bluuebunny/crossref_metadata_2025_split huggingface dataset:
Perfusion CT of the Brain in the Assessment of Flow Alterations during Brachytherapy of Meningioma
Authors: Bondestam S. , Halavaara J. T. , Jääskeläinen J. E. , Kinnuen J. J. , Hamberg L. M. 
Published: October 2009

Purpose: the aim was to investigate the use of perfusion CT of the brain in the assessment of flow alterations during brachytherapy of meningiomas. Material and Methods: Six patients with an intracranial meningioma were investigated during brachytherapy treatment by stereotactic implantation of I-125 seeds. Cerebral blood flow (CBF) in the tumour centre and the tumour periphery as well as in the normal brain parenchyma was determined by perfusion CT. Follow-up examinations were performed during the first year after the implantation. the CBF of the normal brain parenchyma was used as control. Results: In the beginning of therapy, the mean±SEM blood flow in the tumour centre was 231.4±58.1 ml/100 g/min and in the periphery 223.5±53.8 ml/100 g/min. Within three months after the iodine seed implantation, the tumour blood flow had decreased 41%. At the one-year follow-up, the tumour blood flow in the centre had decreased to 68.7±45.9 ml/100 g/min. In the periphery of the tumour, it remained nearly unchanged (199.3±101.0 ml/100 g/min). the CBF values obtained from normal brain parenchyma did not decrease during the treatment. Throughout the study, the mean CBF for the normal grey matter was 38.5±2.9 ml/100 g/min, and 22.3±1.2 ml/100 g/min for the normal white matter. Conclusion: Perfusion CT seems to enable accurate monitoring of the blood flow of meningiomas during brachytherapy, and could be used in clinical situations where blood flow changes in brain and tumours should be investigated.
Hypoplasia of the Sphenoid Sinuses as a Diagnostic Tool in Cystic Fibrosis
Authors: Eggesbø H. B. , Eken T. , Eiklid K. , Kolmannskog F. 
Published: October 2009

Purpose: To measure and compare the size of the sphenoid sinuses in patients with cystic fibrosis (CF) to patients with inflammatory sinonasal disease, and to correlate the size with number of CF mutations in each patient. Material and Methods: Ninety-six CF patients aged 5–47 years (median 19 years) and 130 control patients aged 7–51 years (median 32 years) were examined using coronal CT of the paranasal sinuses. In each patient, the CT image with the largest coronal area of the sphenoid sinuses was scanned into a Macintosh computer with image processing and analysis software. Largest coronal area and largest circumference of the right and left sphenoid sinuses were automatically measured. Additionally, antero-posterior extension of the sphenoid sinuses was calculated from the lateral scanograms. CF patients were grouped according to number of confirmed mutations (CF-0, CF-1, or CF-2). Results: CF patients generally had small sphenoid sinuses. the largest differences for all parameters were observed between the CF-2 and the control groups (p<0.0001). No CF-2 patient had pneumatization beyond the presphenoid. the CF-0 and CF-1 groups consisted of two populations, one overlapping the CF-2 group and another overlapping the control group. Conclusion: Hypoplasia of the sphenoid sinuses is a characteristic finding in CF patients. When pneumatization of the basisphenoid is present, the existing CF diagnosis should be questioned.
Evaluation of Planar Scintimammography with 99mTc-MIBI in the Detection of Axillary Lymph Node Metastases of Breast Carcinoma
Authors: Danielsson R. , Boné B. , Perbeck L. , Aspelin P. 
Published: October 2009

Purpose: the aim of our prospective study was to evaluate the role of planar scintimammography with 99mTc-MIBI in detecting axillary lymph node metastases in women with primary breast carcinoma. Material and Methods: Fifty-eight patients underwent scintimammography prior to axillary lymph node dissection. Ten minutes after injection of 700 MBq 99mTc-MIBI, two prone lateral projections were obtained, followed by a supine anterior projection. Sixty-one axillae (3 bilateral) were operated upon and the status of the lymph nodes verified with histopathology. the scintigraphic result was compared to the histopathologic findings. Results: A sensitivity of 67% and a specificity of 80% of planar scintimammography in detecting axillary lymph node metastases were achieved. Conclusion: Scintimammography with 99mTc-MIBI is not recommended as a routine method for the detection of axillary lymph node metastases in patients with breast carcinoma.
CT Findings in Pulmonary Hydatid Disease
Authors: Kervancioĝlu R. , Bayram M. , Elbeyli L. 
Published: October 2009

Purpose: the purpose of this study was to present the CT findings of complicated pulmonary hydatid cysts on the basis of the CT appearances. Material and Methods: Preoperative CT examinations of 19 cases with hydatid cysts were evaluated retrospectively for the number and various features of the cysts and secondary changes in adjacent structures. the results were compared with surgical findings. Results: While 7 patients had multiple pulmonary hydatid cysts, 12 patients had solitary cyst. the total number of the cysts was 29. Eleven of them were intact cysts. Two of the 18 complicated cysts were only ruptured, while the remaining 16 complicated cysts were ruptured and infected. the endocyst was separated from a pericyst in a local area in one ruptured cyst. Air-bubbles were seen within 14 infected cysts. Nine of the infected cysts had characteristic appearances of hydatid disease. the other 2 infected cysts showed soft tissue density. Conclusion: CT can provide the specific diagnosis of pulmonary hydatid cysts by demonstrating the number and features of the cysts, characteristic appearances of complicated cysts, and secondary changes in adjacent structures. Whether there are characteristic signs or not, the demonstration of air-bubbles within the cyst, together with ring enhancement, are strong indicators for infected hydatid cysts.
Prospective Randomized Study for an Injection Protocol for Intravenous Contrast Media in Abdominal and Pelvic Helical CT
Authors: Gocke P. , Gocke C. , Neumann K. , Henseke P. , Langer R. , Müller R.-D. 
Published: October 2009

Objective: To develop an injection protocol for intravenous administration of contrast media in abdominal and pelvic helical CT which provides optimal contrast enhancement of arterial and venous vessels. Material and Methods: for the study on a Somatom Plus 4 unit, a standard helical CT examination procedure of abdomen and pelvis consisted firstly of a native helical examination of the liver, a second one of the liver after intravenous injection of 120 ml nonionic contrast medium with a constant start delay of 50 s, and subsequently a third helical CT of the lower abdomen and pelvis. 125 patients were randomized for examination under different protocols, varying the injection flow from 2.0–4.0 ml/s and the time delay between the second and the third helical examinations from an additional 20–40 s. the efficacy of the contrast injection was checked by region of interest (ROI) measurements of HUs in aorta, inferior vena cava, and in femoral arteries and veins. the results were compared by t-test statistics. Results: A slow flow rate of 2.0 ml/s led to a higher contrast enhancement in the aorta than a flow rate of 3.0 and 4.0 ml/s. the difference between 2.0 ml/s and 4.0 ml/s was statistically significant. In the inferior vena cava, a flow of 3.0 ml/s caused a better contrast than a flow of 2.0 ml/s or 4.0 ml/s but the measurements did not reach statistical significance. the measurements in the femoral arteries and veins did not show any significant differences. Maximal enhancement in the pelvic vessels was achieved when the third helical examination was started immediately after the second one had ended. Adding any delay (20 s, 40 s) led to a reduced contrast in the pelvic vessels, with a significant reduction in aorta and femoral arteries. Conclusion: for routine abdominal and pelvic helical CT, we recommend an injection of 120 ml contrast medium with a flow rate of 3.0 ml/s. Contrast-enhanced examination of the liver should be started after 50 s, and examination of the lower abdomen and pelvis region should be performed without any further delay. This gives an appropriate contrast in the major vessels.
Imaging of Abdominal Neuroblastoma in Children
Authors: Hugosson C. , Nyman R. , Jorulf H. , McDonald P. , Rifai A. , Kofide A. , Jacobsson B. 
Published: October 2009

Purpose: the aims of the study were: 1) to assess the efficacy of different imaging methods for use prior to treatment; 2) to compare the surgico-histopathologically-based International Neuroblastoma Staging System (INSS) staging with the imaging results; and 3) to suggest a localisation scheme for abdominal neuroblastoma. Material and Methods: Thirty-one children with an abdominal neuroblastoma (median age 2 years), underwent abdominal US, CT of chest and abdomen, MR imaging of abdomen and spine, chest radiography, skeletal survey, radionuclide bone scintigraphy, MIBG scintigraphy, and bone marrow biopsy. Results: In the evaluation of local disease, CT and MR were superior to US. There was no significant difference between CT and MR in assessment of the location or size of the tumour. Evaluation of invasive growth and lymphadenopathy was uncertain irrespective of imaging modality. Intraspinal extension was more distinctly demonstrated with MR. Tissue characterization with CT and MR did not contribute in the assessment of the tumours. Contrast enhancement at CT and MR examinations both improved demarcation between tumour and kidney, and was a necessity for evaluation of vessel encasement with CT. the local disease was best assessed by either CT or MR, while metastatic disease was best revealed by CT, MR, scintigraphy or bone marrow biopsy. Conclusion: Imaging may be a valuable basis for clinical assessment and pre-treatment staging of abdominal neuroblastoma.
Placement of a Spring Filter during Interventional Treatment of deep Venous Thrombosis to Reduce the Risk of Pulmonary Embolism
Authors: Hosaka J. , Roy S. , Kuroki K. , Xian Z. , Kvernebo K. , Enge I. , Lærum F. 
Published: October 2009

Purpose: To assess the efficacy of the Spring filter during interventional treatment of deep venous thrombosis in vivo. Material and Methods: A model of inferior vena cava thrombosis was used. Part I: the thrombus was treated by the pulse-spray technique (PT) (urokinase 250,000 IU; n=7) or a rotatory basket catheter, Thrombolizer (MT) (activated with compressed air at 7 atm; n=5). Part II: Following placement of a Spring filter, the animal underwent PT (n=5) or MT (n=5). Based on the results of part I, the treatment protocol was modified (PT, urokinase 500,000 IU; MT, compressed air at 8 atm). Embolus volumes trapped by the filter and found in the lungs were calculated and the filtering efficacy quantified. Results: Part I: Pulmonary emboli (1 to 4 mm in diameter) were observed in 3 animals in the PT group and 1 animal in the MT group, respectively. Median reduction in thrombus volume was 21% and 4% by PT and MT, respectively. Part II: In the PT group, 58% and 100% of the total embolus load was trapped in 2 animals, while the filter failed to trap emboli (1 to 1.5 mm in diameter) in 1 animal. In the remaining 2 animals, no embolus was found trapped by the filter or in the lungs. In the MT group, 55–97% (median 83%) of the embolus load was trapped. Emboli found in the lungs did not exceed 4 mm in diameter. Conclusion: Preceding interventional treatment of venous thrombosis with placement of the Spring filter reduced the embolic burden on the lungs.
Characterization of Breast Masses by Dynamic Enhanced MR Imaging
Authors: Ikeda O. , Yamashita Y. , Morishita S. , Kido T. , Kitajima M. , Okamura K. , Fukuda S. , Takahashi M. 
Published: October 2009

Purpose: To identify features useful for differentiation between malignant and benign breast neoplasms using multivariate analysis of findings by MR imaging. Material and Methods: In a retrospective analysis, 61 patients with 64 breast masses underwent MR imaging and the time-signal intensity curves for precontrast dynamic postcontrast images were quantitatively analyzed. Statistical analysis was performed using a logistic regression model, which was prospectively tested in another 34 patients with suspected breast masses. Results: Univariate analysis revealed that the reliable indicators for malignancy were first the appearance of the tumor border, followed by the washout ratio, internal architecture after contrast enhancement, and peak time. the factors significantly associated with malignancy were irregular tumor border, followed by washout ratio, internal architecture, and peak time. for differentiation between benignity and malignancy, the maximum cut-off point was to be found between 0.47 and 0.51. In a prospective application of this model, 91% of the lesions were accurately discriminated as benign or malignant lesions. Conclusion: Combination of contrast-enhanced dynamic and postcontrast-enhanced MR imaging provided accurate data for the diagnosis of malignant neoplasms of the breast. the model had an accuracy of 91% (sensitivity 90%, specificity 93%).
Postoperative Nerve Root Displacement and Scar Tissue
Authors: Nygaard Ø. P. , Jacobsen E. A. , Solberg T. , Kloster R. , Dullerud R. 
Published: October 2009

Purpose: To investigate the association between postoperative nerve root displacement and epidural scar tissue. Material and Methods: One hundred patients who had undergone lumbar microdiscectomy were included in a prospective cohort study with a 1-year follow-up. the patients were classified as failures or successes at the 12-month follow-up according to a clinical score. Patients with signs of recurrent disc herniation on MR were excluded from the study. All the 13 patients classified as failures were investigated with MR at the 1-year follow-up, and 40 patients classified as successes were picked at random for MR imaging; thus MR was performed in 53 patients. the MR images were independently evaluated by two neuroradiologists. the images were rated according to the presence or absence of nerve root displacement at the surgically treated disc interspace. Scar formation was rated according to two different classification systems. Results: Nerve root displacement was observed in 13 patients. No evidence of scar formation was found in 4 patients, a small amount in 11, intermediate in 37 and extensive scar formation in 1 patient. No association between nerve root displacement and the amount of scar tissue was found. Conclusion: Postoperative nerve root displacement seems to be an independent clinical entity not associated to postoperative scar tissue.
Power Doppler Sonography of Hepatocellular Carcinoma Treated by Transcatheter Arterial Chemoembolization
Authors: Hosoki T. , Yosioka Y. , Matsubara T. , Minamitani K. , Higashi M. , Ohtani M. , Choi S. , Mitomo M. , Tono T. 
Published: October 2009

Purpose: To evaluate the usefulness of power Doppler sonography (PDS) in assessing the therapeutic effect of transcatheter arterial chemoembolization (TACE) in hepatocellular carcinoma (HCC). Material and Methods: TACE was performed in 43 patients (48 lesions) with HCC. All patients were examined with both PDS and color Doppler sonography (CDS) to assess the therapeutic results 1 week after TACE. Follow-up hepatic angiography was performed in 39 patients 3–4 months after TACE and then CT after iodized oil reinjection was also performed 3–4 weeks after a repeat TACE; in the remaining 4 patients, hepatectomy was performed within one month after chemoembolization and histologic study was undertaken to confirm the Doppler findings. Results: Determination of therapeutic results with PDS and CDS were in agreement with those of follow-up findings in 37 and 29 of the 48 lesions, respectively. There was a significant difference in overall accuracy ( p=0.038) between PDS and CDS results. Conclusion: PDS is more effective than CDS for evaluating changes in tumor vascularity after TACE. PDS may also replace angiography in assessing the therapeutic effects of TACE for HCCs, except in deep-seated areas.
Localization of Pancreatic Insulinomas with MR Imaging at 0.5 T
Authors: Catalano C. , Pavone P. , Laghi A. , Panebianco V. , Fraioli F. , Pediconi F. , Napoli A. , Passariello R. 
Published: October 2009

Objective: To determine the role of MR imaging in the localization of pancreatic insulinomas in patients with clinical and laboratory diagnosis of insulinproducing tumor. Material and Methods: Thirty-one patients presenting with signs and symptoms of pancreatic insulinomas were prospectively included in our study. Twenty-six patients underwent surgery, and pathologic specimens were examined: 5 patients, in whom the initial diagnosis of insulinoma was excluded, were also studied and then followed up. All patients were studied with a high gradient power 0.5 T magnet. Images were evaluated by 2 radiologists blinded to previous investigations, tests and results. Results: MR imaging correctly localized 24 of the 26 insulinomas (2 were false-negative and 1 false-positive) and was correctly negative in the 5 control patients. the interobserver agreement had a kappa value of 0.89. Conclusion: MR imaging was accurate in localizing pancreatic insulinomas and as a consequence, patients in our institution are now submitted to surgery directly after the MR examination. Invasive methods are considered only in cases in which, despite clear biochemical results, MR imaging has not demonstrated a pancreatic focal lesion.
Radiological Demonstration of Gastroesophageal Reflux
Authors: Aksglaede K. , Funch-Jensen P. , Thommesen P. 
Published: October 2009

Purpose: To correlate gastroesophageal reflux (GER), demonstrated by a radiological method using food, with the reflux events, as determined by 24-h pH monitoring. Material and Methods: One hundred and seventeen patients with a median age of 47 years (86 male and 31 female) were examinated. In the supine left position, the patient consumed 360 ml of barium contrast. Fluoroscopy was performed with the patient in the supine right oblique position during mastication and swallowing a piece of rye bread with liver paté and barium. the test was positive if barium was observed ≥5 cm proximal to the gastroesophageal junction. An antimony pH-probe was placed 5 cm above the lower esophageal sphincter, previously determined by manometry. the position was controlled by radiography after positioning and before removal. the total time of esophageal pH<4 exceeding 5.0% was considered pathological. Results: the radiological method had a specificity of 100% and a sensitivity of 52% compared to 24-h pH monitoring. Conclusion: the high specificity of this radiological method justify direct therapeutic consequence of a positive test. However, a negative test still renders the problem unsolved.
Ankle Function and Sports Activity after Total Ankle Arthroplasty
Authors: Bonnin Michel P. , Laurent Jean-Raphael , Casillas Mark 
Published: October 2009

Background: The return to sporting activities after ankle arthroplasty has rarely been evaluated. The purpose of the present study was to evaluate function and return to sports after total ankle arthroplasty. Materials and Methods: One hundred seventy-nine Salto Total Ankle Arthroplasties (TAA) were implanted between 1997 and 2005. A self-administered questionnaire including the Foot Function Index (FFI) and Foot and Ankle Ability Measurement (FAAM) was sent to all patients. At last followup, six were deceased, 22 were not available for evaluation, and six questionnaires were incomplete. One hundred forty-five questionnaires were available. The mean age was 60.9 years and the mean followup was 53.8 months. The main indications for TAA were osteoarthritis (OA) in 100 cases and Rheumatoid arthritis (RA) in 40 cases. Results: 15.2% of the patients said that their operated ankle was “normal”; 60.7% “nearly normal”; 20% “abnormal” and 4.1% “highly abnormal.” The FFI scores were 13.7 ± 17 for “activity limitations”, 31.7 ± 23 for “disability” and 16.9 ± 19 for “pain”. The FAAM scores were 74.9 ± 18 for activities of daily living and 48.9 ± 28 for sports activities. On a Visual Analog Scales (0 to 100 were 100 is the “pre-pathology level”) the mean rating was 70.2 ± 19.6 for Activities of Daily Living and 53.7 ± 28 for sport activities. In the OA patients, 38 regularly road bicycle, 21 perform recreational gymnastics, 58 swimming, 50 home gardening, 27 dancing, and 43 hiking. Seven patients regularly practice tennis, nine cross-country skiing, 17 downhill skiing, and six regularly run more than 500 m. Conclusion: This study showed that TAA improved the quality of life and that return to recreational activities was generally possible but the return to impact sport was rarely possible. Level of Evidence: III, Retrospective Case Control Study
Prospective Comparative Study of the Scarf and Ludloff Osteotomies in the Treatment of Hallux Valgus
Authors: Robinson Andrew HN , Bhatia Maneesh , Eaton C. , Bishop L. 
Published: October 2009

Background: This study compares two diaphyseal osteotomies (scarf and Ludloff) which correct moderate to severe metatarsus primus varus. This is a single surgeon, prospective cohort study with clinical and radiological follow up at 12 months. Materials and Methods: There were 57 patients in each group. Both groups were similar in terms of age, gender and preoperative deformity. Clinical assessment included visual analogue scale questionnaires for subjective assessment and functional activities and the American Orthopaedic Foot and Ankle Society (AOFAS) score. Standardized weight bearing radiographs were analyzed. Results: There was no statistically significant difference between the two groups at 6 and 12 months in subjective satisfaction, AOFAS score, improvement in functional activities and range of movements. The improvement in pain (at best) and transfer lesions at 12 months was significantly better in the scarf group ( p < 0.05). The radiological results at 6 and 12 months including intermetatrsal angle ( p < 0.001), hallux valgus angle ( p < 0.01), distal metatarsal articular angle and seasmoid position ( p < 0.05) were significantly better in the scarf osteotomy group. There were three cases (5%) of delayed union in the Ludloff group. Two of these healed with dorsiflexion malunion. One patient in the Ludloff osteotomy group developed a complex regional pain syndrome. There were two wound complications in the scarf group. Conclusion: Overall the patients who had a scarf osteotomy had a superior outcome at 6 and 12 months. Level of Evidence: II, Prospective Comparative Study
Treatment of Brachymetatarsia of the First and Fourth Ray in Adults
Authors: Lee Woo-Chun , Suh Jin-Soo , Moon Jeong-Seok , Kim Ji Yeong 
Published: October 2009

Background: The purpose of this study was to review our results of treatment for brachymetatarsia involving the first and fourth ray. Materials and Methods: This study includes 47 feet of 30 patients who have been treated for brachymetatarsia of the first and fourth rays. The average age of patients was 26.4 (range, 20 to 36) years. The second and third metatarsals were shortened in 44 feet. In 41 feet, the fourth metatarsals were lengthened at one stage with resected bones from the second and third metatarsals. The lengthening or shortening of each metatarsal was recorded. American Orthopaedic Foot and Ankle Society score and subjective satisfaction were obtained for the clinical evaluation. Results: The average amount of shortening in the second and third metatarsal was 8.9 ± 2.8 mm and 7.2 ± 2.6 mm respectively. The average amount of lengthening in the fourth metatarsal was 10.3 ± 4.1 mm. Postoperative AOFAS score was 83.2 ± 7.6. Stiffness of the fourth metatarsophalangeal joint was the most common cause of functional deficit. All except three patients were satisfied with some reservation. Additional operations were performed on eleven feet. Conclusion: Most adult patients with the first and fourth ray brachymetatarsia have been subjectively satisfied with the treatment with some loss of function mostly due to stiffness of the metatarsophalangeal joints. Level of Evidence: IV, Retrospective Case Series