bluuebunny/crossref_metadata_2025_split huggingface dataset:
Value of Ultrasonography, CT and MR Imaging in the Diagnosis of Primary Hyperparathyroidism
Authors: Tziakouri C. , Eracleous E. , Skannavis S. , Pierides A. , Symeonides P. , Gourtsoyiannis N. 
Published: June 2015

Purpose: To evaluate the significance of preoperative localization of abnormal parathyroid glands to the surgical outcome in patients with primary hyperparathyroidism. Material and Methods: Thirty-nine patients with primary hyperparathyroidism were studied preoperatively with US (39 patients), CT (30 patients) and MR imaging (18 patients). The overall diagnostic accuracy for US was 87%, CT 66% and MR 94%. In patients with a single parathyroid adenoma US was the most cost-effective localization technique with a detection rate of 96%. CT had a lower detection rate (78%) but was of particular value for fairly large ectopic adenomas in the root of the neck. MR imaging was a good confirmatory test (93%). In patients with multiple gland disease (primary hyperplasia and multiple adenomas), no single localization study alone was sufficient. Combination of all 3 studies, however, alerted the physician to the presence of disease in more than one gland in 87% of these patients. Conclusion: US, CT and MR imaging followed by surgery performed by an experienced surgeon provided good clinical results in 39 patients with primary hyperparathyroidism. Preoperative localization was especially useful in patients with primary parathyroid hyperplasia or multiple adenomas and in patients with ectopic parathyroid adenomas in the root of the neck. We recommend identification of all abnormal parathyroid glands prior to surgery.
Prognostic Significance of Pathological Chest Radiography in Transplant Patients Affected by Cytomegalovirus and/or Pneumocystis Carinii
Authors: Wilczek B. , Wilczek H. E. , Heurlin N. , Tydén G. , Aspelin P. 
Published: June 2015

Purpose: In order to evaluate the prognostic significance of chest film findings in connection with cytomegalovirus (CMV) and/or pneumocystis carinii infection (PC), a retrospective review was made of the pulmonary charts of 274 recipients of kidney and/or pancreatic grafts transplanted between April 1987 and December 1990. Material, Methods and Results: Positive laboratory findings for CMV and/or PC were seen in 92 patients. In 77 patients only CMV was found, 13 patients had both CMV and PC, and 2 patients had only PC. In 57 patients a chest examination was performed. The films were reviewed by 2 radiologists independently. In 32 patients normal chest film findings were seen, while 25 patients demonstrated pathological changes. Of the patients with pathological changes 3 had only pleuritis while the remaining 22 demonstrated parenchymal infiltrations. No deaths occurred among patients infected with CMV and/or PC, when the chest film findings were normal or pleuritis only was seen, but there were 9 deaths in the group of patients with parenchymal infiltrations. Of the patients who died, 2 had only CMV, 5 had both CMV and PC, and 2 had only PC. The overall mortality, regardless of radiological findings, did not exceed 3% in patients with CMV only, but increased to 38% in patients with both CMV and PC. In patients with parenchymal infiltrations the corresponding mortality figures were increased to 18% and 56%, respectively. Conclusion: We conclude that a radiologically verified pneumonia related to the infectious agent influences the prognosis, and that CMV pneumonia has a better prognosis than PC pneumonia.
Effects of Varying Filter Kernel Sizes on the Image Quality of Interstitial Lung Diseases
Authors: Müller R.-D. , Herting D. , Hirche H. , John V. , Buddenbrock B. , Gocke P. , Wiebringhaus R. , Braunschweig R. , Voss M. , Mohnke M. , Konietzko N. 
Published: June 2015

Purpose: The aim of the study was to optimize the postprocessing of digital luminescence radiographs of interstitial infiltrates of the lung. Material and Methods: Ninety-seven patients with established diseases of the lung parenchyma were examined: 514 pathological details were investigated, using a 200-speed screen-film system and a storage phosphor plate. In digital postprocessing, the size of the filter kernel (S) varied between S 5 and S 70. Based upon 32896 individual evaluations, the image quality was evaluated in multifactorial variance analyses. Results: The digital standards were significantly inferior to the tested screen-film system. The large filter kernel S 70 and the small filter kernels S 5 and S 10, as well as an algorithm for edge enhancement, showed selective advantages in the depiction of nodular or small linear structures. For micronodular and linear structures, kernel sizes of S 20 and S 40 produced equally good results (p>0.05). Conclusion: Whenever optimized postprocessing is involved, storage phosphor radiography is equal to a modern screen-film system and can be substituted for the latter without any loss of image quality; this is especially valid for the imaging of interstitial infiltrates of the lung.
Breast and Pectoralis Muscle Hypoplasia
Authors: Aznar J. M. Perez , Urbano J. , Laborda E. Garcia , Moreno P. Quevedo , Vergara L. Ferrer 
Published: June 2015

Purpose: Poland's syndrome is a congenital and unilateral aplasia of the pectoralis major muscle (PMM), with other anomalies of the ipsilateral upper extremity. We present 6 cases in which the only clinical expression was asymmetry of the breasts associated with partial absence of the PMM. Material and Methods: We reviewed 95000 mammograms (obtained 1985–1995) to find patients with asymmetrical breast size. Where the asymmetry could not be ascribed to any other cause, the patients were recalled for an examination of the PMM which was conducted at rest and with active contraction of the muscle. Results: Unilateral volume reduction of the PMM was found in 5 women of whom 2 were studied with MR. A 6th case was a fortuitous finding in a male patient. Conclusion: Mild forms of Poland's syndrome are more frequent than severe forms, and may go undiagnosed. Hypoplasia of one breast or a horizontal anterior axillary fold may be the sole clinical manifestation of this syndrome.
MR Imaging, CT and CEA Scintigraphy in the Diagnosis of Local Recurrence of Rectal Carcinoma
Authors: Blomqvist L. , Holm T. , Göranson H. , Jacobsson H. , Ohlsén H. , Larsson S. A. 
Published: June 2015

Purpose: To compare advanced imaging techniques in the diagnosis of recurrent rectal cancer. Material and Methods: Twenty-five consecutive patients with either suspected or verified recurrence were examined by CT (n=25), MR with phased-array capabilities (n=24) and CEA scintigraphy (n=16). Three experienced radiologists (who were blinded to results obtained at surgery and histopathology) independently evaluated the films, one observer for each modality. Results: The MR radiologist arrived at a correct diagnosis in 87.5% of the examinations, the CT radiologist in 76% and the CEA radiologist in 75%. The MR radiologist's results correlated more often with reported pathology than did those of the CT radiologist with regard to the relation of recurrent tumor to surrounding structures in the pelvis. Conclusion: MR imaging is the most effective of the 3 modalities in the diagnosis of recurrent rectal cancer.
Endosonography for Preoperative Staging of Rectal Tumours
Authors: Nielsen M. B. , Qvitzau S. , Pedersen J. F. , Christiansen J. 
Published: June 2015

Purpose: The aim of this study was to evaluate the use of rectal endosonography for preoperative staging of tumour extension and lymph node involvement in rectal tumours. Material and Methods: Over a 4-year period 100 patients with rectal tumours were studied with sonography using 7 MHz endoprobes. Tumour spread was assessed according to the TNM classification, and the number and maximum size of perirectal lymph nodes were registered. The sonographic findings were compared with the surgical and histological findings. Results: The overall accuracy of endosonography in assessing local tumour extension was 85% (76–91%; 95 percent confidence limits). T4 tumours with a large contact surface to an adjacent organ tended to be nonresectable. Lymph node assessment could be made in 81 patients who underwent radical resection: sonography showed lymph nodes in 49 patients, 30 of whom had nodal metastases; the histological examination showed lymph nodes in the remaining 32 patients, 8 of whom had nodal metastases. The number of lymph nodes at the histological examination was markedly higher than the number depicted by preoperative ultrasound. Conclusion: This study confirmed the use of endoluminal ultrasound in the preoperative evaluation of local tumour spread. However, endosonographic assessment of perirectal nodal involvement seems to be too unreliable to be used for the preoperative selection of patients.
Non-Cardiogenic Pulmonary Oedema after Intravenous Administration of Non-Ionic Contrast Media
Authors: Hauggaard A. 
Published: June 2015

A case of adverse respiratory reaction to the i.v. injection of iohexol (300 mg I/ml, 131 ml in 4 min) in association with abdominal CT is described. The potentially pathogenetic mechanisms of pulmonary oedema induced by radiographic contrast media are discussed.
The Full-Scale Pacs Archive
Authors: Nissen-Meyer S. A. , Fink U. , Pleier M. , Becker C. 
Published: June 2015

Purpose: Increasing percentages of digital modalities in radiology, in particular of digital image acquisition in conventional radiography, call for digital reporting, communication, and archiving techniques. These techniques are prerequisites for the “filmless” hospital. The first 2 have been covered extensively in the literature and by vendors. However, as regards online digital image archives there are still no satisfactory concepts available in the medical field. The present paper puts forward some suggestions as to how this situation could be improved. Material and Methods: Analyses of radiology operations consider the prevailing PACS (picture archiving and communication system) archive concepts that use optical discs to be too small, too slow and too cumbersome to manage and therefore unable to function as comprehensive image archives for filmless hospitals. We suggest borrowing and adapting the well tested archive technologies from space research and the oil and broadcasting industries which have much higher capacities and speeds and better software interfacing possibilities. With such technologies the needs of filmless hospital operations can be met. Results: A feasible concept for a transition strategy from conventional analog to digital archives is presented. Model calculations of the necessary investments and potential savings, including generous placement of viewing stations in the entire hospital, indicate amortization periods of 3.8–4.8 years. Conclusion: Alternative technologies for digital image archives already today make full-scale PACS for filmless hospitals technologically and conceptually feasible and financially mandatory.
Complicated Bone and Soft-Tissue Infections
Authors: Hovi I. 
Published: June 2015

Purpose: To assess the value of imaging by 0.1 T MR and by 99mTc-HMPAO-labeled leukocytes in confirming skeletal infection in patients with soft-tissue infections and/or bone pathology. Methods: Thirty-nine anatomical sites (35 patients) with suspected bone infection were prospectively imaged with 0.1 T MR and 99mTc-HMPAO-labeled leukocytes. Thirty-two infected areas were confirmed: 12 osteomyelitis (out of which 3 were spondylitis) and 27 soft-tissue infections (both bone and soft-tissue infection in 7 areas). Results: MR imaging showed 31 true-positive, 3 true-negative, 4 false-positive and one false-negative diagnosis of infection and scintigraphy 27, 7, 0 and 5 respectively. The sensitivity of MR for osteomyelitis was 100% (12/12) and of scintigraphy 42% (5/12), p<0.01. The specificity of MR and of scintigraphy for osteomyelitis were 81% (22/27) and 93% (25/27) respectively. The sensitivity of MR for soft-tissue infection was 96% (26/27) and specificity 75% (9/12). The correspoding figures for scintigraphy were 85% (23/27) and 100% (12/12). MR and scintigraphy were concordant with respect to the final diagnosis in 28/39 (72%) sites and discordant in 10 (26%). In one patient with Charcot osteoarthropathy a false-positive finding was found by both methods. MR detected all 3 cases of spondylitis, scintigraphy none. Nonpyogenic inflammations and neuroarthropathic joints were indistinguishable from infection by MR. Conclusion: Combined imaging with MR and 99mTc-labeled leukocytes is recommended in diagnostically complicated bone infections except for spondylitis where MR is the method of choice. Congruent positive findings are highly suggestive of infection, the extent of which can be determined. Congruent negative results exclude infection.
Imaging Approach to the Diagnosis of Pulmonary Sequestration
Authors: Hang J.-D. , Guo Q.-Y. , Chen C.-X. , Chen L.-Y. 
Published: June 2015

Purpose: To describe the characteristic features of pulmonary sequestration (PS), to evaluate the usefulness of various imaging modalities, and to find a rational approach to accurate diagnosis. Material and Methods: Twenty-four patients with PS proved by operation and pathology were reviewed retrospectively. Plain chest films were done in all patients, bronchography in 3, sonography in 14, CT in 6 (including CT angiography in 1 case), MR in 8 (including MR angiography in 1 case) and aortography in 12 (including DSA in 1 case). Results: Plain chest films demonstrated a solid mass in 14 patients and a cystic mass in 10. Bronchograms showed displacement of adjacent bronchi with no filling of contrast medium within the lesion in 2 cases, while another case had a blind intermediate portion of the right bronchus (hypoplasia of middle and lower lobes associated with extralobar sequestration). Sonography demonstrated a solid lung mass in 12 cases and a solid mass with cystic areas in 2, and detected vessel-like structures within the mass or in its surroundings in 12. Doppler analysis showed arterial spectral wave confirming a feeding artery. CT revealed a solid mass in all patients, a mass with low density area in 4, and emphysema surrounding the mass in 3. MR imaging depicted anomalous arteries in all patients and venous drainage in 4 cases. Aortography demonstrated anomalous systemic arterial supply to the PS in all patients. In this series, 21 cases (87.5%) were correctly diagnosed preoperatively by the imaging modalities. Conclusion: Plain chest films can provide a diagnostic clue to PS. Sonography, CT and MR are helpful for showing arterial blood supply and for making a definite diagnosis. We recommend a rational imaging approach for the diagnosis of PS.
Crescentic and Ring-Shaped Opacities
Authors: Voloudaki A. E. , Bouros D. E. , Froudarakis M. E. , Datseris G. E. , Apostolaki E. G. , Gourtsoyiannis N. C. 
Published: June 2015

Two cases of idiopathic bronchiolitis obliterans organizing pneumonia (BOOP) with unusual CT findings are presented. On CT both cases exhibited crescentic and ring-shaped opacities, surrounding areas of groundglass attenuation, and associated with a nodular pattern in one patient and airspace consolidations in the second patient. CT—pathologic correlation disclosed that the central areas of groundglass attenuation corresponded to alveolar septal inflammation, in contrast to the denser periphery where granulomatous tissue in peripheral airspaces predominated. In the broad spectrum of CT findings, BOOP can exhibit specific CT features with regard to the crescentic or ring-shaped opacities with a central groundglass attenuation area. Since these features have not been described in any other disease, they might be characteristic features for the diagnosis of BOOP.
Wedge-Shaped Lesion in the Liver Seen on Postoperative CT
Authors: Yoshimitsu K. , Charnsangavej C. , Park J. Mi , Ibukuro K. 
Published: June 2015

Purpose: To demonstrate CT findings of a wedge-shaped lesion (WSL) in the liver following abdominopelvic surgery and to determine the etiology and incidence of WSL. Material and Methods: Retrospective review of teaching files in our institution revealed 18 cases showing postoperative WSL in the liver. We also retrospectively reviewed CT images of the liver in 104 patients with a recent history of abdominopelvic surgery performed during a period of 12 months, as well as in 102 patients with no history of surgery during the same period to be used as control. Three additional patients with WSL were found in the postoperative group and none in the control group. Liver CT images from the 21 patients showing WSL, along with their clinical data and follow-up CT where available, were retrospectively analyzed. Results: I.v. contrast-enhanced CT showed homogeneous higher attenuation of WSL than the surrounding liver in all cases; unenhanced CT showed low density in 5 patients, isodensity in 7 patients, and high density in 5 patients as compared with the surrounding liver. Density on unenhanced CT was significantly correlated with the presence or grade of fatty liver (p<0.01). In 5 cases CT demonstrated clots in the portal vein branch within the area of WSL and in 2 cases portal perfusion defects were observed on arterial portal CT, corresponding to the areas of WSL. Follow-up CT examinations were available on 15 patients: WSL became less prominent, or atrophic, or showed no change in 10, 2 and 3 patients respectively. Follow-up CT showed development of liver metastasis in only 3 cases. Only 2 of the 21 patients were clinically symptomatic; one had postoperative ileus and the other obstructive jaundice. Conclusion: Postoperative WSL may represent a thromboembolic phenomenon at the peripheral intrahepatic branch of the portal venous system during or after abdominopelvic surgery, resulting in a compensatory increase in the hepatic arterial flow that appears as wedge-shaped enhancement on CT. This is a clinically asymptomatic and uncommon phenomenon (occurring in 3% of abdominopelvic surgeries). It is important that this phenomenon is not confused with liver metastasis.
“Aggressive” Renal Angiomyolipoma
Authors: Cittadini G. , Mucelli F. Pozzi , Danza F. M. , Derchi L. E. , Mucelli R. S. Pozzi 
Published: June 2015

Purpose: We describe the US and CT examinations of 4 patients with renal angiomyolipoma with an “aggressive” appearance, and review the literature. Material and Methods: The imaging findings in 4 patients with benign renal angiomyolipomas associated with thrombosis of the renal vein and/or inferior vena cava are presented. In one case, enlarged lymph nodes at the renal hilum were found. Results: CT demonstrated fat densities within both tumor and thrombus. In one patient, small lymph nodes with low density internal areas were detected in the para-aortic region. When considering our patients together with those reported in the literature, we found that most angiomyolipomas with venous invasion were large and centrally located within the kidney. Venous thrombosis was observed in 9 lesions of the right kidney, and in only 4 of the left one; detection of the site of origin was impossible in one case. One patient only had symptoms due to the thrombus; 10 had problems due to the tumor; and 3 were asymptomatic. Only 4 patients with pararenal enlarged lymph nodes have been reported on in the imaging literature. Fat-containing nodes were detected by CT in one case only; the others had enlarged nodes of soft-tissue density. In one patient the diagnosis of hamartomatous lymph node invasion was established by angiography. Conclusion: In patients with renal angiomyolipoma, demonstration of both fatty thrombus and the fatty infiltration of lymph nodes of the renal hilum cannot be regarded as an indication of malignancy, but only of local aggressive behavior. Although surgery is commonly contemplated to prevent symptoms from venous thrombosis, conservative treatment seems possible. Detection of enlarged lymph nodes of soft tissue density may cause difficult diagnostic problems, with the diagnosis addressed only by the presence of associated lesions. Increased awareness that renal angiomyolipoma can sometimes appear “aggressive” could help to prevent such lesions from being considered malignant, and thus avoid surgical confirmation of their nature.
Distal Biceps Tendon Ruptures
Authors: Kelly Mick P. , Perkinson Scott G. , Ablove Robert H. , Tueting Jonathan L. 
Published: June 2015

Background: The incidence of distal biceps tendon ruptures was studied more than 10 years ago in a small patient cohort. Recent diagnostic advancements have improved the ability to detect this rare injury. Hypothesis: The incidence of distal biceps tendon ruptures will be significantly greater than previously reported. Study Design: Descriptive epidemiologic study. Methods: A query of the PearlDiver Technologies national database containing public and private insurance patients was used to estimate the national incidence of distal biceps tendon ruptures in the United States. A retrospective chart review of our local population identified demographic groups and risk factors that increased likelihood of injury. Results: The estimated national incidence of distal biceps tendon rupture was 2.55 per 100,000 patient-years. The local incidence was 5.35 per 100,000 patient-years. The mean and median ages of patients in our regional cohort were 46.3 and 46 years, respectively. Males composed the majority of the injured population (national 95%, regional 96%). Smoking and elevated body mass index were found to be associated with increased likelihood of injury, while diabetes mellitus showed no association. Conclusion: The incidence of distal biceps tendon ruptures in this study was higher than previously reported.
Field Research and Parametric Analysis in a Medical–Surgical Unit
Authors: Nanda Upali , Pati Sipra , Nejati Adeleh 
Published: June 2015

Objective: To study the workplace in a medical–surgical (med-surg) unit and to identify suboptimal environmental conditions that can be improved in the current unit and avoided in future design, through rapidly deployed field research and timely simulation. Background: Literature emphasizes the importance of the healthcare workplace and the effect on patient outcomes. What is lacking are studies conducted on-site and used for immediate application in design to assess and improve workplace conditions. Methods: A rapidly deployed field research and simulation study was conducted in a 40-bed med-surg unit of a large healthcare system as part of the process of designing a new medical tower. Online surveys, systematic behavioral observations, semi-structured interviews, sound studies, and advanced spatial analysis through parametric modeling were conducted. Results: The following created challenges for patient monitoring, care coordination, and management: (1) waste and variability in walking, (2) limited point-of-use access to supplies, (3) large distances traveled for minor tasks, and (4) low visibility and connectivity. The corridor is used as a workspace/communication hub. There is a distinct difference in beginning of day and night shift patterns and between walking “distance” and walking “sequence.” There is a tendency for nurses to multitask, but a simulation exercise shows that for key tasks like medication delivery, multitasking may not always reduce walking distances. Conclusion: Co-location of medications, supplies, and nourishment; accommodation for work on wheels; and spatial and technological connectivity between care team and patients should be considered while designing a med-surg unit. Understanding the key activity sequences helps determine the proximity of spaces in relationship to patient rooms and each other.