bluuebunny/crossref_metadata_2025_split huggingface dataset:
Determination of Tissue Volumes
Authors: Lönn L. , Starck G. , Alpsten M. , Ekholm S. , Sjöström L. 
Published: October 2009

Purpose: To evaluate MR imaging for tissue volume measurements. Material and Methods: Imaging was done with a spoiled gradient echo technique using the human lower leg as a simple model and CT as the reference technique. Areas of adipose tissue, muscle plus skin and bone tissue were evaluated in 5 volunteers using signal intervals (MR) and attenuation intervals (CT) defined by histograms. Volumes were determined from 7 images (MR-7, CT-7), from 70 contiguous images (MR-70), and also from a commercially-available 3D program based on a seeding technique applied according to the operators' judgment (MR-op). Results: the sum of bone tissue, muscle plus skin and adipose tissue were similar for CT and MR. Compared to CT-7, MR-7 and MR-70 overestimated adipose tissue (0–8%) and muscle plus skin (11–15%), while bone tissue was underestimated (61–78%). Determinations based on the contiguous images or the 7 images were similar (standard error 2–5%). MR-op resulted in pronounced underestimation of muscle plus skin and bone tissue and a minor underestimation of adipose tissue. Conclusion: Valid determinations of adipose tissue volume are possible with MR but further technical development is required for other tissue volumes. the technique applied according to the operators' judgement, as used for 3D surface rendition, is unreliable for tissue volume determinations.
CT-Guided Fine-Needle Aspiration Biopsy of Spinal Lesions
Authors: Kang M. , Gupta S. , Khandelwal N. , Shankar S. , Gulati M. , Suri S. 
Published: October 2009

Purpose: A retrospective study of CT-guided fine-needle aspiration biopsies (FNABs) of spinal lesions performed over a period of 6 years was carried out with the aim of assessing the safety and efficacy of the procedure and to analyse the various approaches used. Material and Methods: Ninety-three FNABs were performed in 87 patients, 4–70 years of age, under CT guidance. Lytic or mixed vertebral lesions with or without a paraspinal soft tissue component were included in the study. the approach depended on the anatomic region and part of the vertebra involved. Results: A definite cytological diagnosis was obtained in 77 patients (88.5%); of these, 47 patients had benign lesions and 30 patients had neoplasms. the most common pathologies encountered were tuberculosis (n=33) and metastases (n=17). There were 10 inconclusive FNABs; these showed blood only, necrotic material or scanty material insufficient for diagnosis. There were no procedure-related complications. Conclusion: CT-guided FNAB is a safe and effective technique for the evaluation of spinal lesions and is helpful in planning therapy. Choosing the appropriate approach results in a low complication rate.
The Additional Value of us to Mammography in the Diagnosis of Breast Cancer
Authors: Skaane P. 
Published: October 2009

Purpose: To assess the additional value of ultrasonography (US) to mammography in the diagnosis of malignant breast tumors. Material and Methods: Prospectively recorded final assessment categories for mammography and US were compared for 327 (228 palpable and 99 nonpalpable) consecutive malignant tumors confirmed at histology. the additional value of US was assessed for a subpopulation of 71 of these 327 malignancies after excluding mammographically conclusive malignant findings, ductal carcinomas in situ (DCIS), and invasive carcinomas presenting with suspicious microcalcifications, since there is no indication for performing US in these patients. Results: A total of 267 (82%) of the 327 malignant tumors were correctly diagnosed on both imaging modalities. Mammography correctly diagnosed 41 cancers with false-negative US findings as compared with 11 true-positive US diagnoses of malignant tumors with false-negative findings on mammography (McNemar test p<0.001). US correctly diagnosed (“upgraded”) 31 (10%) of the 327 malignant tumors with benign or indeterminate mammographic diagnoses. In the subpopulation, US upgraded 20 (42%) of 48 palpable and 10 (44%) of 23 nonpalpable malignant tumors. Conclusion: the overall additional value of US to mammography in the diagnosis of breast cancer was rather limited in a population of mixed malignant tumors. Excluding cancers with mammographically conclusive diagnosis and suspicious microcalcifications as well as DCIS from analysis, US correctly upgraded more than 40% of palpable and nonpalpable malignant tumors.
New Classification of Small Pulmonary Nodules by Margin Characteristics on Highresolution CT
Authors: Furuya K. , Murayama S. , Soeda H. , Murakami J. , Ichinose Y. , Yauuchi H. , Katsuda Y. , Koga M. , Masuda K. 
Published: October 2009

Purpose: To analyze margin characteristics of pulmonary nodules on highresolution CT (HRCT) in order to improve imaging diagnoses. Material and Methods: HRCT images of 193 pulmonary nodules of less than 30 mm maximum diameter (113 primary cancers, 15 metastatic cancers, 55 inflammatory nodules, and 10 benign tumors) were reviewed and classified as to 6 types of margins: round, lobulated, densely spiculated, ragged, tentacle or polygonal and halo. the relationships of these imaging types to the diagnoses, the underlying pathological features, mainly those of tumor growth patterns in 93 neoplasms, and the pathological characteristics of 14 inflammatory nodules were investigated. Results: Eighty-two percent of the lobulated, 97% of the densely spiculated, 93% of the ragged and 100% of the halo nodules were malignant. Eighty percent of the tentacle or polygonal nodules were inflammatory and 66% of the round ones were benign. the 6 types differed statistically as to the nature of the benignity/malignancy ( p<0.001). Pathologically, in case of neoplasms, most of the 6 types had a relationship to a particular tumor growth pattern. Conclusion: This HRCT classification method is useful for determining the nature of small pulmonary nodules and reflects the underlying pathological characteristics.
Detection of Small Peripheral Lung Cancer by Digital Chest Radiography
Authors: Yang Z.-G. , Sone S. , Li F. , Takashima S. , Maruyama Y. , Hasegawa M. , Hanamura K. , Asakura K. 
Published: October 2009

Purpose: To clarify whether processed digital chest radiography can improve the detection rate for small peripheral lung cancer. Material and Methods: Five radiologists independently interpreted 54 digitized chest radiographs of 18 patients with small peripheral lung cancers measuring less than 20 mm, which were displayed following 3 types of digital processing: 1) an original version; 2) unsharp mask processing with a type 1 filter (very low-frequency-enhancing, mid-frequency-suppressing, and high-frequency-enhancing filter); and 3) unsharp mask processing with a type 2 filter (very low— and high-frequency-enhancing filter). A total of 1,620 pooled observations were evaluated by receiver operating characteristic (ROC) analysis. Results: the mean area under the ROC curves was 0.68 for the type 1 filter, 0.68 for the type 2 filter, and 0.65 for the unprocessed (original) image. There were no statistically significant differences among these 3 kinds of image processing ( p>0.05). In all types of images, the small lung cancer with an alveolar lining tumor growth was less visible than a solid tumor growth ( p<0.01); the sensitivity increased with tumor size when the 3 groups of cancers, those measuring less than 10 mm, 11–15 mm, and 16–20 mm, were compared ( p<0.01). Conclusion: Unsharp mask-image processing of digital chest radiography will not improve the detection rate of small peripheral lung cancer, probably due to a substantial drawback: the limited conspicuity of cancer lesions in the surrounding lung and superposition of structures.
Hypoperfusion in the Renal outer Medulla after Injection of Contrast Media in Rats
Authors: Liss P. , Nygren A. , Hansell P. 
Published: October 2009

Purpose: the effect on regional renal blood was studied after injection of nonionic iso-osmolar iotrolan or ionic high-osmolar iothalamate. Material and Methods: Laser-Doppler flowmetry was used to measure outer medullary (OMBF) and superficial cortical blood flow (CBF) simultaneously in anesthetized rats. Iotrolan (320 mOsm/kg H2O) was injected i.v. at a dose of 600 mg I/kg b.w. (normal dose) over 2 min or 1,600 (high dose) mg I/kg b.w. over 2 or 8 min. Iothalamate (2,580 mOsm/kg H2O) was injected i.v. at a dose of 1,600 (high dose) or 2,900 (extremely high dose) mg I/kg b.w. over 2 min. Results: At the normal dose and 2-min injection of iotrolan, OMBF was reduced by 25±9% over 20 min. the high dose of iotrolan injected over 8 min resulted in a reduction in OMBF slightly smaller (17±9%) than that induced by the normal dose but lasting longer (30 min). Compared to the normal dose, the high dose and fast (2 min) injection of iotrolan resulted in a greater and more prolonged decrease in OMBF (32±6% lasting 50 min). After the high dose of iothalamate (1,600 mg I/kg) there was a decrease in OMBF by 21±6%, lasting 30 min. An extremely high dose (2,900 mg I/kg b.w.) gave a heterogeneous response with a mean increase in OMBF of 48 ±24% occurring 60 min after the injection. Conclusion: Iso-osmolar and high-osmolar contrast media (CM), at normal and high doses, decrease OMBF, while an extremely high dose of iothalamate may result in an increase. the depression of outer medullary perfusion may have implications for CM-induced acute renal failure in view of the vulnerability of this region to a decrease in oxygen tension.
Long-Term follow-up in Patients with Malignant Biliary Obstruction after Percutaneous Placement of Uncovered Wallstent Endoprostheses
Authors: Kaskarelis I. S. , Papadaki M. G. , Papageorgiou G. N. , Limniati M. D. , Malliaraki N. E. , Piperopoulos P. N. 
Published: October 2009

Purpose: Evaluation of the treatment of malignant obstructive jaundice by percutaneous insertion of uncovered stents. Material and Methods: 51 patients (35 men, 16 women) with inoperable malignant biliary obstruction underwent percutaneous placement of uncovered Wallstent biliary endoprostheses. A total of 65 endoprostheses were inserted. Results: the technical success rate was 98%, and the procedure-related complications rate was 10%. Early complications rate within the first 30 days was 2%. the clinical success rate within the first 30 days was 98% and the 30-day mortality rate was 2%. the late complications rate was 16%. the overall stent occlusion rate was 18% at a mean of 288.4 days. Mean survival time of the 50 patients was 214 days, and the mean total duration of hospital stay was 9.8 days. Conclusions: the advantages of uncovered Wallstent endoprostheses justify their placement in patients with inoperable malignant obstructive jaundice since patients' quality of life is markedly improved. Stent insertion is associated with a low complication rate, most stents remain patent longer than the patients' survival time and patients' hospital stay is relatively short.
Impact of CT in Patients with Sepsis of unknown Origin
Authors: Barkhausen J. , Stöblen F. , Dominguez-Fernandez E. , Henseke P. , Müller R.-D. 
Published: October 2009

Purpose: To evaluate the diagnostic relevance of CT in patients with sepsis of unknown origin. Material and Methods: Sixty-three consecutive intensive care patients with suspicion of an abscess and negative or inconclusive previous radiological examinations were included. CT was performed using the helical technique. A total of 45 abdominal and 38 chest examinations were evaluated. Results: 5/38 examinations of the chest revealed the source of sepsis (pleural empyema 2, lung abscess 1, mediastinitis 1, retrosternal abscess 1). 7/45 abdominal CT examinations showed the source of sepsis (intraabdominal abscess 2, hepatic abscess 3, intestinal perforation 1, gangrenous colitis 1). Conclusion: CT is useful for the evaluation of patients with fever or sepsis without a known source. Due to the detection of a septic focus by CT, 19% of the patients in our study could be immediately referred to causal therapy as percutaneous drainage or surgery.
Bronchopulmonary Arterial Anastomosis at the Precapillary Level in Human Lung
Authors: Hasegawa I. , Kobayashi K. , Kohda E. , Hiramatsu K. 
Published: October 2009

Purpose: To investigate the interrelationships between the bronchial and pulmonary circulations including the existence of precapillary bronchopulmonary arterial anastomoses. Material and Methods: CT of bronchial arteriography (BAG-CT) was performed in 10 patients and BAG-CT during a pulmonary artery block test (PA-block) in 5 patients with lung cancer. Bronchial and pulmonary circulations were evaluated in 5 autopsied normal lungs by injecting silicone rubber with different colors into the bronchial and pulmonary arteries. Results: BAG-CT correlated well with the findings at silicone rubber injection into lung autopsy samples. BAG-CT demonstrated inflow of contrast medium into the pulmonary artery during PA-block in all cases, while no inflow was observed before and following reversal of PA-block. Mixed silicone rubber was observed in the lobar to subsubsegmental bronchial arteries in all cases and in the subsubsegmental pulmonary artery in one case. Conclusion: Precapillary bronchopulmonary arterial anastomoses may exist at the level of the lobar bronchi to the periphery. If either the pulmonary or bronchial circulation is disturbed, flow occurs inside the anastomoses to supplement the other flow, especially flow from the bronchial to the pulmonary arteries via the anastomoses, which occurs within 30 min.
Optimising Imaging Parameters for Post Mortem MR Imaging of the Human Brain
Authors: Blamire A. M. , Rowe J. G. , Styles P. , McDonald B. 
Published: October 2009

Purpose: MR imaging of post mortem brains has the potential to yield volumetric information and define the extent of structural changes prior to pathological examination. Although standard T2-weighted clinical imaging sequences have been used for the examination of formalin-fixed brains, these protocols may not yield optimum contrast. We examined the effect of varying durations of formalin fixation on the transverse relaxation time (T2) and the tissue spin density. Material and Methods: Three post mortem brains were examined weekly during formalin fixation from the unfixed state to 35 days fixation. Standard MR spin-echo imaging was used at 5 echo times (20–100 ms) to calculate transverse relaxation time (T2) and spin density. Results: T2 decreased significantly (ANOVA, p<0.001) in both grey and white matter by 7 days fixation and there was a further (but non-significant) trend towards lower values between 7 and 35 days. Grey and white matter T2 times converged with fixation. Conversely, the grey to white matter spin density ratio increased from 1.19±0.01 to 1.54±0.06 over five weeks of fixation. Conclusion: Our results suggest that spin density-weighted imaging sequences would provide improved grey to white matter contrast over T2-weighted sequences.
110 Subfascial Lipomatous Tumors
Authors: Einarsdottir H. , Söderlund V. , Larsson O. , Mandahl N. , Bauer H. C. F. 
Published: October 2009

Purpose: To evaluate whether liposarcoma, atypical lipomatous tumors and lipoma can be differentiated radiologically. Material and Methods: We have retrospectively analyzed CT and/or MR images of 110 subfascial lipomatous lesions. the amount of fat within the tumors was visually graded from the images as: none, 1–75%, 75–95% or 95–100%. the structure of non-fatty tumor components was compared. the images were compared to histopathology and in 37 cases to cytogenetic findings. Results: Only 4 of 20 liposarcomas contained fat. All 4 lesions, histopathologically diagnosed as atypical lipomatous tumors, contained fat but less than 75% of tumor volume. All lesions with more fat than 75% of tumor volume were histologically diagnosed as lipomas. However, one-third of the karyotyped lipomas had ring chromosomes which are considered typical for atypical lipomatous tumors. Conclusion: When a tumor is composed more or less solely of fat, the diagnosis of a lipoma or atypical lipomatous tumor with a phenotype simulating a lipoma can be assumed. When the fat content is less than 75% of the tumor volume or non-fatty nodules are found, biopsies from different tumor components have to be performed to exclude malignancy. When no fat is found, imaging does not help in differentiating lipoma or liposarcoma from other soft tissue tumors.
MR Assessment of Movement and Morphologic Change in the Menisci during Knee Flexion
Authors: Kawahara Y. , Uetani M. , Fuchi K. , Eguchi H. , Hayashi K. 
Published: October 2009

Purpose: To examine movement and morphologic alteration in the menisci during knee flexion. Material and Methods: Twenty healthy knees were imaged at 0°, 45°, and 90° of passive non-weight-bearing flexion in the sagittal plane with MR. In each meniscus, posterior movement distance during knee flexion and the ratio of anteroposterior (a.p.) diameter at flexion to that at extension were calculated. Results: Each meniscus moved posteriorly during knee flexion. Movement was greater in the anterior horn than in the posterior horn, and greater in the medial meniscus than in the lateral meniscus (p<0.05). the a.p. diameter of each meniscus was reduced at flexion (p<0.05). Conclusion: Knee flexion normally leads to posterior movement and shortening of the a.p. diameter of the menisci, which may be related to the positioning and curvature of femoral condyles at the femorotibial contact point at knee flexion.
MR Imaging in Suspected Acute Trauma of Wrist Bones
Authors: Lohman M. , Kivisaari A. , Vehmas T. , Kinnunen J. , Karaharju E. , Kaukonen J.-P. , Kivisaari L. 
Published: October 2009

Objective: the purpose of this study was to evaluate the findings of MR imaging compared to plain radiography in acute wrist trauma. Methods: Radiography and MR imaging (obtained at 1.5 T) of 67 patients (38 female, 29 male, aged 15–80 years) were analysed by three senior radiologists in a blinded random fashion. Results: One-third (n=13) of the 37 fractures observed on MR images were missed on the radiographs. the McNemar test indicated significant differences in diagnoses between radiography and MR. Conclusion: We recommend that MR imaging should be considered in the diagnosis of acute wrist trauma when: 1) There is a clear discrepancy between the clinical status and a negative radiography and when splint treatment would increase cost by causing occupational restrictions; and 2) Healing of trauma diagnosed as contusion or distension does not occur within the expected time.
Spio-MR Imaging versus Double-Phase Spiral CT in Detecting Malignant Lesions of the Liver
Authors: Müller R.-D. , Vogel K. , Neumann K. , Hirche H. , Barkhausen J. , Stöblen F. , Henrich H. , Langer R. 
Published: October 2009

Purpose: To assess the diagnostic performance of superparamagnetic iron oxide MR (SPIO-MR) imaging compared with double-phase spiral CT in detecting liver metastases and hepatocellular carcinoma. Material and Methods: Thirty-eight patients with a total of 144 malignant lesions of the liver were examined by CT and SPIO-MR. After definition of a gold standard by a panel of experts, the patient images were randomized and presented to a blinded jury of 5 independent observers whose task was to identify as many lesions as possible. the results were tested for statistical significance using multifactorial analysis of variance (α=5%). Results: SPIO-MR produced the highest detection rate and was significantly superior ( p<0.05) to unenhanced MR imaging and double spiral-phase contrast-enhanced CT (DPS-CECT). Maximum performance in DPS-CECT was obtained during the portal venous contrast phase but was significantly inferior to SPIO-MR imaging. the scores for unenhanced CT and unenhanced MR were significantly lower than for the corresponding enhanced procedures. SPIO-MR imaging produced a higher incidence of false-positive findings (n=39). Conclusion: SPIO-MR produced a significantly better detection rate for malignant focal liver lesions compared with double-phase spiral DPS-CECT but was associated with a higher rate of false-positive findings.
Single-Session Alcohol Sclerotherapy in Symptomatic Benign Hepatic Cysts
Authors: Larssen T. B. , Jensen D. K. , Viste A. , Horn A. 
Published: October 2009

Purpose: To evaluate the long-term results of single-session alcohol sclerotherapy of symptomatic benign liver cysts. Material and Methods: 23 cysts in 19 patients were treated by single-session percutaneous catheterization and injection of 96% ethanol. Evaluation of long-term results was possible in 11 cysts (volume 200–2700 ml, mean 1,317 ml) in 11 patients. Time of observation was 12–67 months, mean 38.3 months. Results: the reduction of volume was 93–100% (mean 98%). the re-accumulation of fluid after therapy seen in 9 patients proved to be transitory. Except for pain there were no complications. Conclusion: Single-session sclerotherapy resulted in satisfactory cyst volume reduction in all 11 long-term follow-up patients.
Predicting the Effect of Gonadotropin-Releasing Hormone (GnRH) Analogue Treatment on Uterine Leiomyomas Based on MR Imaging
Authors: Matsuno Y. , Yamashita Y. , Takahashi M. , Katabuchi H. , Okamura H. , Kitano Y. , Shimamura T. 
Published: October 2009

Purpose: To test the hypothesis that the simple assessment of signal intensity on T2-weighted MR images is predictive of the effect of hormonal treatment with gonadotropin-releasing hormone (GnRH) analogue. Material and Methods: The correlation between T2-weighted MR imaging of uterine leiomyomas and histologic findings was evaluated using 85 leiomyomas from 62 females who underwent myomectomy or hysterectomy. We also correlated the pretreatment MR images features obtained in 110 women with 143 leiomyomas with the effect of GnRH analogue treatment. The size (length×width×depth) of the leiomyoma was evaluated before and at 6 months after treatment by ultrasound. Results: The proportion of leiomyoma cell fascicles and that of extracellular matrix affected signal intensities of uterine leiomyomas on T2-weighted MR images. The amount of extracellular matrix was predominant in hypointense leiomyomas on T2-weighted images, while diffuse intermediate signal leiomyomas were predominantly composed of leiomyoma cell fascicles. Marked degenerative changes were noted in leiomyomas with heterogenous hyperintensity. The homogeneously intermediate signal intensity leiomyomas showed significant size reduction after treatment (size ratio; posttreatment volume/pretreatment volume 0.29±0.11). The size ratio for the hypointense tumors was 0.82±0.14, and 0.82±0.18 for the heterogeneously hyperintense tumors. There was a significant difference in the response to treatment between the homogeneously intermediate signal intensity leiomyomas and the hypointense or heterogeneously hyperintense leiomyomas (both p<0.01). Conclusion: Signal intensity on T2-weighted MR images depends on the amount of leiomyoma cell fascicles and extracellular matrix. Simple assessment of the MR signal intensity is useful in predicting the effect of GnRH analogue on uterine leiomyomas.