bluuebunny/crossref_metadata_2025 huggingface dataset:
Attenuation Values, Volume Changes and Artifacts in Tissue Due to Freezing
Authors: Pech P. , Bergström K. , Rauschning W. , Haughton V. M.
Published: June 2015

Freezing of animal and human tissue may change their shape, size and other physical properties such as attenuation of roentgen rays. In correlative radiologic-anatomic studies such artifacts are potential sources of inaccuracy. In fluid phantoms changes of computed tomography (CT) numbers and volume were measured before and after freezing. Frozen saline decreased in attenuation by 80 Hounsfield units (HU) and increased in volume by 9 per cent. Pure soy oil increased in attenuation by 40 HU after freezing and shrank in volume by 4 per cent. Emulsions of 10, 20 and 30 per cent lipid expanded in inverse relationship to the changes in attenuation. In animal and human tissue, changes in CT number of −80 to + 55 HU were measured and changes in volume of —6 to +9 per cent were calculated. The attenuation of the vitreous body in the eye decreased by 80 HU and its volume was calculated to increase by 8 to 9 per cent. In the muscle and spinal cord the attenuation decreased by 40 to 60 HU, corresponding to the increase in volume of 4 to 6 per cent. Attenuation of fat was increased by 55 HU after freezing and a decrease in volume of 5 to 6 per cent was calculated. Deformation of soft tissue and herniation of the cerebellar tonsils into the foramen magnum were observed. Most anatomic, freezing artifacts can be avoided by careful preparation.
Pulmonary Artery Sling
Authors: Malmgren N. , Laurin S. , Lundström N.-R.
Published: June 2015

Aberrant left-sided pulmonary artery (pulmonary sling) is an uncommon anomaly, which may cause significant respiratory morbidity. The condition should be considered on finding a mass interposed between the trachea and the esophagus on the esophagogram, but diagnosis is usually made with invasive methods. Magnetic resonance imaging (MRI) has been reported as an excellent method for diagnosing cardiovascular anomalies but the findings at MRI in cases of pulmonary artery sling have not been reported previously. In this communication the use of MRI is described for demonstration of pulmonary sling in three patients.
Effect of Interferon on T1 Relaxation Times of Liver Metastases from Endocrine Gastrointestinal Tumours
Authors: Andersson T. , Eriksson B. , Hemmingsson A. , Jung B. , Lindh E. , Thuomas K.-Å. , Öberg K.
Published: June 2015

Eight patients with liver metastases from endocrine gastrointestinal tumours were examined with magnetic resonance imaging of the liver before and during treatment with interferon. T1, T2 and tumour size were measured and compared with tumour marker levels and symptomatic improvement or deterioration. Before therapy all tumours showed a long T1 and T2, in comparison to normal liver and fat, and during therapy they all showed a decrease in T1. As no change in liver T1 and fat T1 occurred, the decreased tumour T1 is considered to be a therapy effect. This cannot be fully explained but is possibly due to a reduction in tumour growth rate during interferon treatment. There was no certain correlation between tumour T1 and tumour marker levels or symptomatic changes.
Addition of Local Anesthetics to Contrast Media
Authors: Nilsson P. , Almén T. , Golman K. , Jonsson K. , Nyman U.
Published: June 2015

The acute intravenous toxicity (i.v. LD50) of solutions of the ratio 1.5 contrast media metrizoate or diatrizoate and the ratio 3.0 contrast medium metrizamide was determined in mice with and without the addition of local anesthetics to the solutions. The two local anesthetics mepivacaine or lidocaine were added to final concentrations up to 2.0 mg/ml of the contrast medium solutions. This corresponds to clinically used concentrations. All additions of local anesthetics to the solutions increased the mortalities caused by the contrast medium solutions. Addition of local anesthetics to a final concentration of 2 mg/ml approximately doubled the acute intravenous toxicity of the contrast media. The ratio 3 contrast media produce less hypertonic solutions than the ratio 1.5 contrast media and should be preferred for angiography because they cause less pain and do not require the addition of local anesthetics which increase the acute toxicity of the solutions.
Radiography and Scintigraphy in the Assessment of Early Gonarthrosis
Authors: Egund N. , Frost S. , Brismar J. , Gustafson T.
Published: June 2015

The radiographic and scintigraphic appearances in early gonarthrosis were compared in 62 knees. Early femorotibial osteoarthrosis was found to be confined to one compartment (medial or lateral) of the joint. However, concomitant patellofemoral osteoarthrosis was common. 99Tcm-MDP scintigraphy was consistently positive when the joint space (femorotibial and patellofemoral) was reduced by 75 per cent or more. Joint space narrowing by as much as 50 per cent could be observed in a scintigraphically normal knee. The inconsistency between the radiologic and scintigraphic findings in the earliest stages of gonarthrosis points to the importance of appropriate radiographic technique.
Comparison of Myelography and Computed Tomography in Establishing Lumbar Disc Herniation
Authors: Fagerlund M. K. J. , Thelander U. E.
Published: June 2015

The results of lumbar myelography and computed tomography (CT) were compared in 51 consecutive patients with clinically suggested lumbar disc herniation. A total of 100 intervertebral levels were examined. At 62 levels, either L4/L5 or L5/S1, myelography was normal. CT showed no pathologic changes at 55 levels. The results concurred between myelography and CT in 89 per cent of the patients with normal findings. Four cases of disc herniation and one bulging disc, which had been missed at myelography because of a large epidural space at L5/S1, were picked up by CT. Two of these were verified by surgery and two were treated conservatively. There was one possible false negative case with CT as well. Abnormalities were shown at 38 intervertebral levels, 22 in the bulging and 16 in the herniated disc group. The pathologic changes concurred in 84 per cent between the two investigations. For intervertebral disc herniation the true negative rate was, for myelography 88 per cent and for CT 97 per cent. The treatment strategy could have been based on CT alone at 37 out of 38 levels (97%), and on myelography alone at 34 out of 38 levels (89%). Furthermore, at CT the imaging of soft tissues and intervertebral joints was superior to that at myelography. It is concluded that CT should be the primary examination method of imaging for lumbar disc herniation. Myelography is, however, to be preferred where the level of the lesion is clinically unclear or when the entire lumbar region and thoraco-lumbar junction are to be examined.
Chemical Sclerosis of the Gallbladder
Authors: Uchiyama N. , Stridbeck H. , Stenram U.
Published: June 2015

Chemical ablation of the gallbladder with absolute ethanol and polidocanol 3% was attempted in 23 and 10 pigs, respectively, after open transhepatic cholecystostomy. Absolute ethanol caused complete necrosis of the gallbladder epithelium in 10 pigs and partial necrosis with focally present gallbladder epithelium in 9. An intact epithelium was observed in 4 pigs but it was not possible to determine whether this epithelium was the original one, not affected by the ethanol, or regenerated after previous damage. Gallbladders with hemorrhage and hydrops were frequently encountered. Gallbladders treated with polidocanol all had an intact epithelium.
Caroli's Disease in Two Sisters
Authors: Höglund M. , Muren C. , Schmidt D.
Published: June 2015

Caroli's disease is a rare congenital disease with multiple segmental dilatations of the bile ducts. It may present in two forms: one (the simple form) with segmental dilatations only, and the other with dilatations combined with fibroangioadenomatosis, frequently complicated by portal hypertension. The disease is thought to be recessively inherited, but few familial cases have been reported. We have observed two sisters with the disease, one with the simple form, the other with fibroangioadenomatosis. Their case histories and diagnostic findings, with special reference to ultrasonography and computed tomography, are presented, and the potential for diagnosis by different imaging modalities is discussed.
Radiologic Assessment of Humeral Head Retroversion
Authors: Söderlund V. , Kronberg M. , Broström L.-Å.
Published: June 2015

A radiologic method for assessment of the humeral head retroversion angle has been developed using one radiograph obtained in the semi-axial view. Validity and reliability of the method has been tested. In five healthy volunteers both shoulders were examined both with CT and with the new radiographic method. The average difference in angle determinations between the methods was 1.5° and the maximum difference was 2°. Angle determination on radiographs from 22 healthy shoulders was performed by two independent radiologists. The coefficient of variation for intraobserver measurements was 2.8 per cent and for interobserver measurements it was 4.6 per cent. Three isolated humerus bones were examined in multiple semi-axial projections and the humeral head retroversion was measured. The effect of humeral position (flexion, extension, abduction) on angle assessments was analyzed. A method error exceeding 2° was only seen when the specimens were in an extended or extremely abducted position. It is concluded that with the arm in the correct position measurements of humeral head retroversion can be performed with this method with high accuracy.
Neonatal Systemic Candidiasis Diagnosed by Ultrasound
Authors: Tung K. T. , MacDonald L. M. , Smith J. C.
Published: June 2015

The diagnosis of systemic candidiasis in ill high-risk neonates is often delayed as there are no specific clinical features and the significance of positive cultures for Candida species may be uncertain. Early diagnosis and treatment is essential to reduce mortality and may be aided by ultrasound examination of the commonly involved organs — The brain and kidneys. In this paper we describe 2 cases where the diagnosis was first raised following ultrasound examination, and review the spectrum of abnormalities seen on renal and cranial ultrasound examination. We emphasise the importance of using this imaging technique in the high-risk neonate in initiating earlier diagnosis and treatment, or in establishing the significance or otherwise of positive cultures.
Systemic, Pulmonary and Renal Haemodynamic Effects of Large Intravenous Doses of High and Low Osmolar Contrast Media; An Investigation in the Pig of Ratio 1.5 and Ratio 3 Media
Authors: Sunnegårdh O. , Hietala S.-O. , Wirell S. , Reiz S. , Häggmark S.
Published: June 2015

The central, peripheral and renal haemodynamic effects of intravenous infusion (1 ml/s) of large doses (4 ml/kg body weight) of non-ionic (iohexol) and ionic (metrizoate and ioxaglate) contrast media were studied in 24 anaesthetized pigs. All contrast media showed marked haemodynamic effects with an increase of mean right atrial pressure, mean pulmonary arterial pressure, mean pulmonary occlusion pressure, cardiac output and stroke volume. The response of the pulmonary circulation to contrast media was a fall rather than a rise in pulmonary vascular resistance. No significant changes were detected in the renal circulation after infusion of contrast media.
A Computer-Based System for Measurements and Analyses in Radiology
Authors: Erasmie U. , Dalianis H. , Ringertz H.
Published: June 2015

A computer-based system for direct measurements on images and for analyses of data is presented. Distances, angles, and areas are measured on a backlighted digitizer table. Calibration corrects for actual magnification. Data are analyzed and compared to normal values by a microcomputer. The system is precise and time saving.
Ultrasonographic Measurement of the Soft-Tissue of the Upper Jaw
Authors: Traxler M. , Solar P. , Ulm C. , Gritzmann N.
Published: June 2015

For preimplantation diagnoses, various mechanical methods for measuring the width of the soft tissue and thus measuring indirectly the osseous bed of the implant can be used. The ability to determine soft tissue thickness above the jaw by ultrasound was evaluated in 8 autopsy specimens. The data obtained were compared with findings from the needle measurement method which is usually employed in clinical practice. The ultrasound measurement method produced realistic data in all sectional planes chosen.
Left Ventricular Systolic and Diastolic Function during Coronary Arteriography before and after Acute Left Ventricular Failure in Dogs
Authors: Kløw N. E. , Mortensen E. , Refsum H.
Published: June 2015

The hemodynamic side effects of intracoronary injection of low osmolality contrast media were studied in anesthetised dogs, both with and without left ventricular (LV) failure. LV failure was induced by microembolization of the area supplied by the left main coronary artery. LV pressure and volume, aortic pressure, and cardiac output were recorded. 6 ml iodixanol 320 mg I/ml containing 20 mmol Na+/l, a new non-ionic dimer, was compared to iohexol and ioxaglate. Iodixanol induced small systolic alterations both before and after LV failure. Iohexol increased LV inotropy while ioxaglate depressed myocardial function. Before failure iodixanol and ioxaglate impaired isovolumic relaxation, but early diastolic filling was not reduced. After failure the relaxation process was not affected, but ioxaglate reduced early diastolic filling. Ioxaglate also increased LV end-diastolic pressure and volume more than the non-ionic contrast media. In conclusion, iodixanol induced only small changes in systolic and diastolic function. Iodixanol should therefore be hemodynamically well tolerated during coronary arteriography, and also in acute ischemic heart failure.
Percutaneousc Gastrostomy
Authors: Lindberg C.-G. , Ivancev K. , Kan Z. , Lindberg R.
Published: June 2015

Fluoroscopic percutaneous gastrostomy for the purpose of nutrition was performed in 28 patients with the aid of a specially designed gastrostomy set. No major complications were reported. Exchange to Foley catheter was performed after 7 days and could be used without complications for the patients' remaining life span. In order to evaluate the formation of a gastrocutaneous tract, an experimental study with the same instruments as in clinical practice was performed in 13 rabbits. Within one week a gastrocutaneous tract was formed, which was possible to dilate for insertion of a balloon catheter of larger size. The described procedure is a simple and time-saving method for a percutaneous gastrostomy in debilitated patients with dysphagia.
High Resolution CT and Bronchography in the Assessment of Bronchiectasis
Authors: Young K. , Aspestrand F. , Kolbenstvedt A.
Published: June 2015

To elucidate the reliability of CT in the assessment of bronchiectasis, a retrospective study of high resolution CT and bronchography was carried out. A segment by segment comparison of 259 segmental bronchi from 70 lobes of 27 lungs in 19 patients was performed using bronchography as standard. CT was positive in 87 of 89 segmental bronchi with bronchiectasis giving a false-negative rate of 2%. CT was negative in 169 of 170 segmental bronchi without bronchiectasis at bronchography, giving a false-positive rate of 1%. There was agreement between the two modalities in identifying the different types of bronchiectasis.
CT and Angiography in Adrenocortical Carcinoma
Authors: Kolmannskog F. , Kolbenstvedt A. , Brekke I. B.
Published: June 2015

CT and angiography were performed in 15 patients with adrenocortical carcinoma. The tumors had a mean diameter of 11 cm (range 4–20 cm). At CT, the 8 largest tumors were ill-defined, and in these, the organ of tumor origin could not be established. Angiographically the correct organ of tumor origin was established in all but one patient. It is concluded that CT is excellent in showing the extent of an adrenal tumor, but is often unable to predict the organ of origin in large tumors. Angiography is still of great value in the preoperative work-up in patients with large adrenocortical carcinomas for correct identification of tumor origin and for vascular mapping.
Diagnostic Imaging in Fracture of Lumbar Vertebral Ring Apophyses
Authors: Wagner A. , Albeck M. J. , Madsen F. F.
Published: June 2015

The findings at plain radiography, myelography, CT, and MR imaging in 3 cases of fracture of the lumbar vertebral ring apophysis are presented. Familiarity with this entity is important in evaluating low back pain in children and young adults. Conventional radiographs and/or MR imaging may suggest ring apophysis fracture; CT will confirm and classify the diagnosis.
Pharmacokinetics of Iopentol in Patients with Chronic Renal Failure
Authors: Svaland M. G. , Kolmannskog F. , Lillevold P. E. , Nordal K. P. , Ressem L. , Berg K. J.
Published: June 2015

Iopentol 350 mg I/ml was injected in doses of 265 to 533 mg I/kg b.w. (mean 417 mg I/kg b.w.) in 10 patients with advanced nondiabetic chronic renal failure (S-creatinine 672 ± 259 μmol/l (mean ± SD)). Urine (10 patients) and feces (7 patients) were collected at 24 h intervals for 5 days after the injection. The elimination of iopentol was delayed. Five days after injection a mean of 54% (range 35–79%) of the dose was recovered in urine, and 11% (0–20%) in feces. Mean elimination half-life was 28.4 h, about 14 times the half-life found in healthy volunteers. The apparent volume of distribution was 0.27 1/kg b.w., indicating distribution only to extracellular fluid. Using renal iopentol clearance as reference value, GFR was overestimated by 40 to 60% with iopentol total clearance, showing extrarenal elimination of iopentol. The difference was most pronounced in patients with low GFR. In conclusion, this study shows an extrarenal elimination of iopentol and demonstrates a substantial increase in the fecal elimination in patients with severe renal failure.
Large Vein Sampling for Intact Parathyroid Hormone in Preoperative Localization of Enlarged Parathyroid Glands
Authors: Bergenfelz A. , Lundstedt C. , Stridbeck H. , Ahrén B.
Published: June 2015

Unilateral neck exploration for primary hyperparathyroidism (pHPT) of old and high risk patients can be safely performed under local anesthesia, provided there is a correct preoperative side localization of the enlarged parathyroid gland. We performed large vein sampling and measured intact parathyroid hormones (PTH) with a new, highly sensitive immunoradiometric assay. The method was used before operation in 20 patients with pHPT. A unilateral positive gradient of serum PTH levels was obtained in 15 patients. At surgery, 13 of these (87%) proved to be correct, i.e., the adenoma was localized on the same side. Thus, the technique correctly lateralized the parathyroid adenoma in 65% of the patients. We conclude that large vein sampling with measurement of intact PTH is a potentially useful investigation for preoperative side localization of parathyroid adenomas in pHPT patients scheduled for unilateral surgery under local anesthesia. However, prior to routine bilateral neck exploration large vein sampling is not justified.
High Resolution CT in Children with Cystic Fibrosis
Authors: Stiglbauer R. , Schurawitzki H. , Eichler I. , Götz M.
Published: June 2015

High resolution CT (HRCT) was performed in 24 children (median age 57.9 months) suffering from cystic fibrosis (CF). In 23 patients (one examination unacceptable because of motion artifacts) the most frequent finding was bronchial wall thickening, shown in 21 patients (91%), followed by bronchiectasis in 15 patients (65%). Less frequent findings were mucus plugging and patchy consolidations, which could be demonstrated in 11 patients each (48%). Findings were classified using a CT scoring system and including only irreversible pulmonary changes; a statistically significant correlation with lung function tests (FEV1/FVC; MEF50) could be established. HRCT to date seems to be the most valuable method to determine extent and severity of lung involvement in children with CF and should therefore be routinely used for the staging of this disease.
Comparison of Intravenous Contrast Agents for CT Studies in Children
Authors: Cohen M. D. , Herman E. , Herron D. , White S. J. , Smith J. A.
Published: June 2015

One hundred and eighty children undergoing CT examination were randomly allocated to receive meglumine diatrizoate, iohexol, or iopamidol as their i.v. contrast agent. Minor side effects were detected in 85% of children receiving meglumine diatrizoate, in 18% of those receiving iohexol, and in 36% of those receiving iopamidol. Because many of these minor side effects cause patient motion or delay scanning after contrast medium injection, they potentially degrade image quality. These findings are an indication for the use of low osmolarity contrast agents for i.v. use in pediatric CT imaging.
Wrist Arthrography
Authors: Fransson S.-G.
Published: June 2015

The ligaments of the proximal row of carpal bones and the triangular fibrocartilage (TFC) strongly influence the function and stability of the wrist. Injury to the ligaments may result in chronic wrist pain or instability. Wrist arthrography is valuable in the investigation of such damage when surgical intervention is considered and plain radiography is unrewarding. There are also several technical modifications of the standard radiocarpal arthrography available. Owing to the possibility of congenital perforations and degenerative changes in these ligaments the arthrographic findings should be related to the clinical signs and the age of the patient. CT has less diagnostic importance in this respect while MR imaging is an alternative and may become the method of choice. Both these methods have great potential in the evaluation of soft tissues of the wrist other than the TFC.
High-Osmolar and Low-Osmolar Contrast Media
Authors: Thomsen H. S. , Dorph S.
Published: June 2015

During the past 3 years a great number of papers about adverse drug reactions to intravascular injection of high-osmolar and low-osmolar iodinated contrast media (CM) have been published. They include observational studies, randomized trials, meta-analyses and committee reports. Thorough analysis of this material substantiates an improvement in safety of at least 6-fold using nonionic low-osmolar CM compared with ionic high-osmolar CM. The point where only a small minority is continuing to argue effectively that low-osmolar CM are not better than conventional high-osmolar CM has now been reached. High-osmolar CM are used less and less for intravascular purposes, and, in fact, have been totally replaced by low-osmolar CM in 4 countries.
Intramedullary Nailing and Cortical Bone Mineral Content
Authors: Kaartinen E. , Keskisaari L. , Holmström T.
Published: June 2015

A transverse diaphyseal osteotomy of the tibia was stabilized using rigid intramedullary nailing in rabbits. In a 2nd group, nailing was performed without osteotomy. The rabbits were sacrificed 3 to 24 weeks postoperatively, and the nails were removed. The mineral content (BMC) was measured by dual photon absorptiometry and the mineral density (BMD) was calculated. At 24 weeks the osteotomized bones had significantly lower BMC values than did the respective nonosteotomized bones or the intact bones. The BMC of the nonosteotomized bones remained above the control level throughout the experiment. The minimum BMD values of the osteotomized bones were detected at 3 weeks, whereafter they gradually approached the control level over time. The results suggest that rigid intramedullary nailing in connection with osteotomy causes a significant decrease in cortical bone mineral mass, seen at 24 weeks postoperatively. The photon absorption method used seemed sensitive enough to detect changes in cortical bone mineral quantity in these experimental conditions.
Postirradiation Changes in the Pelvic Wall
Authors: Søvik E. , Lien H. H. , Tveit K. M.
Published: June 2015

MR images of 45 patients who had received radiation therapy for carcinoma of the anus or recurrent carcinoma of the rectum were reviewed with regard to postirradiation changes of the pelvic wall. High signal intensity in bone marrow on T1-weighted images due to fatty replacement was almost always observed. Presacral edema occurred in 7 of 36 patients who were examined 4 to 6 weeks after the end of irradiation and was more frequent at later studies. The pelvic wall muscles showed high signal intensity on T2-weighted images compatible with edema. This finding was most frequent on studies performed more than 6 weeks after the end of irradiation. The changes subsided more than a year after radiation therapy. To avoid an erroneous diagnosis of tumor infiltration into the pelvic wall, it is important to be familiar with the normal postirradiation changes of the presacral space and the muscles.
Intravascular Contrast Media and Thrombin Generation
Authors: Parvez Z. , Vik H.
Published: June 2015

This study focuses on the effect of contrast media (CM) on thrombin generation. In vitro studies consisted of incubating nonanticoagulated whole blood with ionic CM (sodium meglumine diatrizoate, ioxaglate), nonionic CM (iohexol, iopamidol) or glucose in plastic tubes. Thrombin generation was assessed by measuring F1 + 2, ATM and FpA levels in plasma using ELISA assay kits. In a separate protocol, the procoagulant activity of 3 nonionic CM (iohexol, iopamidol, and iopromide) was investigated by one-stage plasma recalcification time method. Rabbit brain tissue thromboplastin and physiologic saline were used as standard and experimental controls. Incubation of ionic and nonionic CM with whole blood did not enhance thrombin generation compared to glucose control. Similarly, the plasma recalcification times were not significantly shortened by either of the 3 nonionic CM tested. These studies suggest that ionic and nonionic CM exhibit different levels of anticoagulant properties in vitro and the latter are not procoagulant materials.
Conventional and High-Resolution CT in Asymptomatic Asbestos-Exposed Workers
Authors: Gevenois P. A. , De Vuyst P. , Dedeire S. , Cosaert J. , Vande Weyer R. , Struyven J.
Published: June 2015

To compare the value of conventional CT (CCT) and high-resolution CT (HRCT) to detect benign asbestos-related diseases, 159 exposed workers with a normal chest radiography were imaged by both techniques. Pleural plaques were detected in a total of 59 cases (37.1%). Ten cases (16.9%) were detected by CCT only and one case (1.7%) by HRCT only. Pulmonary lesions compatible with parenchymal asbestosis were detected by HRCT in 20 cases, whereas CCT showed abnormalities in 45% of these. Rounded atelectasis was equally recognized by both techniques. The results confirm that in a subject with a normal chest radiography, HRCT is a better diagnostic tool to demonstrate lesions of asbestosis. On the other hand, HRCT is insufficient to exclude the presence of pleural plaques. When HRCT does not reveal pleural abnormalities, CCT should be performed.
Mammography Screening
Authors: Thurfjell E.
Published: June 2015

Five experienced screeners independently and blindly reviewed mammograms from the first screening round of 46 healthy women, and of 74 women who had histologically proven breast cancers in the first screening round or later. The films were reviewed first as one-view screening and later as two-view screening. Fifty-one breast cancers were detected by at least one of the screeners on either one-view or two-view screening. The mean increase in sensitivity by using two views, instead of one, was 2%. The median of the proportional increase in detected cancers as the result of independent double reading was 14.5% with one-view screening and 12% with two-view screening. Two screeners using one-view screening detected about 10% more cancers than one screener using two-view screening.
CT and Ultra Low Field (0.02 T) MR Imaging of Uterine Cervical Carcinoma
Authors: Varpula M. , Kiilholma P. , Klemi P.
Published: June 2015

Nineteen pelvic MR and 21 CT examinations were performed in 21 patients with uterine cervical carcinoma. The results were compared with clinical (FIGO) staging in all patients, and with the histopathologic results after operation in 8. In the evaluation of local tumor growth CT agreed with clinical staging in 29%, MR imaging with clinical staging in 47% and CT with MR in 53%. The greatest discrepancy between the imaging methods and clinical examination was in the evaluation of parametrial extension. From 8 Stage I tumors with surgical confirmation the local tumor growth was overestimated with CT in 3 cases, with clinical examination in 2 and with MR imaging in 2 cases. CT and MR imaging at 0.02 T did not differ in the evaluation of parametrial tumor growth. Clinical examination overestimated parametrial growth but was relatively accurate in detecting vaginal wall involvement. MR imaging at 0.02 T is a convenient, inexpensive and accurate method for the local staging of early uterine cervical carcinoma.
Accuracy of Double Contrast Barium Enema and Sigmoideoscopy in the Detection of Polyps in Patients with Diverticulosis
Authors: Stefánsson T. , Bergman A. , Ekbom A. , Nyman R. , Påhlman L.
Published: June 2015

The sensitivity between double contrast barium enema (DCBE) and sigmoideoscopy in diagnosing neoplastic lesions in the sigmoid colon was compared in patients with diverticulosis. In 52 patients with severe diverticulosis (≥15 diverticulas) the DCBE detected one out of 4 polyps found by sigmoideoscopy. In the remaining 54 patients with mild diverticulosis (<15 diverticulas) DCBE detected 7 out of 10 polyps found by sigmoideoscopy. Successful bowel preparation did not influence the outcome of the DCBE. Sigmoideoscopy was incomplete in 17 (16%) of the patients; females were more difficult to examine than males (p= 0.012), as were those with a previous pelvic operation (p= 0.032). We conclude that neither DCBE nor sigmoideoscopy alone is sufficient to detect all neoplastic lesions in the sigmoid colon in patients with sigmoid diverticulosis of the colon.
Craniopharyngioma Identification by CT and MR Imaging at 1.5 T
Authors: Hald J. K. , Eldevik O. P. , Skalpe I. O.
Published: June 2015

To compare the detectability of craniopharyngiomas by CT and MR imaging, preoperative CT and MR studies obtained within 16 days of each other were evaluated retrospectively in 9 patients. MR imaging demonstrated cystic and solid tumor components in all 9 tumors, and enhancement in the 7 tumors that were studied after contrast medium injection. MR imaging demonstrated a signal void consistent with calcification in 4 patients. Combining unenhanced and contrast medium-enhanced studies, CT also identified all the tumors. CT demonstrated cysts in 7 lesions, calcification in 7 and enhancement in 6 of the 7 lesions that received i.v. contrast medium. Calcification was better seen by CT than MR imaging, while MR imaging identified cystic tumor components not seen on CT. The contrast medium enhancement pattern was the same with the 2 modalities. MR imaging of the sellar region, including at least one contrast medium-enhanced sequence, should be sufficient in most instances to establish a preoperative diagnosis of craniopharyngioma.
Percutaneous Gastrostomy Guided by Ultrasound and Fluoroscopy
Authors: Lorentzen T. , Skjoldbye B. , Nolsøe C. , Torp-Pedersen S. , Mygind T.
Published: June 2015

Percutaneous gastrostomy, utilizing a dedicated catheterization kit, with a combination of ultrasonographic (US) and fluoroscopic guidance, was carried out in 27 patients. The main indication for gastrostomy was the need for nutritional support in malignant esophageal stricture. After distending the stomach with water via a nasogastric tube, the gastric antrum was punctured under US guidance and a guide wire was inserted, followed by fluoroscopically guided tract dilatation and insertion of a 2.5-mm Cope-loop catheter. In all patients but one (96%) the procedure was successfully completed in one or 2 attempts. Two complications occurred: one case of a small subcutaneous abscess near the puncture site, and one late incident of dislodgement of a catheter without string-loop fixation, which had been inserted at a catheter exchange after 6 weeks. Percutaneous gastrostomy guided by US and fluoroscopy is a safe and efficacious alternative to endoscopic and surgical gastrostomy.
MR Imaging in Advanced Abdominal Pregnancy
Authors: Wagner A. , Burchardt A.-J.
Published: June 2015

Abdominal pregnancy is a rare but life-threatening condition. The preoperative diagnosis may be difficult. When there is a suspicion of abdominal pregnancy and ultrasonographic findings are equivocal or inconclusive, MR imaging should be performed. We report a case of an abdominal pregnancy of 28 weeks' gestation diagnosed by MR.
Effects on Erythrocyte Aggregation and Blood Coagulation from Iohexol Solutions with and without Sodium Chloride
Authors: Chai C.-M. , Almén T. , Aspelin P. , Bååth L.
Published: June 2015

Solutions of the nonionic monomeric contrast medium iohexol (300 mg I/ml) with and without added NaCl were investigated for effects on red blood cell aggregation and blood coagulation. Three volumes of a test solution were mixed in test tubes with one volume of human blood. During 30 min samples of the mixture were taken for investigation. Six test solutions were used: 1) iohexol, 2) iohexol+glucose 280 mM, 3) iohexol+NaCl 150 mM, 4) glucose 280 mM, 5) glucose 140 mM+NaCl 75 mM, 6) NaCl 150 mM. Test solutions with NaCl caused no aggregation. Test solutions without NaCl always caused macroscopic red cell aggregates. These aggregates always disappeared when saline was added to the sample. The macroscopic red cell aggregates could be dispersed to microscopic aggregates by shaking the test tubes. During the next 30 min macroscopic aggregates returned in the glucose solution but not in the iohexol solutions. In 30 min, blood mixed with iohexol solutions never coagulated while blood layered on top of the same iohexol solutions always coagulated. Blood mixed with solutions 5 and 6, both without iohexol, always coagulated. It is concluded that adding 150 mM NaCl to iohexol did not eliminate its ability to antico-agulate whole blood, but inhibited its ability to aggregate red cells. This inhibition was not caused by the osmotic effects of the added NaCl.
Cervical Invasion of Endometrial Carcinoma — Evaluation by Parasagittal MR Imaging
Authors: Murakami T. , Kurachi H. , Nakamura H. , Tsuda K. , Miyake A. , Tomoda K. , Hori S. , Kozuka T.
Published: June 2015

Twenty-seven consecutive patients were examined by T2-(1 800/70 ms) and postcontrast T1-weighted (600/15) spin echo (SE) or dynamic (200/15) SE MR imaging to determine the usefulness of parasagittal MR imaging in assessing cervical invasion of endometrial carcinoma. The images were obtained in a direction parallel to the longitudinal axis of the uterus (parasagittal). The cervical epithelium, being hyperintense on the late phase dynamic and postcontrast T1-weighted SE images, had disappeared partially or totally in all 4 patients with cervical invasion. The enhanced cervical epithelium was completely seen in one patient with the tumor protruding into the cervical canal in a polyp-like form without cervical epithelial invasion. The same was also seen in the 22 patients with the tumor remaining in the corpus cavity. The enhanced parasagittal MR images facilitated the evaluation of the extent of the endometrial carcinoma.
CNS-Effects from Subarachnoid Injections of Iohexol and the Non-Ionic Dimers Iodixanol and Iotrolan in the Rabbit
Authors: Sundgren P. , Bååth L. , Maly P.
Published: June 2015

The neural tolerance of the new non-ionic dimer iodixanol was compared with that of the clinically used monomer iohexol and the dimer iotrolan. Behaviour of non-anaesthetised rabbits was monitored for 3 hours after intracisternal injection, at a dose-volume of 1 ml/kg of iodixanol 150 mg I/ml, iodixanol 320 mg I/ml, iohexol 350 mg I/ml, or iotrolan 300 mg I/ml (10 rabbits in each group). Iotrolan induced generalised seizures in 5 rabbits, iodixanol 320 mg I/ml in 2 rabbits, and iodixanol 150 mg I/ml in one rabbit. No excitative changes were observed in rabbits injected with iohexol, but compared with the dimeric contrast media the difference was not significant. Iohexol produced significantly more severe depressive changes than iodixanol 150 mg I/ml (p<0.01), iodixanol 320 mg I/ml (p<0.05), and iotrolan 300 mg I/ml (p<0.05). The results indicate that the excitative neurotoxic potential of the dimer iodixanol is likely to be lower than that of the clinically used dimer iotrolan, but slightly higher than that of iohexol. It may be expected that both dimers will produce a lower frequency of minor neurological adverse reactions than iohexol.
Legg-Calvé-Perthes Disease
Authors: Kaniklides Costa , Lönnerholm Torsten , Moberg Anders , Sahlstedt Bo
Published: June 2015

In a prospective study of 22 patients (24 hips) with Legg-Calvé-Perthes disease (LCPD) the findings at conventional radiography, arthrography, bone scintigraphy and MR imaging, obtained at the time of diagnosis, were compared. MR was superior to conventional radiography and bone scintigraphy in the detection of the extent of involvement in the femoral head. Arthrography was as good as or better than MR imaging in determining the shape of the articular surfaces and the occurrence of lateral subluxation. Conventional radiography was less sensitive in identifying the degree of lateral subluxation and the extent of the necrosis in the femoral head. MR imaging provided anatomical and pathophysiological information about the extent and location of head involvement as well as the degree of lateral subluxation. Revascularisation was more clearly demonstrated with MR than with bone scintigraphy, irrespective of symptom duration.
Chemoembolization of Head and Neck Cancer with Carboplatine Microcapsules
Authors: Tomura N. , Kobayashi M. , Hirano H. , Watarai J. , Okamoto Y. , Togawa K. , Kowada M. , Murota H.
Published: June 2015

Fourteen patients with malignant tumor in the head and neck region were treated with infusion of carboplatine microcapsules (CBDCA-mc) via percutaneous superselective catheterization. A microcatheter was advanced into a feeding artery using a coaxial catheter system. Eleven patients had over 30% reduction of the tumor size on CT within 1 month after embolization. Twelve patients had an increased amount of low attenuation tissue in the tumor on CT after embolization, suggesting increased necrosis in the tumor. No definite hematologic toxicity was found. A majority of patients complained of moderate pain in the embolized region immediately after embolization, easily relieved by i.v. analgesics. Chemoembolization using CBDCA-mc may be an effective therapeutic modality in advanced cases of head and neck cancer.
MR Diagnosis of Retropatellar Chondral Lesions under Compression
Authors: Andresen R. , Radmer S. , König H. , Banzer D. , Wolf K.-J.
Published: June 2015

Purpose:

The aim of the study was to improve the chondromalacia patellae (CMP) diagnosis by MR imaging under defined compression of the retropatellar cartilage, using a specially designed knee compressor. The results were compared with histological findings to obtain an MR classification of CMP.

Method:

MR imaging was performed in in vitro studies of 25 knees from cadavers to investigate the effects of compression on the retropatellar articular cartilage. The results were verified by subsequent histological evaluation.

Results:

There was a significant difference in cartilage thickness reduction and signal intensity behaviour under compression according to the stage of CMP.

Conclusion:

Based on the decrease in cartilage thickness, signal intensity behaviour under compression, and cartilage morphology, the studies permitted an MR classification of CMP into stages I—IV in line with the histological findings. Healthy cartilage was clearly distinguished, a finding which may optimize CMP diagnosis.
Petrous Bone Extension of Middle-Ear Acquired Cholesteatoma
Authors: Robert Y. , Dubrulle F. , Carcasset S. , Hennequin C. , Gaillandre L. , Vanecloo F.-M. , Lemaitre L.
Published: June 2015

Purpose:

To describe CT and MR features of extension to the petrous bone, which is a rare complication of acquired cholesteatoma (AC).

Material and Methods:

Postcontrast CT was performed in 4 patients, in axial (n=4) and coronal planes (n=2). The section thickness was 1.2 or 2.5 mm. MR was performed in 3 cases, using T1- and T2-weighted images (n=3) and postcontrast T1-weighted images (n=2).

Results:

CT demonstrated a well-outlined lesion involving the petrous bone (n=4). Density could be assessed in 3 cases, showing a hypodense unenhanced mass. Lateral (n=1), superior (n=2), and posterior (n=2) semicircular canals were affected in 3 patients. AC extended to the vestibula, cochlea, and internal acoustic meatus (IAM) in 3 patients. Two ACs extended to the level of IAM, whereas 2 extended further, to the petrous apex. In one case the sphenoid sinus was affected. On MR imaging the lesion was hypointense relative to brain on T1-weighted images and hyperintense on T2-weighted images. MR imaging helped to delineate the lesion and to distinguish it from other cystic lesions of the petrous bone.

Conclusion:

CT and MR offer accurate preoperative assessment of the extension of cholesteatoma, which helps to choose the surgical approach.
Dermatofibrosarcoma Protuberans
Authors: Miyakawa E. , Fujimoto H. , Miyakawa K. , Nemoto K. , Kozawa K. , Sugano I. , Odani Y. , Hirata T. , Ogata H. , Ohno T.
Published: June 2015

Purpose:

To characterize the CT findings of dermatofibrosarcoma protuberans.

Material and Methods:

CT and pathologic specimens of 6 patients with dermatofibrosarcoma protuberans (5 in the trunk and 1 in the leg) were retrospectively reviewed.

Results:

CT clearly defined the tumors in the dermis and subcutaneous tissue with a characteristic, if not pathognomonic, protrusion. On postcontrast CT, 3 tumors showed marginal enhancement and central low density, while the others showed homogeneous enhancement. Pathologically, the marginal enhancement on CT corresponded to fibrosarcomatous changes, and the central low density to necrosis. The tumors with homogeneous enhancement had no sarcomatous changes.

Conclusion:

CT allows detection and precise anatomic localization of dermatofibrosarcoma protuberans. Marginal enhancement with central low density on CT may suggest a relatively poor prognosis.
Elimination of Low-Osmolality Contrast Media by Hemodialysis
Authors: Furukawa T. , Ueda J. , Takahashi S. , Sakaguchi K.
Published: June 2015

Purpose:

To compare the dialyzability and safety of 2 types of low-osmolality contrast media administered to end-stage renal failure patients maintained on regular hemodialysis.

Material and Methods:

Of 44 CT examinations, iohexol was used in 22 and ioxaglate in the other 22. Adverse reactions and hemodynamic changes were recorded. Thirty minutes after the beginning of CT investigation, hemodialysis was commenced. Elimination rate and clearance of the contrast media were measured as indices of their dialyzability.

Results:

After 4 hours of hemodialysis, 78.4±6.5% of iohexol and 72.4±6.0% ioxaglate were eliminated. Clearance of iohexol was higher than that of ioxaglate at all sampling times. No severe hemodynamic change nor adverse reaction were observed. Minor reactions were more frequently observed in the ioxaglate group.

Conclusion:

Iohexol, a nonionic monomeric contrast medium, is more advantageous for hemodialysis patients than ioxaglate, an ionic dimeric contrast medium.
Effects of Mannitol and Iohexol Infusions on the Renal Cortical Blood Flow in Dehydrated 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 intravenous infusions of equimolar concentrations of mannitol and iohexol were studied in normal lean mice and obese/hyperglycemic mice after dehydration overnight. All infusions produced marked effects in distribution and velocity of renal cortical blood flow. Initially increased blood flow was seen in a number of capillaries after infusion of both mannitol and iohexol, and renal cortical blood flow was inhomogeneous for different capillaries. A significantly (p<0.05) larger number of capillaries with decreased blood flow, within the first minutes after start of infusion, was observed after infusion of iohexol to normal mice when the animals had been dehydrated overnight. Our results indicate that the minor adverse effects on renal cortical blood flow caused by the infusion of contrast medium are potentiated by dehydration.
Complications following High-Dose Percutaneous Ethanol Injection into Hepatic Tumors
Authors: Tapani E. , Soiva M. , Lavonen J. , Ristkari S. , Vehmas T.
Published: June 2015

Purpose:

Percutaneous ethanol injection therapy (PEIT) with a 2–10 ml ethanol dose per session is widely used in the treatment of small hepatocellular carcinoma. Larger doses have been restricted for fear of complications. The aim of the present study was to make a retrospective evaluation of the complications following treatment of hepatic tumors with high doses of ethanol (up to 200 ml).

Material and Methods:

The medical records of 15 patients treated repeatedly with PEIT were reviewed retrospectively to detect side effects or complications. Eleven of these patients had undergone transarterial chemoembolization (TAE) prior to PEIT. Of 173 ethanol injections in doses of 2–200 ml (mean 49 ml), more than 10 ml had been injected on 138 occasions. The chi-square test was used to evaluate the differences in pain frequency among the various dosage groups.

Results:

Serious complications did not occur. Pain was a common side effect, occurring in 48% of the procedures. Immediate pain during the treatment was related to the ethanol dose and increased significantly with increasing doses (p<0.01). Other side effects were rare.

Conclusion:

PEIT with doses higher than previously reported seems to be safe. This should encourage further clinical studies that aim at fully working out the clinical value of such treatment.
Thyroid Ultrasound Findings 7 Years after the Chernobyl Accident
Authors: Kumpusalo L. , Kumpusalo E. , Soimakallio S. , Salomaa S. , Paile W. , Kolmakow S. , Zhukowsky G. , Ilchenko I. , Nissinen A.
Published: June 2015

Aims:

The accident at the Chernobyl nuclear power station occurred in April 1986. We report on a comparative epidemiological study on thyroid abnormalities in the contaminated and uncontaminated populations of the Bryansk region, South-West Russia, in 1993, 7 years after the accident.

Material and Methods:

The study material consisted of all inhabitants aged 3–34 years in the contaminated village of Mirnyi and in the uncontaminated village of Krasnyi Rog, excluding those who had moved to the villages after the accident. The total material comprised 302 inhabitants in Mirnyi and 200 in Krasnyi Rog.

Results:

No pathological US findings in either village were found in children born after the accident. In the age group 0–9 years old at the time of the accident, the prevalence of thyroid abnormalities was 8.1% in the contaminated village compared to 1.6% in the uncontaminated village. In the age group 10–27 years the corresponding figures were 18.8% and 17.7%. Only 55% of the pathological US findings were detected by physical palpation.

Conclusion:

The total prevalence of thyroid abnormalities was higher among children in the contaminated village. We recommend an active screening of young contaminated subjects with US, supplemented with fine needle biopsy.