bluuebunny/crossref_metadata_2025 huggingface dataset:
Radioimmunoscintigraphy of Gynecologic Tumors with 131I-Labeled Anti-Plap Monoclonal Antibodies
Authors: Riklund K. E. , Edbom G. , Makiya R. , Johansson B. , Gerdes U. , Hietala S.-O. , Ekelund L. , Stigbrand T. , Stendahl U.
Published: June 2015

Radioimmunoscintigraphy (RIS) was performed in 20 patients with gynecologic tumors, 14 ovarian, 5 cervical, and one endometrial carcinoma. One murine monoclonal antibody (mab) against placental alkaline phosphatase (H7) was used after radiolabeling with 131I. The labeling procedure yielded antibodies with specific activity varying between 60 and 73 MBq/mg mab. Each patient received 57 to 100 MBq of the preparation. RIS was performed 7 to 35 days later. Patients with ovarian adenocarcinoma had an accumulation of activity on RIS at tumor sites (79%, 11/14) verified by ultrasonography, CT, and clinical examination. A low or absent accumulation of activity was seen in patients with cervical tumors. The patient with an endometrial adenocarcinoma was seen to have an activity accumulation at RIS corresponding to tumor sites determined by ultrasound and/or CT. It is concluded that RIS using monoclonal antibodies against placental alkaline phosphatase can provide information which will supplement that gained from other investigations of patients with ovarian adenocarcinomas.
Radiographic Grading of Extrinsic Allergic Alveolitis
Authors: Jaakkola J. , Partanen K. , Terho E. O. , Niemitukia L. , Soimakallio S.
Published: June 2015

We analyzed the acute phase radiographs of 107 consecutive patients with clinically confirmed extrinsic allergic alveolitis. Three readers independently recorded the profusion and the type of opacities according to the standard ILO criteria extended with categories x, y, z, and ground glass for description as proposed by McLoud et al. (20). The profusion of the changes was grade 0 in 13%, grade 1 in 37%, grade 2 in 35%, and grade 3 in 15% of the interpretations. The type of predominant small opacities was p in 33%, x in 22%, s in 13%, t in 10%, q in 9%, and 0, r, u, y, and z in 13% of the interpretations. Ground glass density was seen in 8% of the recordings. The changes were predominantly located in the middle and lower lung zones. For comparison, according to the classification of Hapke et al. (15), miliary changes (68%) predominated over fibrotic (27%) and normal (11%) recordings. The intraobserver agreement was good by both methods, but there was less interobserver variation with the ILO method. The semiquantitative standardized modified ILO scheme was considered more informative than Hapke's descriptive classification for epidemiologic and research purposes.
Precision of Hyaline Cartilage Thickness Measurements
Authors: Jonsson K. , Buckwalter K. , Helvie M. , Niklason L. , Martel W.
Published: June 2015

Measurement of cartilage thickness in vivo is an important indicator of the status of a joint as the various degenerative and inflammatory arthritides directly affect the condition of the cartilage. In order to assess the precision of thickness measurements of hyaline articular cartilage, we undertook a pilot study using MR imaging, plain radiography, and ultrasonography (US). We measured the cartilage of the hip and knee joints in 10 persons (4 healthy volunteers and 6 patients). The joints in each patient were examined on two separate occasions using each modality. In the hips as well as the knee joints, the most precise measuring method was plain film radiography. For radiographs of the knees obtained in the standing position, the coefficient of variation was 6.5%; in the hips this figure was 6.34%. US of the knees and MR imaging of the hips were the second best modalities in the measurement of cartilage thickness. In addition, MR imaging enabled the most complete visualization of the joint cartilage.
Level of Plasma Prekallikrein and its Inhibitors in Reactors and Nonreactors during Intravenous Enhancement with Contrast Media
Authors: Aronen H. J. , Kivisaari L. , Torstila I. , Paavonen T. , Meri S. , Karonen S.-L. , Standertskjöld-Nordenstam C.-G.
Published: June 2015

Complex contact activation systems may play a major role in the side effects of i.v. contrast media (CM). This is why quantitative measurements of several factors (plasma prekallikrein, hematocrit (hct), α-2-macroglobulin, α-1-antitrypsin, and C1-esterase inhibitor) were determined prior to and following the injection of CM during body CT examination in 5 patient groups, each (n = 10) receiving one of 5 different CM, including ioxaglate, meglumine iodamide, metrizamide, iohexol, and meglumine diatrizoate. The initial plasma prekallikrein level was available from 45 patients and was statistically lower in reactors (mean 90.6 μmol TAMe/ml/h; n = 13) than in nonreactors (mean 107 μmol TAMe/ml/h; n = 32) (p = 0.006), but there was no statistically significant difference in the decrease of plasma prekallikrein before and at 5 min after the injection for those 2 groups. The initial plasma C1-esterase inhibitor level was lower in reactors, while the plasma α-2-macroglobulin level was higher in that group than in nonreactors. The results indicate that the measurement of plasma prekallikrein combined with plasma C1-esterase inhibitor and α-2-macroglobulin measurement could be useful when predicting which patients are prone to CM reactions.
Bedside Chest Radiography Using Digital Luminescence
Authors: Lyttkens K. , Andersson B. , Kehler M. , Lindberg L.
Published: June 2015

The introduction of picture and archiving communicating systems is currently being evaluated in several institutions. We decided, as an intermediate step, to see if image quality after transferral to a personal computer (PC) is sufficient for the diagnostic needs in an intensive care unit. Seventy-five portable digital chest radiographs were studied both as hard-copies and on a monitor after transferral to a PC. Two chest radiologists and one anesthesiologist reviewed the examinations. Our intention was to evaluate if everything that is routinely checked by the anesthesiologist is demonstrable after electronic transfer to a local workstation. We found practically no difference between the performance of monitor and film for the whole material.
Polyetiology of Renal Allograft Dysfunction
Authors: Mallek R. , Mostbeck G. H. , Kain R. , Sunder-Plassmann G. , Helbich T. , Tscholakoff D.
Published: June 2015

In 101 consecutive patients with renal allograft dysfunction a correlation of Duplex Doppler sonography (DDS) with histopathologic reports of simultaneously performed biopsies was made. Renal vascular impedance was estimated by calculating the resistive index (RI). A total of 290 different specific histologic diagnoses (mean 2.1 ± 0.84 diagnoses/biopsy) was noted. With increasing time interval to transplantation, single diagnoses as cause of allograft dysfunction decreased. DDS could not reliably differentiate, exclude, or grade any of the common causes of renal allograft dysfunction like vascular and/or cellular rejection, chronic rejection, acute tubular necrosis, cyclosporin nephrotoxicity, relapse of glomerulonephritis and infection. Follow-up studies after established histologic diagnosis in 19 patients with persisting allograft dysfunction demonstrated a lack of sensitivity of DDS to significant superimposed causes of transplant malfunction. We conclude that biopsy is still necessary to direct proper therapy of renal allograft dysfunction.
Radiographic Assessment of Coxarthrosis following Slipped Capital Femoral Epiphysis
Authors: Hansson G. , Jerre R. , Sanders S. M. , Wallin J.
Published: June 2015

In all, 108 patients (151 hips) previously treated for slipped capital femoral epiphysis (SCFE), were evaluated radiographically for assessment of coxarthrosis at an average age of 47 years. Five projections were obtained of each hip (supine a.p., supine modified frog lateral, standing a.p., standing anterolateral oblique, and standing posterolateral oblique) and the superior, anterior, and posterior joint space heights were measured (abnormal: superior ≤ 3.0 mm and/or anterior and/or posterior ≤ 2.5 mm). Sixty-three hips (42%) had joint space narrowing in at least one projection. The standing a.p. and 2 lateral oblique views identified 54 hips as abnormal, and the supine a.p. and modified frog lateral views uncovered an additional 9. The supine a.p. view was the least helpful; 12 abnormal hips on the standing a.p. view were normal on the supine a.p. view. Isolated narrowing in the anterior and/or posterior joint space was found in 9 hips (6%). These changes could only be assessed by the 2 lateral oblique views. Our results illustrate that a combination of standing radiographs, visualising the circumference of the articular space of the hip joint, and modified frog lateral projections is necessary to fully identify coxarthrosis in hips previously treated for SCFE.
Endothelial Influence on Vessel Wall Induced Vasospasm after Balloon Angioplasty
Authors: Mattsson E. , Jansen I. , Edvinsson L. , Bergqvist D.
Published: June 2015

Aortic segments from 47 New Zealand rabbits were used, of which 14 were denuded of endothelium. Balloon angioplasty was performed on the aortic segments in vitro. The inner surfaces were perfused and the perfusates then given to vessel segments with or without endothelium. The contraction evoked was then counteracted by adding either vasoactive intestinal polypeptide (VIP), substance P (SP), acetylcholine (ACh), or nitroglycerin (NTG) in increasing concentrations. Perfusates from aortic segments with or without endothelium and previously treated with angioplasty induced vasoconstriction of similar magnitude in the segments used for vasomotor investigation irrespective of whether the endothelium was intact in these or not. Endothelial dependent dilators (ACh, SP) did not counteract the contraction whereas endothelial independent dilators did (NTG, VIP). Neither the induction nor the reversal of vessel wall induced vasoconstriction after balloon angioplasty seems to depend on the presence of endothelial cells.
Chest Imaging with Dual-Energy Subtraction Digital Tomosynthesis
Authors: Sone S. , Kasuga T. , Sakai F. , Hirano H. , Kubo K. , Morimoto M. , Takemura K. , Hosoba M.
Published: June 2015

Dual-energy subtraction digital tomosynthesis with pulsed X-ray and rapid kV switching was used to examine calcifications in pulmonary lesions. The digital tomosynthesis system used included a conventional fluororadiographic TV unit with linear tomographic capabilities, a high resolution videocamera, and an image processing unit. Low-voltage, high-voltage, and soft tissue subtracted or bone subtracted tomograms of any desired layer height were reconstructed from the image data acquired during a single tomographic swing. Calcifications, as well as their characteristics and distribution in pulmonary lesions, were clearly shown. The images also permitted discrimination of calcifications from dense fibrotic lesions. This technique was effective in demonstrating calcifications together with a solitary mass or disseminated nodules.
Percutaneous Catheter Drainage of Tuberculous Psoas Abscesses
Authors: Pombo F. , Martín-Egaña R. , Cela A. , Díaz J. L. , Linares-Mondéjar P. , Freire M.
Published: June 2015

Six patients with 7 tuberculous psoas or ilio-psoas abscesses were treated by CT-guided catheter drainage and chemotherapy. The abscesses (5 unilateral and 1 bilateral) were completely drained using a posterior or lateral approach. The abscess volume was 70 to 700 ml (mean 300 ml) and the duration of drainage 5 to 11 days (mean 7 days). Immediate local symptomatic improvement was achieved in all patients, and there were no procedural complications. CT follow-up at 3 to 9 months showed normalization in 5 patients, 2 of whom are still on medical therapy. One patient, who did not take the medication regularly, had a recurrent abscess requiring new catheter drainage after which the fluid collection disappeared. Percutaneous drainage represents an efficient and attractive alternative to surgical drainage as a supplement to medical therapy in the management of patients with large tuberculous psoas abscesses.
Microangiography — A Sensitive Method for Studying Experimental Diabetic Nephropathy
Authors: Merikanto J. , Hietala S.-O. , Lithner F. , Hägg E. , Päivänsalo M.
Published: June 2015

Microangiographic and conventional histopathologic investigations of the kidney were compared in 15 alloxan diabetic and 7 nondiabetic control rats. Contrary to the relatively sparse histologic lesions, microangiography disclosed advanced vascular abnormalities, including arteriolar aneurysms, which increased with the duration of diabetes. It is concluded that microangiography is a sensitive and suitable method for studying the development of microvascular lesions of the kidney in experimental diabetes.
Hemodynamic Effects of Gadodiamide Injection and Gadopentetate Dimeglumine in Anesthetized Dogs
Authors: Peters J. L. , Shaw D. D.
Published: June 2015

A nonionic (gadodiamide injection) and an ionic (gadopentetate dimeglumine) contrast medium were compared for their effect on hemodynamics in the anesthetized, open-chest dog. Both agents were administered i.v. over 15 s at dosages of 1.0 and 1.5 mmol/kg, in randomized order. Both contrast agents resulted in transient but statistically significant decreases in aortic pressure, left ventricular pressure, indices of left ventricular contractility and relaxation, and systemic and pulmonary vascular resistance, and increases in aortic blood flow. At each dosage investigated, the changes associated with the administration of gadodiamide injection were of significantly smaller magnitude than those seen after gadopentetate dimeglumine and returned to preadministration levels sooner. The results from this study confirm that gadodiamide injection produces less severe alterations in hemodynamics than gadopentetate dimeglumine.
In Vivo Fluorescence Microscopy of Microcirculation in the Renal Cortex of Mice
Authors: Högström B. , Hietala S.-O. , Rooth P.
Published: June 2015

In vivo fluorescence microscopy was used in experimental studies of renal cortical microcirculation in mice. The effects of i.v. infusions of mannitol and iohexol were studied in normal and obese/hyperglycemic mice and in mice with streptozotocin-induced diabetes mellitus. All infusions produced marked effects on the distribution and velocity of cortical blood flow with no differences between iohexol and mannitol. The renal cortical blood flow was inhomogeneous regarding different capillaries and there was an initial rise in the number of capillaries with increased blood flow after infusions of both mannitol and iohexol. The infusions of contrast medium were initially followed by a significantly larger number of capillaries with decreased blood flow in the obese/hyperglycemic mice (p < 0.05) than in the diabetic and nondiabetic mice. The variations in obese/hyperglycemic groups were, however, large. The effects were the same in normal and diabetic animals.
CT and Chest Radiography in the Evaluation of Adult Respiratory Distress Syndrome
Authors: Tagliabue M. , Casella T. C. , Zincone G. E. , Fumagalli R. , Salvini E.
Published: June 2015

CT is seldom employed in adult respiratory distress syndrome (ARDS), mostly due to problems in transporting and monitoring these severely ill patients. We reviewed the findings of 74 ARDS patients who underwent chest CT. Lung opacities were bilateral in almost all patients and dependent in most cases (86%). The opacities were patchy (42%), homogeneous (23%), ground glass (8%) or mixed (27%). Opacities prevailed in basal regions (68%) compared to hilar and apical ones. Air bronchograms were frequently seen in areas of consolidation (89%). In contrast with previous reports, pleural effusion was a frequent finding (50%) that did not worsen prognosis. Often loculated pneumothorax (32%) was mostly anteromedial. Ineffective position of thoracostomy tubes was detected at CT in 13/20 patients. Pulmonary air cysts (30%>), always multiple and mostly bilateral, were associated with a higher mortality (55%) than that of the whole study group (35%). Compared to chest radiographs, CT often yielded additional information (66%), with direct influence on patient treatment in 22% of cases.
Paraesophageal Varices Presenting as a Retrocardiac Mediastinal Mass
Authors: Nyman R. , von Sinner W. , Mygind T. , Kagevi I.
Published: June 2015

This report is a reminder that portal hypertension with paraesophageal varices can present as a retrocardiac mass on the chest radiograph. Schistosoma mansoni, the probable etiology in this case, causes periportal fibrosis and is the most common explanation for portal hypertension worldwide. Modern imaging techniques were most helpful in the diagnostic work-up, ultrasonography revealing pathognomonic hyperechoic periportal bands, and CT and MR imaging showing the extent of collaterals.
Mr Imaging of Edematous Limbs in Lymphatic and Nonlymphatic Edema
Authors: Fujii K.
Published: June 2015

MR imaging reflects the water content of various tissues. To evaluate the role of MR imaging in the diagnosis of edema, various types of edema were examined with MR imaging. MR imaging of edematous limbs was performed on 60 patients (lymphatic edema 48, nonlymphatic edema 12) using T1- and T2-weighted spin-echo and short inversion time inversion recovery sequences. Thickness and signal intensity of the cutis, subcutis and subfascia were evaluated in the images. In all 48 cases with lymphatic edema, trabecular structures suggesting dilated collateral lymphatic vessels were observed in the swollen subcutis. Two cases with nephrotic syndrome showed similar findings. In 6 cases with venous edema, fatty intensity was found in the subfascia. In the remaining 4 cases, the subcutis exhibited only water intensity. MR imaging is a potential contributor to the diagnosis of various edematous diseases.
Evaluation of Lipomatous Soft Tissue Tumors by MR Imaging
Authors: Gelineck J. , Keller J. , Jensen O. Myhre , Nielsen O. Steen , Christensen T.
Published: June 2015

Large soft tissue tumors — 5 cm or greater — or deep-seated tumors have a greater risk of being malignant than smaller and superficially located tumors (9). In a period of 2 years 43 consecutive patients with lipomatous tumors 5 cm in diameter or greater were examined with MR imaging. The MR findings were correlated to histologic features and diagnosis. Twenty-six tumors were classic lipomas both on MR and at microscopy; 8 lipomas showed other features — some of them raising suspicion of malignancy at MR; all, however, were histologically benign. Nine tumors were considered malignant at MR imaging; all 9 proved to be malignant by microscopy.
Simultaneous Urography and Determination of Glomerular Filtration Rate
Authors: Lundqvist S. , Hietala S.-O. , Berglund C. , Karp K.
Published: June 2015

The total plasma clearance of iohexol at urography and51Cr-EDTA was compared in 31 patients with di- or tetraparesis. A reference51Cr-EDTA clearance was also performed 24 hours prior to the urography. The GFR was calculated from one, 2 or 4 plasma samples collected 180, 210, 240 and 270 min after the injection. An X-ray fluorescence analyzer was used for the analysis of iohexol in plasma as well as the contrast medium clearance calculations. It was shown that single or multiple sample clearance of iohexol and51Cr-EDTA were equivalent methods for measurement of the GFR. The GFR was not affected by iohexol in a dose routinely used for urography. It was concluded that the patient comfort is improved if51Cr-EDTA clearance is replaced by contrast medium clearance in association with urography.
Ultrasound or CT in Splenic Diseases?
Authors: Siniluoto T. M. J. , Tikkakoski T. A. , Lähde S. T. , Päivänsalo M. J. , Koivisto M. J.
Published: June 2015

To compare the value of US and CT for the detection and analysis of splenic abnormalities, we reviewed the medical records and imaging findings of 93 patients with 93 proven textural lesions of the spleen, which were visualized by US and/or CT. US revealed the abnormality in 91 (97.8%) patients and CT in 74 (79.6%) patients. US was more sensitive than CT in the detection of malignant lesions, particularly splenic lymphoma, while US and CT were equally effective in benign lesions. In 2 patients, one with sarcoidosis and the other with an acute infarct, the lesion was visualized by CT but not by US. On CT, i.v. injection of contrast material improved both the sensitivity of the examination and the delineation of the abnormality. The echogenicity or the attenuation of the lesions did not usually allow differentiation between the various benign and malignant splenic lesions. US is recommended as the method of choice for splenic imaging.
Multiple Bile Duct Hamartomas: US, CT, and MR Findings
Authors: Gallego J. C. , Suarez I. , Soler R.
Published: June 2015

We report ultrasound, CT and MR findings in a patient with multiple bile duct hamartomas (BDH) which were associated with disseminated peritoneal leiomyomatosis, a coincidence not previously reported. At MR imaging, the multiple hepatic nodules of BDH were hypointense in T1-weighted images and moderately hyperintense in T2-weighted images, which is in agreement with the findings in the 2 previously reported cases examined with this modality.
Ultrasound-Guided Renal Biopsy with Biopsy Gun Technique — Efficacy and Complications
Authors: Christensen J. , Lindequist S. , Knudsen D. Ulrik , Pedersen R. Smith
Published: June 2015

One hundred and thirty-one ultrasound-guided renal biopsies performed in 127 patients with automated spring-loaded biopsy technique were evaluated. Adequate tissue for histologic diagnosis was obtained in 92% of the procedures (94% of the patients). The mean glomerular yield was 16.8 glomeruli. Complications were seen in 21% of the patients, 18% having minor and 3% having major complications. Patients with severe hypertension had significantly more complications than the rest of the patients. The rate of complications in patients who had 3 or 4 biopsy passes was not increased compared to patients who had one or 2 biopsy passes. Thus, this study indicates that the risk of complications and the safety of the procedure is not influenced by increasing the number of biopsy passes in order to obtain representative specimens.
Differentiation between Contained and Noncontained Lumbar Disk Hernias by CT and MR Imaging
Authors: Dullerud R. , Johansen J. G. , Johnsen U. L.-H. , Magnæs B.
Published: June 2015

Aims:

The investigation was carried out in order to compare the accuracy of CT and MR imaging in depicting whether disk hernias were contained by the posterior longitudinal ligament (PLL). This is crucial in the evaluation of patients who are possible candidates for percutaneous nucleotomy, which is considered effective only in contained hernias.

Results:

Of 124 pathologic disks examined in 114 patients, CT was more accurate than MR imaging in 7 patients due to misinterpretation of the integrity of the PLL by MR. These hernias were therefore erroneously classified as noncontained. There was consistency between the classification by CT and MR imaging in the other 117 disks, of which 109 were correct. Both methods overstaged a large hernia that was contained by the PLL, and failed to demonstrate that 7 others were noncontained.

Conclusions:

CT, which has higher sensitivity in depicting calcifications, representing further contraindications to percutaneous nucleotomy, is therefore recommended as the primary examination in these patients. Additional MR imaging should be considered if the results of CT are equivocal or at variance with the clinical presentation.
CT-Diskography in Patients with Sciatica
Authors: Dullerud R. , Johansen J. G.
Published: June 2015

Aims:

The findings at CT-diskography (CT-D), including recording of the pain introduced at contrast injection, were compared with plain CT and MR imaging in 111 disks in 101 patients aged 18 to 68 years.

Results:

Six disks which were normal at CT had normal CT-D and 5 of them had normal signal on MR imaging. The degree of annular degeneration and the depth of the annular tears were significantly associated with each other and with loss of disk height, but not with size or location of the hernias. Only the depth of the tears was significantly associated with loss of signal on MR. However, frequently complete annular tears and severe annular degeneration were seen in association with small bulges and hernias, even in disks with normal or slightly reduced signal on MR and with normal height. The type and intensity of the pain introduced were associated with each other and with the depth of the annular tears, but not with the degree of annular degeneration, size of the hernia or the MR signal intensity of the disks.

Conclusions:

Annular degeneration and tears on one hand, and the type and intensity of pain introduced on the other, seem to be related rather than separate phenomena.
Deuterium MRin VivoImaging of the Rat Eye Using 2H2O
Authors: Obata T. , Ikehira H. , Shishido F. , Fukuda N. , Ueshima Y. , Koga M. , Kato H. , Kimura F. , Tateno Y.
Published: June 2015

In vivo euterium MR imaging (2H MR) was investigated in rats after intraperitoneal administration of deuterated saline, and a dynamic study of the water movement in rat eyes was performed. Deuterium MR imaging was carried out by means of a gradient-echo (GRE) and a spin-echo (SE) pulse sequence. The rat eye was imaged in2H MR more selectively by SE than by GRE, but a lower signal-to-noise ratio was obtained in2H MR imaging using the SE sequence. The MR signal intensity of the rat eye was followed by a 3-compartment model, which enabled determination of the flow rate constant of the water in the eye (0.359/min). Deuterium MR imaging is useful to visualize the dynamic change of water in rat eyes using2H MR at the same magnetic field (2 T) that can also be used for conventional MR imaging in humans.
Efficient Memory Management Strategy in Hypermedia with Interactive MR Images
Authors: Bondestam S. , Lamminen A. E. , Aronen H. J.
Published: June 2015

When composing hypermedia with interactive image sets the main problem is to allocate minimal memory of random access memory (RAM). The stand-alone product should be accessible to the public and not require too much memory to maintain interaction between the images and the text. We designed a new hypermedia application using SuperCard and image stacks in PICS format running on a Macintosh LC computer. Memory use was effective since the images were kept in external files outside the application. On browsing cards the images were requested from the image file and each image was displayed within about 1 second as a floating frame on top of the card in the top window. Interactivity when presenting, for example, anatomical parts was achieved by bitmap objects which were activated through the image by pointing at them through the image. By pointing at a text object the corresponding anatomical bitmap object was visualised through the image. The stand-alone version of the application with up to 100 cards runs on a 2 Mb RAM set-up. The maximum sizes of the external image stacks are not dependent on the RAM size.
Radiation Dose Reduction in Computed Skeletal Radiography
Authors: Jónsson Á. , Herrlin K. , Jonsson K. , Lundin B. , Sanfridsson J. , Pettersson H.
Published: June 2015

Purpose:

To evaluate the effect of radiation dose reduction on image quality in computed musculoskeletal radiography and determine optimal exposure range.

Material and Methods:

In 11 corpses, 1 hand and 1 hip were examined with film-screen radiography, and a series of computed radiographs was obtained using exactly the same technique except for the exposure, which was 100, 50, 25, 12.5, 6.25, and 1.56% of the mAs numbers used for the film-screen images. The computed hip radiographs were processed in 2 different ways, one simulating the film-screen images and one using contrast enhancement. Four radiologists reviewed the images regarding the following parameters: cortical bone, trabecular bone, joint space, and soft tissue, giving each a diagnostic quality rating on a scale from 1 to 5. The median and mean values were found for the pooled results.

Results:

For the hands, the computed radiographs were ranked inferior to the film-screen images for all parameters except soft tissue, where the computed radiographs scored higher. The computed images with 50 and 25% exposure were ranked equal to the 100% ones. The quality rating slowly declined with lower exposures. For the hips, the 100 and 50% computed radiographs were generally similar to or slightly better than the film-screen images. The decline was somewhat faster than for the hands. The contrast-enhanced hip images scored less than the nonenhanced images at any given exposure for all parameters except soft tissue, where the contrast-enhanced images scored better at all exposures. The difference between nonenhanced and enhanced images became less at the lower exposures.

Conclusion:

Lowering the exposure in computed musculoskeletal radiography below the level of film-screen radiography is feasible, especially in the peripheral skeleton. Contrast enhancement seems to be valuable only in the evaluation of soft-tissue structures.
Reliability of Radiological Measurements of the Distraction Gap during Leg Lengthening
Authors: Tjernström B. , Jakobsson O. , Pech P. , Rehnberg L.
Published: June 2015

Purpose:

The aim of this study was to determine the accuracy of length measurements on plain radiographs during leg lengthening and to evaluate a reliable method of measuring the amount of lengthening suitable for clinical praxis.

Material and Methods:

In an experimental study, a plastic femur was lengthened 40 mm and assessed radiographically in different positions, and the orthoradiographically calculated total length of the femur was compared with the true value. In a clinical study, 96 radiographs encompassing 14 femoral and 2 tibial lengthenings were assessed on a digitized table with a computer program (PROFILE) with regard to the amount of lengthening and the degree of magnification.

Results:

The radiographic magnification in the experimental study, depending on position of the femur, was 17% (5–25%), and in the clinical material it averaged 16% (0–36%).

Conclusion:

Radiographs obtained with a radiopaque ruler placed at the same level as the lengthened bone allowed reliable measurements of the distraction gap.
Positron Emission Tomography in the Diagnosis and Staging of Urinary Bladder Cancer
Authors: Ahlström H. , Malmström P.-U. , Letocha H. , Andersson J. , Långström B. , Nilsson S.
Published: June 2015

Purpose:

Evaluation of positron emission tomography (PET) using 18F-2-fluoro-2-deoxy-d-glucose (18FDG) and l-methyl-11C-methionine in the diagnosis and staging of urinary bladder carcinoma.

Material and Methods:

Twenty-three patients with biopsy-proven urinary bladder carcinoma were examined with PET after intravenous injection of 11C-methionine; 2 were also examined with 18FDG. The results from the PET investigations were compared with CT or MR findings and TNM classification before and after treatment.

Results:

The urinary excretion of 18FDG prevented distinction of the primary tumour from the surrounding tracer. With 11C-methionine it was possible to detect 18/23 primary tumours. A trend was seen, suggesting that the higher the uptake values of 11C-methionine in the tumour, the greater the tumour stage.

Conclusion:

It is possible to visualize urinary bladder tumours larger than 1 cm in diameter with PET using 11C-methionine, but the value of the method in the staging of the lesions is not superior to conventional methods.
Sensitivity and Specificity of MR Mammography with Histopathological Correlation in 250 Breasts
Authors: Boné B. , Aspelin P. , Bronge L. , Isberg B. , Perbeck L. , Veress B.
Published: June 2015

Purpose:

The aim of our prospective study was to determine the diagnostic accuracy of MR mammography (MRM) in detecting malignant disease.

Material and Methods:

In 231 consecutive patients scheduled for surgery because of mammographic or palpable lesions suspected of malignancy, the breasts were examined with T1-weighted transversal images using a 3-D fast low angle shot (FLASH) sequence. One pre- and 2 post-contrast images were obtained. Histological examination of the surgical specimens showed carcinoma in 155 breasts, of which 138 were invasive and 17 in situ.

Results:

MRM detected 144 of the 155 malignancies and was false-negative in 11 cases. Eight of these MRM-missed tumours were invasive and 3 were in situ cancers. Benign lesions were found at microscopy in 95 breasts, of which MRM correctly diagnosed 69. The cellular composition of the 26 false-positive lesions (myxomatous stromal change, high vascularity, and epithelial or apocrine hyperplasia) might explain the false positivity. The sensitivity and specificity of MRM were 93% and 73%, respectively.

Conclusion:

MRM should be interpreted with caution, and supplemented with e.g. mammography and ultrasonography.
Tolerance and Efficacy of Omniscan (Gadodiamide Injection) in MR Imaging of the Central Nervous System
Authors: Ekholm S. , Jonsson E. , Sandvik L. , Fagerlund M. , Holtås S. , Isberg B. , Lindell D. , Lindén B. , Sjöberg S. , Thuomas K.-Å. , Tollesson P. O.
Published: June 2015

Purpose:

This Swedish multicenter trial was performed on patients with known or suspected lesions of the CNS for which an MR examination using a contrast medium was indicated. A total of 8 MR centers participated in the study to establish the safety and efficacy of Omniscan (gadodiamide injection) in clinical routine using a standard dose of 0.1 mmol Gd/kg b.w.

Material and Methods:

Seven hundred adult patients who had been referred for MR investigation of suspected CNS lesions were included in the study. Since most patients were examined on an outpatient basis, it was decided to use an explicit questionnaire regarding adverse events that developed within 24 h after examination. The efficacy evaluation involved comparisons of detectability, delineation, and number of lesions before and after injection of Omniscan.

Results:

No serious or unexpected adverse event was found. There were a total of 70 (10.2%) patients with adverse events, excluding those judged not to be contrast media-related. However, only 15 patients (2.2%) had adverse events that possibly or probably were related to the contrast medium. Usually, the symptoms were headache, dizziness, abnormal taste, and nausea. Two patients complained of itching, but only one developed urticaria. The efficacy was similar to that of other currently used Gd-based MR agents. Lesions were more often seen on T2-weighted images, but the contrast medium improved lesion delineation, contributing to higher certainty in diagnosis, and provided more confidence in excluding suspected abnormality.

Conclusion:

Omniscan was found to be a safe and clinically valuable contrast medium for MR imaging of the CNS.
Prevention of Intimal Hyperplasia by Irradiation
Authors: Hirai T. , Korogi Y. , Harada M. , Takahashi M.
Published: June 2015

Purpose:

This experimental study was designed to investigate the effect of irradiation in prevention of intimal hyperplasia.

Material and Methods:

Twenty rabbits were divided into 4 groups, which were irradiated with 2, 5, 10, and 20 Gy, respectively. The intima of both femoral arteries was injured by air-drying, and irradiation was performed on the unilateral side. The contralateral femoral artery served as a control. Angiograms as well as histologic specimens were obtained 1 month later.

Results:

Marked intimal hyperplasia was observed in all control sites. There were no significant differences in thickness of intimal hyperplasia between irradiated and control sites in groups irradiated with 2 and 5 Gy. However, in the 10-Gy- and 20-Gy-irradiated groups, intimal hyperplasia of the irradiated site was significantly suppressed. Medial thinning and dilation of the lumen were observed in the 20-Gy-irradiated group.

Conclusion:

Radiation may prevent intimal hyperplasia. Further investigation of the optimal dose, timing of irradiation, and long-term patency of irradiated vessels may be needed.
Palliation of Malignant Obstructive Jaundice
Authors: Men S. , Hekimoğlu B. , Kaderoğlu H. , Pinar A. , Conkbayir I. , Soylu S. Özbal , Bulut A. , Yandakçi K. , Baran I. , Aran Y.
Published: June 2015

Purpose:

The aim of this study was to analyze the clinical efficacy of metal stents in the palliation of malignant obstructive jaundice.

Material and Methods:

Fifty patients with malignant biliary obstruction were palliated by means of drainage with a metallic self-expandable stent (Wallstent). Nineteen patients had pancreatic carcinoma, 22 cholangiocarcinoma, 4 hepatocellular carcinoma, and the remaining 5 metastatic carcinoma from a variety of primary sites. The obstruction was at the level of the liver hilum in 19 cases, in the middle common bile duct in 11, and in the lower common bile duct in 20.

Results:

The patients were followed over a period of 1–17 months. A total of 36 patients (72%) died; 14 (28%) survived. The mean observation time for the whole group of 50 patients was 3.3 months. The 30-day mortality rate was 14% (7 patients). Short-term complications occurred in 6 patients (12%). Long-term complications included stent occlusion requiring a 2nd intervention in 2 patients (4%), and cholangitis in 2 patients (4%). Excellent palliation was achieved in most of the patients. No stent migration was observed.

Conclusion:

The metallic stent provides good palliative drainage, and the percutaneous insertion of metallic stents is well tolerated by the patients. The procedure is simple and safe to use and can be executed in one stage. The one-stage procedure, compared to the 2-stage procedure, may reduce hospital stays.
Sleep Apnea Syndrome
Authors: Suto Y. , Inoue Y.
Published: June 2015

Purpose:

We attempted to determine the usefulness of high-speed MR imaging for evaluating the severity of sleep apnea syndrome (SAS) by comparing findings of pharyngeal obstruction obtained with high-speed MR with those of all-night polysomnography (PSG).

Subjects and Methods:

A total of 33 patients with SAS underwent turbo-FLASH MR examination, while awake and after i.v. injection of hydroxyzine hydrochloride. Serial images were examined by cinemode. Pharyngeal findings on MR were divided into single-site obstruction (SO) at the velopharynx, multiple-site obstruction (MO), and no obstruction (NO). PSG findings were analyzed to determine the predominant type of apnea, severity as evaluated by an apnea index (AI), and the lowest SaO2 value during sleep.

Results:

Seventy-five percent of the central apnea group had SO, and 70% of the mixed apneas had MO, while only 15% of the obstructed apneas had MO. The percentage of patients with severe SAS (AI of 20% or higher) was 48% for the SO, and 70% for the MO. The lowest SaO2 value tended to be low in the mixed apnea in the case of PSG, and tended to be low in the MO at MR examination.

Conclusion:

Analysis of pharyngeal dynamics using high-speed MR may provide some useful information for evaluating the severity of SAS.
Swedish Radiology as Reflected in Acta Radiologica 1921–96
Authors: Boijsen E.
Published: June 2015

The development and innovations in Swedish radiology as reflected in Acta Radiologica during 75 years are reviewed.
US and CT Findings in the Diagnosis of Tuberculous Peritonitis
Authors: Demirkazik F. B. , Akhan O. , Özmen M. N. , Akata D.
Published: June 2015

Purpose:

To evaluate the ultrasonographic and CT findings of tuberculous peritonitis.

Material and Methods:

Ultrasonographic and CT findings of 11 patients with the ascitic type of tuberculous peritonitis were reviewed.

Results:

All patients had ascites, and ultrasonography (US) demonstrated fine complete and incomplete mobile septations in 10 patients. In 5 of them, the ascites had a lattice-like appearance. Diffuse regular peritoneal thickening was detected in all patients by CT and in 10 patients by US. CT demonstrated infiltration of the greater omentum in 9 patients, whereas US showed omental thickening in only 5 patients.

Conclusion:

Peritoneal and omental thickening detected by CT and ascites with fine, mobile septations shown by US strongly suggest the ascitic type of tuberculous peritonitis. The 2 imaging modalities should be used together for accurate diagnosis of tuberculous peritonitis.
Reproducibility of Doppler Ultrasound Measurements
Authors: Mikkonen R. H. M. , Kreula J. M. , Virkkunen P. J.
Published: June 2015

Purpose:

The reproducibility of Doppler ultrasound measurements was studied in a group of radiologists with different experience of such measurements.

Material and Methods:

The 12 participating radiologists measured peak systolic velocity (PSV), resistance index (RI), and pulsatility index (PI) from 3 arteries and PSV alone in one artery of a healthy person under standardized circumstances. Each participant repeated the measurements 10 times.

Results:

Significant (p<0.005) interobserver variation was seen in all of the variables, with an up to 14-fold difference in the PSV values measured and most variation resulting from differences between observers. The reproducibility of RI was better, most variation being within observers. Experience improved the reproducibility of the Doppler US measurements. Significant difference (p<0.05) in Doppler US measurements was seen between the 3 experience groups. The difference was marked between the highly experienced and the medium experienced group when the variances of the measured values of PSV, RI, and PI from all 4 arteries were combined.

Conclusion:

The reproducibility of Doppler ultrasound measurements is poor. The value of the method is questionable.
Degenerative Changes following Anterior Cervical Discectomy and Fusion Evaluated by Fast Spin-Echo MR Imaging
Authors: Wu W. , Thuomas K.-Å. , Hedlund R. , Leszniewski W. , Vavruch L.
Published: June 2015

Purpose:

To review pre- and postoperative fast spin-echo (FSE) MR images of disc herniation and spondylosis in patients after spinal cervical surgery.

Material and Methods:

Data were reviewed of 68 patients after anterior discectomy and fusion (ADF) operations using the Cloward technique with solid single level (C5–C6 or C6–C7) or 2-level fusions (C5–C7). The average interval from surgery to review was 37 months. Age- and sex-matched controls without neck problems were examined.

Results:

Preoperatively, the fusion groups had a higher incidence of protruded disc, and anterior and posterior osteophytes at the levels to be fused than the controls. Postoperatively, there was a significantly higher incidence of posterior osteophytes at the fused levels compared with the controls. Furthermore, the disc herniations and anterior osteophytes at the levels above and below the operated segments were more frequent in the fusion group.

Conclusion:

ADF causes acceleration of the degenerative changes at the fused level and at the levels below and above the fused segments.
Retroperitoneal Hemorrhage Due to a Ruptured Adrenal Myelolipoma
Authors: Catalano O.
Published: June 2015

Adrenal myelolipomas are usually small and asymptomatic tumors discovered incidentally. In a small number of cases, acute pain may develop secondary to intratumoral and/or retroperitoneal bleeding. We observed a large, surgically and histologically confirmed, myelolipoma of the right adrenal gland with spontaneous internal and external hemorrhage. CT demonstrated heterogeneity of the mass, obliteration of the surrounding fat planes, and retroperitoneal blood dissection. A literature review produced only 5 reports of ruptured myelolipoma with external hemorrhage.
CT Findings in General Practice Patients with Suspected Acute Sinusitis
Authors: Lindbæk M. , Johnsen U. L.-H. , Kaastad E. , Dølvik S. , Møll P. , Lærum E. , Hjortdahl P.
Published: June 2015

Purpose:

To study CT findings in general practice patients with a clinical diagnosis of acute sinusitis, and to examine the interobserver variation between 2 radiologists with regard to their CT evaluation.

Material and Methods:

Two hundred and one patients were examined with coronal CT images of the paranasal sinuses within 2 days of the clinical diagnosis. Patients with chronic sinusitis were excluded. Fluid level or total opacification of any sinus were used as evidence of sinusitis.

Results:

One hundred and twenty-seven (63%) patients had fluid level or total opacification in a sinus region, most in more than one region. One hundred and fifteen had CT signs of sinusitis in the ethmoid region, 84 in the maxillary, 18 in the frontal, and 10 in the sphenoid. Forty-nine patients had a negative CT. In the evaluation of interobserver agreement, the overall assessment of the CT yielded a kappa value of 0.70.

Conclusion:

The study demonstrated great variation in the CT findings in general practice patients with suspected acute sinusitis. More than one sinus region was affected in most patients in whom sinusitis was confirmed by CT imaging; the most common combination was ethmoid and maxillary sinuses. The interobserver agreement was substantial.
Susceptibility Contrast Imaging of CO2-Induced Changes in the Blood Volume of the Human Brain
Authors: Rostrup E. , Larsson H. B. W. , Toft P. B. , Garde K. , Ring P. B. , Henriksen O.
Published: June 2015

Purpose:

To investigate changes in the regional cerebral blood volume (rCBV) in human subjects during rest and hypercapnia by MR imaging, and to compare the results from contrast-enhanced and noncontrast-enhanced susceptibility-weighted imaging.

Material and Methods:

Five healthy volunteers (aged 24–29 years) were studied during inhalation of atmospheric air and 7% CO2. A bolus injection of Gd-DTPA was given during the acquisition of a series of susceptibility-weighted, fast gradient echo images (TR/TE=27/22 ms). The images were converted to ΔR2* maps, and CBV was calculated pixelwise by fitting a gamma-variate function to the data. The tissue concentration vs time curves were deconvoluted using an input function obtained by arterial sampling.

Results:

The ratio of gray to white matter CBV (1.9–2.5) as well as the fractional increase in rCBV during hypercapnia (about 30%) was found to be in accordance with results obtained by other methods. Noncontrast functional MR (fMR) imaging showed signal increases in gray matter, but also inconsistent changes in some white matter regions.

Conclusion:

In this experiment, contrast-enhanced imaging seemed to show a somewhat higher sensitivity towards changes in cerebral hemodynamics than noncontrast-enhanced imaging. The results of the deconvolution analysis suggested that perfusion calculation by conventional tracer kinetic methods may be impracticable because of nonlinear effects in contrast-enhanced MR imaging.
Inter-rater reliability and face validity of the Executive Function Performance Test (EFPT)
Authors: Cederfeldt Marie , Carlsson Gunnel , Dahlin–Ivanoff Synneve , Gosman–Hedstrom Gunilla
Published: June 2015

Introduction

Occupational therapists need an instrument to assess executive dysfunctions before patients are discharged from acute wards. The Executive Function Performance Test (EFPT) appears to be suitable, since it evaluates dysfunctions in complex activities. The aim of this study was to translate the EFPT from English into Swedish and to evaluate its properties when used with older persons with mild stroke in an acute setting.

Method

The study consisted of three parts: (1) a translation procedure using a forward and backward method; (2) evaluation of face validity; (3) inter-rater reliability by four raters (two pairs) who made 34 assessments in 17 older patients with mild stroke in an acute ward.

Results

The inter-rater reliability for the EFPT was good. The median was 88% of the percentage agreement. No occasional disagreement was found between the raters, but there was a systematic disagreement in one out of 20 items. The translation and face validity process resulted in further clarification of the semantic and cultural equivalence of the EFPT, and the manual was changed accordingly.

Conclusion

This study showed that inter-rater reliability was good and that the EFPT was found to be an interesting assessment, although further research is needed.