , Ishii M. , Toyota T.
Published: January 2010

Purpose: To assess the arterial supply to hepatocellular carcinomas (HCCs) by inferior phrenic arteries (IPA).

Material and Methods: A total of 126 consecutive cases of HCC were studied by contrast-enhanced CT and conventional arteriography. Blood supply from an IPA was suspected when the size of the HCC mass as seen on contrast-enhanced CT did not match the size of the tumor mass as seen on hepatic arteriography. Inferior phrenic arteriography was employed to confirm these findings. HCCs fed by the IPA were analyzed in terms of size, location, and history of prior treatment.

Results: In 14 (11%) of the 126 cases, the tumor was found to have a blood supply from an IPA. Eleven of these tumors were located in segments 2 and 7. Three tumors, which had not been treated previously, had a blood supply from an IPA. Six tumors were almost exclusively fed by an IPA and were located in segments 7, 1, and 4.

Conclusion: HCCs located in segments which form the bare area of the liver (S1, S2, S7) can be supplied by an IPA. This should be suspected when a lesion or part of a lesion is identified on contrast-enhanced CT but not on hepatic arteriography.
Differentiating Benign and Malignant Breast Lesions with T2*-Weighted First Pass Perfusion Imaging
Authors: Kvistad K. A. , Lundgren S. , Fjøne H. E. , Smenes E. , Smethurst H.-B. , Haraldseth O.
Published: January 2010

Purpose: Invasive breast carcinomas and fibroadenomas are often difficult to differentiate in dynamic contrast-enhanced T1-weighted MR imaging of the breast, because both tumors can enhance strongly after contrast injection. The purpose of this study was to evaluate whether the addition of T2*-weighted first pass perfusion imaging can increase the differentiation of malignant from benign lesions.

Material and Methods: Nine patients with invasive carcinomas and 10 patients with contrast enhancing fibroadenomas were examined by a dynamic contrast-enhanced T1-weighted 3D sequence immediately followed by a single slice T2*-weighted first pass perfusion sequence positioned in the contrast-enhancing lesion.

Results: The carcinomas and the fibroadenomas were impossible to differentiate based on the contrast enhancement characteristics in the T1-weighted sequence. The signal loss in the T2*-weighted perfusion sequence was significantly stronger in the carcinomas than in the fibroadenomas ( p=0.0004).

Conclusion: Addition of a T2*-weighted first pass perfusion sequence with a high temporal resolution can probably increase the differentiation of fibroadenomas from invasive carcinomas in contrast-enhanced MR imaging of the breast.
MR Imaging of Lipoma and Liposarcoma
Authors: Einarsdottir H. , Söderlund V. , Larson O. , Jenner G. , Bauer H. C. F.
Published: January 2010

Purpose: To evaluate whether lipoma, atypical lipomatous tumors, and lipo-sarcomas can be differentiated by MR images.

Material and Methods: The MR images of 59 lipomatous lesions and liposarcomas were retrospectively reviewed. Apart from size, surgical site, location and margins, the percentage of fat of the tumor volume was assessed as none, 1-75%, 75-95%, or 95-100%.

Results: None of the 18 liposarcomas contained fat that could be recognized by MR imaging. The 3 atypical lipomatous tumors all contained fat but less than 75% of the tumor volume. In 32 of 38 ordinary lipomas, the percentage of fat was 95-100%, and in 4 less than 95% of the tumor volume. Two lipomas did not contain fat that could be recognized by MR imaging.

Conclusion: A lesion which predominantly has a fat signal is, in all probability, an ordinary lipoma. Lesions with less fat, but still mostly fatty, may either be lipoma or atypical lipomatous tumor. In this group, the discrimination between these two entities cannot be based upon imaging features. In the absence of a fat signal, liposarcoma or lipoma cannot be differentiated from other soft tissue tumors.
Muscle Metabolism of Professional Athletes using 31P-Spectroscopy
Authors: Mäurer J. , Konstanczak P. , Söllner O. , Ehrenstein T. , Knollmann F. , Wolff R. , Vogl T. J. , Felix R.
Published: January 2010

Purpose: The aim of the study was to examine muscle metabolism in athletes by 31P-spectroscopy (MRS) and to evaluate to what degree the respective resonance spectrum correlates with the kind of muscle exercise.

Material and Methods: Twelve runners and 12 young ice skaters were studied by 31P-spectroscopy of the gastrocnemic medialis muscle and the vastus medialis muscle using a surface coil at 1.5 T.

Results: Sprinters displayed a higher phosphocreatinine/inorganic phosphate (PCr/Pi) and PCr/β-ATP ratios than marathon runners. The respective parameters for middle distance runners were in between. Ice skaters could pro-spectively be divided into sprint-and long-distance runners by our results which correlated with the athletes' training performance.

Conclusion:31P-spectroscopy can evaluate the distribution of muscle fiber types. Thus, the athlete's potential for sprint- or long-distance running can be determined. Additional studies will have to demonstrate to what extent training may change muscle fiber distribution.
MR Findings in Primary Retroperitoneal Schwannoma
Authors: Hayasaka K. , Tanaka Y. , Soeda S. , Huppert P. , Claussen C. D.
Published: January 2010

Objective: To evaluate the MR findings in primary retroperitoneal schwannoma.

Material and Methods: Seven cases of primary retroperitoneal schwannoma, in whom the diagnosis was confirmed histopathologically, were analyzed retrospectively. The following items were reviewed at MR imaging: tumor diameter, margin, homogeneity, signal intensity as compared to normal renal parenchyma, presence/absence of infiltration into adjacent organs, and, in 1 and 4 cases, the enhancement on Gd-dynamic images and post-contrast T1-weighted images, respectively.

Results: Tumor diameter was 5.5 ± 3.1 cm, ranging from 2.5 to 10 cm in the 6 benign schwannomas, and 12 cm in 1 malignant. The tumor margin was regular in all of the benign cases and irregular in the malignant one. The malignant case showed infiltration into the liver and duodenum. Four of the benign schwannomas showed a homogeneous, and 2 presented a heterogeneous pattern, while the malignant schwannoma was heterogeneous. On T1-weighted images, the benign schwannomas were hypointense in 4 cases, isointense in 1 and mixed in 1, while on T2-weighted images, they were hyperintense in 5 and mixed in 1. The malignant case showed mixed intensity on both T1- and T2-weighted images. On enhanced T1-weighted images, capsular, septal enhancement was noted in 2 cases, overall enhancement in 2, and, on Gd-dynamic images, late enhancement was shown.

Conclusion: On MR imaging, primary retroperitoneal schwannomas show different signal intensity characteristics, including cystic degeneration. There are, however, no specific characteristics of these tumors.
Correlation of Angiography and MR Imaging in Cerebral Vasculitis
Authors: Cloft H. J. , Phillips C. D. , Dix J. E. , McNulty B. C. , Zagardo M. T. , Kallmes D. F.
Published: January 2010

Purpose: MR imaging and cerebral angiography were correlated in patients with primary angiitis of the central nervous system (PACNS) to assess the relative roles of these imaging modalities in the diagnosis.

Material and Methods: In 9 patients, MR imaging and angiography were compared with regard to the relative involvement of each major vascular territory. Vascular territories assessed were the anterior, middle, and posterior cerebral arteries, and the posterior fossa.

Results: All patients had angiographic findings consistent with vasculitis in multiple vascular territories. MR findings ranged from normal to diffusely abnormal. One patient had a completely normal MR investigation. of 50 territories affected by vasculitis on angiography, 17 (34%) were normal on MR.

Conclusion: Relative to cerebral angiography, MR imaging is a poor indicator of the presence or absence of PACNS. Angiography is indicated when clinical suspicion of PACNS is strong, regardless of the findings on MR.
MR Myelography of Sacral Meningeal Cysts
Authors: Tsuchiya K. , Katase S. , Hachiya J.
Published: January 2010

Purpose: To describe the findings of sacral meningeal cysts (SMCs) on MR myelography and assess its value for the diagnosis of SMCs.

Material and Methods: We evaluated the MR images and MR myelograms obtained from 10 patients with SMC. MR myelograms were obtained using a 2D or 3D single-shot fast spin-echo sequence. In 5 patients, X-ray myelograms and postmyelographic CT images were compared with the MR myelograms.

Results: A total of 33 SMCs were diagnosed within the spinal canal and/or sacral foramen. MR myelograms clearly revealed each cyst as a well-defined mass showing hyperintensity (10 cysts) or isointensity (23 cysts) compared to cerebrospinal fluid. MR myelograms demonstrated SMCs better than X-ray myelograms and postmyelographic CT images in 3 of the 5 patients.

Conclusion: MR myelography can be an adjunct to conventional imaging techniques when surgical treatment is indicated, because it can precisely delineate the extent of SMCs.
Transcatheter Adrenal Arterial Embolization of Cortisol-Producing Tumors
Authors: Ueno K. , Nakajo M. , Miyazono N. , Inoue H. , Nishida H. , Tsuchimochi S. , Hokotate H. , Niwatsukino H.
Published: January 2010

Transcatheter arterial embolization (TAE) was performed in 2 patients with Cushing's syndrome caused by adrenal adenoma by using a mixture of absolute ethanol and iohexol. In 1 patient successful suppression of the hypersecretion of cortisol has continued for 9 months after TAE without complications. However, in the other patient, TAE was discontinued due to marked hypertension and tachycardia induced by a massive release of catecholamines from the embolized “normal” part of the tumor-bearing adrenal gland during the procedure. These results suggest that it is important to perform TAE of only the arterial branches feeding the tumor.
Accessory Wandering Spleen Associated with Short Pancreas
Authors: Kaniklides C. , Wester T. , Olsen L.
Published: January 2010

We present an extremely rare case of a 5-year-old girl with short pancreas associated with three accessory spleens, one of which was a large wandering spleen. The diagnosis was established by US and CT. A large accessory wandering spleen is considered to be at risk of torsion and infarction as well as susceptible to abdominal trauma. The authors discuss the difficulty of establishing the diagnosis and underline the importance of US and CT as pre-operative diagnostic tools.
Clinical Practice Guidelines for the Management of Cryptococcal Disease: 2010 Update by the Infectious Diseases Society of America
Authors: Perfect John R. , Dismukes William E. , Dromer Francoise , Goldman David L. , Graybill John R. , Hamill Richard J. , Harrison Thomas S. , Larsen Robert A. , Lortholary Olivier , Nguyen Minh-Hong , Pappas Peter G. , Powderly William G. , Singh Nina , Sobel Jack D. , Sorrell Tania C.
Published: January 2010

Cryptococcosis is a global invasive mycosis associated with significant morbidity and mortality. These guidelines for its management have been built on the previous Infectious Diseases Society of America guidelines from 2000 and include new sections. There is a discussion of the management of cryptococcal meningoencephalitis in 3 risk groups: (1) human immunodeficiency virus (HIV)–infected individuals, (2) organ transplant recipients, and (3) non–HIV-infected and nontransplant hosts. There are specific recommendations for other unique risk populations, such as children, pregnant women, persons in resource-limited environments, and those with Cryptococcus gattii infection. Recommendations for management also include other sites of infection, including strategies for pulmonary cryptococcosis. Emphasis has been placed on potential complications in management of cryptococcal infection, including increased intracranial pressure, immune reconstitution inflammatory syndrome (IRIS), drug resistance, and cryptococcomas. Three key management principles have been articulated: (1) induction therapy for meningoencephalitis using fungicidal regimens, such as a polyene and flucytosine, followed by suppressive regimens using fluconazole; (2) importance of early recognition and treatment of increased intracranial pressure and/or IRIS; and (3) the use of lipid formulations of amphotericin B regimens in patients with renal impairment. Cryptococcosis remains a challenging management issue, with little new drug development or recent definitive studies. However, if the diagnosis is made early, if clinicians adhere to the basic principles of these guidelines, and if the underlying disease is controlled, then cryptococcosis can be managed successfully in the vast majority of patients.
A Tale of Mother and Daughter
Authors: Yamashita Yukiko M.
Published: January 2010

Loving science and nature and being a scientist can be very different, yet the two are so intertwined in a scientist's life that you will certainly experience both aspects. This essay presents my perspective on how, as one who loves science and nature, I came to fall in love with centrosome behavior in stem cells and how I came to run a lab as a scientist. When I started, there was a big gap between my love for science and my experience as a scientist. I filled this gap by learning a “laid-back confidence.”
It's a Wonderful Life: A Career as an Academic Scientist
Authors: Vale Ronald D.
Published: January 2010

Many years of training are required to obtain a job as an academic scientist. Is this investment of time and effort worthwhile? My answer is a resounding “yes.” Academic scientists enjoy tremendous freedom in choosing their research and career path, experience unusual camaraderie in their lab, school, and international community, and can contribute to and enjoy being part of this historical era of biological discovery. In this essay, I further elaborate by listing my top ten reasons why an academic job is a desirable career for young people who are interested in the life sciences.