bluuebunny/crossref_metadata_2025_split huggingface dataset:
Combined endovascular and surgical treatment in vertebral arteriovenous fistula
Authors: Nakstad P. H. , Haakonsen M. , Magnæs B. , Hetland S. 
Published: January 2010

A 7-year-old girl with a right-sided congenital arteriovenous fistula in the neck was admitted with signs of cardial incompensation. Her fistula was fed from the right vertebral artery in antegrade as well as retrograde directions. A steal from the intracranial arteries was established. In addition, smaller feeding arteries from the neck were found. She was operated on with ligation of the right vertebral artery proximal to the fistula but the attempted ligation of the artery cranially to the fistula was unsuccessful. She was therefore embolized by the formation of a plug of platinum fiber coils in the upper right vertebral artery. Catheterization was performed from the left vertebral artery via the basilar artery. Persisting minor feeders to the fistula from cervical arteries were embolized in a second session. Finally, surgical extirpation of the fistula was performed together with the operative ligation of a crossover feeding artery from the left vertebral artery. Her heart size, heart rate and blood pressure were successively normalized.
SIPAP: A new MR classification for pituitary adenomas
Authors: Edal A. L. , Skjödt K. , Nepper-Rasmussen H. J. 
Published: January 2010

Purpose: To present a new MR classification for pituitary adenomas, a grading system named SIPAP. Material and Methods: SIPAP is an acronym for the 5 juxtasellar directions of tumour extension to or penetration into adjacent structures of the sella region, using a 6-figure number for each adenoma. This retrospective study was based on 87 mid-field MR examinations of 56 patients with biochemically or surgically confirmed pituitary adenomas. Sagittal T1-weighted SE and coronal T1-weighted 3D FFE sequences before and after i.v. contrast administration were performed. Results: The SIPAP classification was well adapted to the material. All tumours except one postoperative remnant could be classified in the grading system. The classification was useful before and after treatment, for follow-up over a longer period, and for comparing adenomas with different hormonal activity with reference to patient age and sex. Conclusion: The SIPAP classification together with tumour size is an optimal method for the registration of pituitary adenomas.
Gadolinium-enhanced 3D time-of-flight Mr angiography
Authors: Yano T. , Kodama T. , Suzuki Y. , Watanabe K. 
Published: January 2010

Purpose: To evaluate the influences of Gd-DTPA on 3D time-of-flight (TOF) MR angiography (MRA). Material and Methods: In an experimental study using a flow phantom, contrast 3D TOF MRA was performed at varying Gd-DTPA concentrations, flow rates, TRs and flip angles. In a clinical study, cranial 3D TOF MR angiograms using Gd-DTPA were obtained in 38 patients to evaluate the efficacy of Gd-DTPA in enhancing the diagnosis of intracranial vascular lesions. Visualization of the venous system and distal arterial branches on contrast MRA was compared with those of noncontrast MRA. Results: In the experimental study, progressive signal loss of inflowing spins due to saturation was smaller with higher concentration of Gd-DTPA. The influences of Gd-DTPA on the saturation effect were more pronounced with a slower flow rate, shorter TR and larger flip angles. In the clinical study, i.v. administration of Gd-DTPA improved the visualization of the venous system and distal arterial branches on 3D TOF MRA. The diagnostic value of MRA was enhanced by Gd-DTPA in patients with intracranial vascular lesions such as vascular malformations and large aneurysms. Conclusion: The T1-shortening effect of Gd-DTPA reduced the signal loss of vessels with slow flow rate, and contrast MRA was particularly useful for evaluation of venous abnormalities. Compared with conventional MRA, shorter TRs and larger flip angles were considered beneficial in contrast MRA.
Evaluation of single sample clearance calculations in 902 patients
Authors: Lundqvist S. , Hietala S. O. , Groth S. , Sjödin J. G. 
Published: January 2010

Purpose: To derive new formulae for the calculation of single sample clearance of the contrast medium iohexol and to compare the formulae to a selection of existing single sample clearance formulae derived for the calculation of 51Cr-EDTA and 99mTc-DTPA clearance. Material and Methods: Glomerular filtration rate (GFR) was calculated from total plasma clearance of iohexol used for urography in 902 patients. Two plasma samples were drawn in each patient. Automated x-ray fluorescence analysis equipment was used for the plasma iodine analysis. Single and multiple sample iohexol clearance values were compared. In 77 patients the multiple sample clearance values were additionally compared to a 51Cr-EDTA clearance performed simultaneously or within 14 days. Results: The precision of the results calculated by the existing single sample clearance formulae and the derived iohexol single sample clearance formulae were essentially the same. The most precise of the derived formulae was that based on the Bak Christensen & Groth formula. The correlation between multiple sample clearance of iohexol and 51Cr-EDTA was high (r=0.918) Conclusion: Iohexol can substitute 51Cr-EDTA for GFR measurement. A valid GFR can be calculated from a single plasma sample determination of iohexol clearance using either the existing formulae or the new formulae derived from the present study.
Outcome of bypass surgery in patients with chronic ischemic left ventricular dysfunction
Authors: Kløw N.-E. , Smith H.J. , Gullestad L. , Seem E. , Endresen K. 
Published: January 2010

Purpose: To determine the preoperative findings of MR imaging of the left ventricle (LV) that could best predict the functional outcome of the LV after surgical revascularization. Material and Methods: Patients with angina pectoris, previous myocardial infarction, and dysfunction of the LV, and who had a preoperative cine MR, were re-evaluated after bypass surgery with MR in a study on the effects of revascularization after mean 22 months. Results: Angina pectoris was relieved in all patients except one, but the maximum workload during the exercise test was increased in only 3 patients. Coronary angiography showed that 37 of 45 (82%) of the distal anastomoses were open. The LV ejection fraction was the same before and after operation both at angiography and MR imaging. MR showed LV end-diastolic volume to be increased from 190 ± 50 ml to 250 ± 70 ml. Compared to angiography, MR provided additional information regarding myocardial wall thickness and function, and the size of myocardial infarction. Improvement in systolic wall thickening was seen in 65% of the segments that had had an end-diastolic wall thickness (EDWT) greater than 15 mm before operation, while only 4% of the segments with EDWT <6 mm improved. In the wall thickness range of 6–15 mm, MR was unable to predict the functional outcome of the LV. Conclusion: Preoperative MR findings of thick myocardial walls with poor function seem predictive of improved function after revascularization. When the LV wall thickness is less than 6 mm, no improvement should be expected.
Rater agreement at lung scintigraphy after consensus training
Authors: Christiansen F. , Andersson T. , Rydman H. , Måre K. 
Published: January 2010

Purpose: Using the PIOPED criteria in the interpretation of lung scintigraphy, perfect agreement between experienced raters with training in consensus interpretation has been demonstrated. In a previous paper we found a kappa value of 0.54 (0.45–0.63) between experienced raters with no experience of interpretation in consensus; this is significantly lower than the perfect agreement described between consensus-trained raters. The purpose of this study was to reinvestigate the same study population with the same raters, but this time after they had undergone consensus training. Material and Methods: Lung scintigrams of 192 patients were reviewed and categorized according to the PIOPED criteria by 2 raters after consensus training. The 2 raters reviewed a training material of 59 cases, which was not part of the study population, in order to reach a full consensus interpretation. Results: After consensus training the kappa value was 0.57 (0.48–0.66). Three cases had a discrepancy of 2 categories (1.6%), and the remaining discrepancies were of one category. Conclusion: Consensus training did not significantly improve the agreement rate between experienced raters from different hospitals. A substantial improvement in agreement rates between hospitals may make heavy demands on resources.
Sonographic measurement of thymic size in healthy neonates
Authors: Hasselbalch H. , Jeppesen D. L. , Ersbøll A. K. , Lisse I. M. , Nielsen M. B. 
Published: January 2010

Purpose: To assess the variation in thymic size in healthy neonates by sonography and to study the possible correlation to clinical variables. Material and Methods: A study was made of 149 healthy term infants, at less than one week of age. The size of the thymus was assessed by sonography as a volume estimate, the thymic index. This index was compared to sex, weight, length, gestational age, and level of perinatal asphyxia of the infant. T-cell subsets (percentages of CD4 and CD8 receptor-positive T-lymphocytes in peripheral blood) were determined in 83 of the infants and compared to the sonographic thymic index. Results: The thymic index varied between 4 and 29, and was positively correlated to the weight of the infant (p=0.0003). There was no correlation to sex, length, gestational age or slight perinatal asphyxia. We found no correlation between the size of the thymus and the CD4 percentage, the CD8 percentage, or the CD4/CD8 ratio. Conclusion: The size of the thymus in healthy neonates as measured by sonography is significantly correlated to the weight of the infant. For a given weight of an infant it is possible to predict the normal range of thymic size.
Lung nodule conspicuity using unsharp mask filters with storage-phosphor-based computed radiography
Authors: Li F. , Sone S. , Kiyono K. 
Published: January 2010

Purpose: To compare the performance of various types of unsharp mask filter applied in storage-phosphor-based computed radiography (SR), and to improve the detection of faint nodules of the lung cancer type. Material and Methods: A total of 120 SR radiographs were obtained by means of an anthropomorphous chest phantom and a combination of 3 types of small simulated nodule (5-mm sphere-shaped, and 5-mm and 10-mm hemisphere-shaped) placed on the phantom's surface. Eight combinations of nodule site were selected from 16 predetermined chosen sites, and 5 types of parameter were used for unsharp mask filtering. Eight observers evaluated the images, and the detectability of the lung nodules was evaluated from the images by a ROC analysis. Results: The visibility of the 10-mm hemispherical nodules was nearly equivalent at each site when 5 types of unsharp mask filter were used. The detection of the 5-mm nodules with mid-frequency suppressing and very-low-frequency enhancing filters was better than with a conventional (department standard) mid-frequency enhancing filter. Conclusion: Mid-frequency suppressing versions of the filter helped to demonstrate faint nodular opacity, which is often shown by early bronchogenic carcinoma. This filter could replace conventional filters in the detection of lung nodules.
Sonomorphology of the gallbladder in critically ill patients
Authors: Helbich T. H. , Mallek R. , Madl C. , Wunderbaldinger P. , Breitenseher M. , Tscholakoff D. , Mostbeck G. H. 
Published: January 2010

Purpose: The aim of the study was to assess the value of a scoring system for the diagnosis of acalculous cholecystitis (AC) on ultrasound (US) follow-up examinations and to discuss the merits of a scoring system compared to clinical outcome and pathohistologic findings. Material and Methods: In this prospective study, 21 patients at the intensive care unit (ICU) of a medical department were examined by follow-up US. Sonographic parameters of the gallbladder (GB) were obtained (longitudinal and transversal diameter, wall thickening, contents, and pericholecystic fluid) and scored (2 points: distension of GB, thickening of GB wall; 1 point: striated thickening of GB wall, sludge, and pericholecystic fluid; range (0-8)). The US findings were correlated with clinical findings and histology at cholecystectomy or autopsy. Results: Of a total of 77 follow-up examinations in these 21 patients, US demonstrated GB distension in 19 patients, wall thickening in 18, sludge in 15, striated thickening of the GB wall in 13, and pericholecystic fluid in 12 patients. Of these, 41 (53%) examinations were scored ≥ 6, and 36 (47%) examinations ≤ 5. None of the patients with a maximum score during follow-up of ≤ 5 (n=8) had pathohistologic proof of AC or died due to GB complications. Patients with maximum scores of ≥ 6: had pathohistologic proof of AC (n=4); survived with normalization of GB morphology (n=4); had a normal GB at autopsy (n=1); or were lost for pathohistologic proof at autopsy (n=2). Conclusion: Our results indicate that regular, short-term follow-up allows early diagnosis and immediate therapy for AC. The scoring system could be helpful in differentiating between patients with an abnormal GB without AC (score ≤ 5) and those with an abnormal GB (score ≥ 6) with a suspicion of AC. In the latter group, more aggressive diagnostic and therapeutic procedures may be indicated.
Radiography and bone scintigraphy in bone marrow transplant multiple myeloma patients
Authors: Ågren B. , Löqvist B. , Björkstrand B. , Rudberg U. , Aspelin P. 
Published: January 2010

Purpose: To compare conventional radiography and bone scintigraphy in relation to clinical outcome in bone marrow transplant multiple myeloma patients. Material and Methods: A total of 70 radiographies and 70 bone scintigraphies were compared in 35 patients. Results: The skull, the extremities, the iliac and pubic bones were better assessed with radiography. For new vertebral lesions and for lesions in the ribs and sternum, bone scintigraphy proved superior. For the sacrum, the methods were equal. When bone scintigraphy was used as a complement to radiography, 4% more pathological sites were found. No patient had both a normal radiography and a pathological bone scintigraphy, but 5 patients had both a normal bone scintigraphy and a pathological radiography. The results of the radiological examinations did not always correlate with the clinician's grading of the patient's disease. The radiological examinations had no prognostic value for the 7 patients examined on several occasions. Conclusion: The ability of conventional radiography and bone scintigraphy to disclose myeloma lesions varies, depending on location and size of the lesions. Radiography should remain the primary examination modality also for bone marrow transplant multiple myeloma patients. Bone scintigrapy can serve as a complement for investigating unexplained pain, e.g. caused by lesions in vertebrae or ribs.
Hemodialysis-related arthropathy
Authors: Karakida O. , Aoki J. , Kanno Y. , Watanabe T. , Tamura K. , Seo G. Suk , Sone S. 
Published: January 2010

Purpose: A prospective examination of hemodialysis-related arthropathy by MR imaging with SE and GRE sequences was undertaken to verify whether the low signal intensity on T2-weighted SE images is caused by a paramagnetic susceptibility effect derived from amyloid or from hemosiderin. Material and Methods: Twenty-seven joints (19 hip joints, 6 discovertebral joints of 5 lumbosacral spines and 1 cervical spine, 2 shoulder joints) in 14 patients undergoing long-term hemodialysis (duration 10-22 years, mean 17) were examined with SE T1-weighted, T2-weighted and GRE T2*-weighted sequences. Results: The signal intensity of the intraarticular and periarticular masses of the involved joints was basically isointense to the muscle in all 3 pulse sequences. No significantly low signal area was found on GRE T2*-weighted images. Conclusion: The low signal areas in the hemodialysis-related arthropathy on SE T2-weighted images are not caused by a paramagnetic susceptibility effect, but probably by the hypocellular and fibrous nature of amyloid-containing tissues. Therefore the GRE sequence can be helpful for differentiating hemodialysis-related amyloid arthropathy from chronic hemarthrosis or juxta-articular brown tumor.
ROC-study of a teleradiology workstation versus film readings
Authors: Størmer J. , Bolle S. R. , Sund T. , Weller G. E. R. , Gitlin J. N. 
Published: January 2010

Purpose: We have used receiver operating characteristic (ROC) analysis to compare screen assessment of digitized radiographic films transmitted by a teleradiology system, with evaluation of the original radiographs on film. Material and Methods: The material contained 120 cases (about 50% with selected pathology) that were difficult to diagnose. Four radiologists each evaluated half of the cases on film, and half on computer screen. The screen display was 1024×836 pixels with 8 bits/pixel. Results: We found the accuracy and sensitivity of the teleradiology system to be clearly inferior to film evaluation. Conclusion: Improvement is needed both in the teleradiology system, and in the training of radiologists to work on the electronic workstation.
Time-resolved white light transillumination for optical imaging
Authors: Jarlman O. , Berg R. , Andersson-Engels S. , Svanberg S. , Pettersson H. 
Published: January 2010

Purpose: To describe a new breast-imaging method with the potential of multi-spectral optical transillumination based on a time-resolved technique. Material and Methods: A breast phantom was irradiated with ultra-short laser pulses of white light generated by self-phase modulation of an incident high-power laser pulse in water. Time-resolved detection of the transmitted light was performed. Contrast resolution was studied using different absorbers located inside the breast phantom. Results and Conclusion: The results showed that simultaneous, multi-spectral transillumination is possible. The technique can also be used for measurements of optical properties in tissue.
Digital fluoroscopy before and after laser uvulopalatopharyngoplasty in obstructive sleep apnea
Authors: Tsushima Y. , Antila J. , Laurikainen E. , Svedström E. , Polo O. , Kormano M. 
Published: January 2010

Purpose: to study the changes in pharyngeal behavior after laser uvulopalatopharyngoplasty (LUPPP). Material and Methods: the dynamic changes in the upper airway size were evaluated with digital fluoroscopy in 24 patients with obstructive sleep apnea (OSA) before and after LUPPP and in 16 normal controls, while they were awake and breathing normally. Cephalometric measurements were also made. the patients were classified into the categories of good and poor responders by means of a static-charge-sensitive bed. Results: Following LUPPP, collapsibility at the velopharyngeal level was within the normal range in 15 of 17 good responders, but only in 2 of 7 poor responders (p=0.0086). the minimum airway size at the same level showed a similar trend. in 3 of 7 poor responders the hyoid bone was positioned more caudally than in the good responders (p=0.017). Conclusion: Digital fluoroscopy provides information on the change in upper airway behavior after LUPPP.
Thymus size evaluated by sonography
Authors: Hasselbalch H. , Jeppesen D. L. , Ersbøll A. K. , Engelmann M. D. M. , Nielsen M. B. 
Published: January 2010

Objective: to use sonography in a follow-up study aimed at assessing the size of the thymus in healthy infants, and to search for a possible relation to clinical variables, breast-feeding status, and illness. Material and Methods: Forty-seven healthy infants were examined as neonates and re-examined at 4 months of age. Thirty-seven of the infants were also re-examined at 8,10, and 12 months of age. the thymus size was measured with the sonographic thymic index used as a volume estimate. the correlations between the thymic index and the sex, weight, length, illness, and breast-feeding status of the infants were analysed. Results: at birth the median thymic index was 12 (range 4–29). at 4 months the median thymic index was 28 (range 12–83). the thymic index was positively correlated to the body length of the infant and to its breast-feeding status (p<0.0001). at 8 months the median thymic index was 29 (range 6–55) and most of the variation could be explained by the length of the infant (p=0.0018, r=0.50). at 10 months the median thymic value had decreased to 19 (range 9–49), and at 12 months to 17 (range 7–53). Infants exclusively breast-fed during the first 4 months of their lives had a larger thymic index at 10 months than formula-fed infants (p=0.0024). Infants with fever episodes from 10 to 12 months had a smaller thymic index at 12 months (p=0.0241). Conclusion: the thymus size in healthy infants increases from birth to 4 and 8 months of age and then decreases. Most of the individual variation can be explained by breast-feeding status and body size, and to a lesser extent by illness. We propose statistical models by which the normal variation/distribution of the thymic size can be estimated in infants up to one year of age.
Cranial MR findings in Wilson's disease
Authors: Saatci I. , Topcu M. , Baltaoglu F. F. , Köse G. , Yalaz K. , Renda Y. , Besim A. 
Published: January 2010

Purpose: to define various cranial Mr appearances in Wilson's disease (WD). Material and Methods: MR examinations of 30 patients (9–44 years old) with WD were retrospectively reviewed. Six patients were asymptomatic siblings. Three other patients had isolated hepatic involvement, one with no symptoms. the remaining 21 patients had neurological involvement, 7 of whom had the mixed form of the disease. Nine patients had hepatic dysfunction, the 3 with isolated hepatic involvement and 6 of the 7 with the mixed form. Results: All symptomatic patients (n=23) had abnormal MR examinations. Atrophy was present in the majority of them. the most frequently involved sites were putamen (18/21) and pons (18/21) in patients with neurological abnormality. the putaminal lesions showed a consistent pattern of symmetric, bilateral, concentric-laminar T2 hyperintensity. Putaminal lesions were lacking in only 3 patients with neurological involvement, all of whom were relatively old and had had the disease for a longer duration. Most of the patients with hepatic dysfunction (8/9) had increased T1 signal intensity in the basal ganglia, particularly in the globus pallidus. Pontine involvement always included the dorsal aspect of the pons, however, in some cases the central portion of pons was also affected but ventrolateral longitudinal fibers were spared. Midbrain (16/21), thalamic (10/21) and caudate nucleus lesions (9/21) were also encountered. in a few patients cortical and subcortical white matter lesions were present with a predilection to the frontal lobe, particularly the precentral region. in one patient, a hemorrhagic focus was identified within the white matter lesion. Conclusion: on T2-weighted images, WD is suggested by: atrophy; putaminal lesions with a pattern of symmetric, bilateral, concentric-laminar T2 hyperintensity; and the involvement of the pars compacta of the substantia nigra, periaqueductal gray matter, the pontine tegmentum and the thalamus. the hepatic component of WD may cause increased T1 signal intensity in basal ganglia. in the adult age group, the basal ganglia lesions may be different from those in the pediatric group; the putaminal lesions may not be present; the globus pallidus and substantia nigra may show increased hypointensity on T2-weighted images. Cortical and subcortical lesions may also be present with a predilection to the frontal lobe.