bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acute neuromedical and neurosurgical admissions: Standard and ultrafast MR imaging of the brain compared with cranial CT
Authors: Griffiths P.D. , Wilkinson I.D. , Patel M.C. , Romanowski C.A.J. , Mitchell P. , Graham A. , Powell T. , Hodgson T.J. , Paley M.N.J. 
Published: July 2004

Purpose: To evaluate the role of standard and ultrafast MR brain imaging and compare the information with CT. Material and Methods: This was a prospective study of 114 patients with acute neurological symptoms and signs. CT brain examinations consisted of axial non-enhanced images. MR imaging consisted of standard spin-echo/fast spin-echo sequences and a series of rapid techniques including echoplanar and single shot fast spin-echo sequences. Results: Using standard MR methods, 41% of the patients had all five sequences of good technical quality, while using ultrafast methods 81% of the patients had good technical quality examinations in all five sequences. In 3% of the cases, ischaemic stroke was incorrectly reported on CT. In 24% of the cases, MR gave extra diagnostic information not reported on CT and in a further 8%, one neuroradiologist reported the abnormality in agreement with the MR, whilst the other neuroradiologist reported the CT as normal. In 2 cases, subarachnoid haemorrhage was missed on MR. Subarachnoid haemorrhage was not shown on the ultrafast sequences. Conclusion: MR can be used to image acute neurological admissions with a high success rate, particularly using ultrafast methods. In many cases, MR provided extra information of direct clinical relevance not shown on CT.
Differentiation of vascular birthmarks by MR imaging: An investigation of hemangiomas, venous and lymphatic malformations
Authors: Kern S. , Niemeyer C. , Darge K. , Merz C. , Laubenberger J. , Uhl M. 
Published: July 2004

Purpose: To evaluate the use of MR imaging using standard sequences in the differentiation of common vascular birthmarks of soft tissues in childhood. Material and Methods: Forty-three lesions in 37 children (median age 33 months) with hemangiomas (n = 25), venous (n = 8) and lymphatic (n = 10) malformations were retrospectively studied. Images were obtained with a 0.2 T and a 1.5 T MR unit, using T1-weighted spin-echo, T2-weighted turbo spin-echo and turbo STIR sequences. In addition, 19 contrast studies were evaluated. Signal intensities and morphological characteristics were analyzed. Results: All hemangiomas were hyperintense in T2-weighted, and mostly (22/25) isointense compared to the surrounding skeletal muscle in T1-weighted images. The lesions were homogeneous or mildly inhomogeneous and well defined. Venous and lymphatic malformations showed similar patterns. Contrary to other lesions, no vessels or lobular architecture were detectable and contrast enhancement was absent in lymphatic malformations. Conclusion: A reliable differentiation between hemangiomas, venous and lymphatic malformations in childhood is not possible by standard MR sequences alone. Contrast media may be helpful as lymphatic malformations show no contrast enhancement. The main role of MR imaging is to determine the local extent or infiltration of deeper tissue layers and narrow the differential diagnosis of other soft tissue tumors.
High-dose percutaneous ethanol injection therapy of liver tumors: Patient acceptance and complications
Authors: Elgindy N. , Lindholm H. , Gunvén P. 
Published: July 2004

Purpose: To study the safety of high-dose ethanol injections in liver tumors and their acceptability as out-patient procedures under local anesthesia. Material and Methods: Twenty-nine patients received 20–95 ml of 95% ethanol by 62 percutaneous injections under local anesthesia. Pain was assessed by a visual analogue scale from 1 to 10 for 33 of the sessions. Side effects, complications, post-treatment requirement of parenteral analgesics, and hospital stay (discharge the same day or later) were recorded. The sessions were compared to 80 injections of  < 20 ml of ethanol in 18 patients. Results: High-dose injections with an average volume of 39 ml gave a mean pain score of 5.1, with a weak relationship between pain and volume. Other side effects and complications were unrelated to the ethanol dose. They comprised 1 syncopation, 1 occasion of hypoventilation requiring antidote to opiates, 12 short episodes of nausea or vomiting without need for i.v. fluids, 2 instances of sepsis, and 1 abscess that was drained percutaneously. Thirty-nine of the 62 sessions were performed in day care. Ethanol was given in high doses without apparent complications after or shortly before liver resections (3 patients in each group), and on 4 occasions in 2 HIV carriers. Low-dose injections resulted in a mean pain score of 4.7 with the same requirement of i.v. analgesics as high doses, fewer instances of nausea and no infectious complications. Conclusion: High-dose ethanol injections in patients with liver malignancy had no mortality and a reasonable complication rate. They could be given without general anesthesia, often in day care.
Swedish metacarpophalangeal standards compared with previously published norms
Authors: Laurencikas E. , Rosenborg M. 
Published: July 2004

Purpose: Metacarpophalangeal lengths are used to create pattern profiles that are useful for assessment of skeletal dysplasias and malformation syndromes. The purpose of this study was to establish Swedish standards and compare them with previously published norms. Material and Methods: A group of healthy Swedish children was followed longitudinally from the age of 1 month to 18 years. The length of the tubular bones of the hand was measured on radiographs. In addition to the conventional measurements including epiphyses, diaphyseal lengths alone were recorded. Results: Means and standard deviations of the metacarpophalangeal lengths are presented by gender and age. Conclusion: In spite of reasonably good correlation to previously published norms, demonstrated deviations encourage us to recommend the use of local standards whenever available.
Arterial enhancement at abdominal CT angiography: Low- versus high-osmolality contrast media
Authors: Rouvière O. , Ecochard R. , Berger P. , Pangaud C. , Fontaine B. , Lyonnet D. 
Published: July 2004

Purpose: To evaluate the effects of contrast media pharmokinetic differences on aortic enhancement at abdominal CT angiography and to determine whether these effects are of clinical relevance. Material and Methods: Two hundred and twelve patients referred for abdominal CT angiography were included in the study. All abdominal CT angiograms were performed with the same parameters (collimation 3 mm, pitch ratio 1.7, scan delay 30 s) after i.v. injection of 120 ml of contrast medium at 3 ml/s. After randomization, patients received either iobitridol 300 (low-osmolar, 300 mg I/ml), iobitridol 350 (low-osmolar, 350 mg I/ml) or ioxithalamate 350 (high-osmolar, 350 mg I/ml). The time attenuation curves obtained with the three contrast media were compared. Results: The time attenuation curve obtained with ioxithalamate 350 was not parallel to those obtained with iobitridol 300 and iobitridol 350. Mean peak enhancements obtained with iobitridol 350 and ioxithalamate 350 were not significantly different but iobitridol 350 provided higher mean peak enhancement than iobitridol 300. Mean delays of the peak enhancements were the same with the three contrast media. After peak enhancement, the decrease of aortic opacification under a selected threshold of 200 HU was significantly slower with iobitridol 350 than with iobitridol 300 and ioxithalamate 350, whereas iobitridol 300 and ioxithalamate 350 showed no significant differences. Conclusion: For a given iodine concentration, low-osmolality contrast media provide longer aortic opacification and may be recommended for CT angiography when long acquisition times are needed.
Contrast-enhanced color doppler ultrasonography in suspected parathyroid lesions
Authors: Mazzeo S. , Caramella D. , Marcocci C. , Lonzi S. , Cambi L. , Miccoli P. , Pinchera A. , Bartolozzi C. 
Published: July 2004

Purpose: To assess the usefulness of US contrast media in the evaluation of patients with primary hyperparathyroidism, with a nodule showing US features of a primary parathyroid lesion but lacking the color Doppler US appearance of a parathyroid mass. Material and Methods: Thirteen patients (7 female, 6 male; age range 51-79 years) were examined with US before and after administration of a stabilized galactose-based microbubble contrast agent. Ten patients underwent surgery and the final histological examination demonstrated parathyroid adenoma in 9 cases and a mesenchymal benign nodule in 1 case. Three nodules were proved to be of thyroid origin at fine-needle aspiration biopsy. Results and Conclusion: The use of a US contrast agent resulted in a diagnostic gain compared to unenhanced studies in 12/13 cases. Color Doppler findings characteristic of parathyroid lesions were observed in 7/13 cases, of thyroid nodules in 4/13 cases, and nonspecific patterns in 2/13 cases. Contrast-enhanced color Doppler US can be proposed in selected patients in whom unenhanced color Doppler provides uncertain findings. Its ideal application should be the evaluation of cervical lesions without detectable intranodular flow at unenhanced Doppler studies. In these cases, the contrast agent helps in visualizing typical color Doppler signals of the parathyroid lesions (“vascular pole” and “mixed pattern”).
Symptomatic Improvement in Dyspnea Following Tracheobronchial Metallic Stenting for Malignant Airway Obstruction
Authors: Tanigawa N. , Sawada S. , Okuda Y. , Kobayashi M. , Mishima K. 
Published: July 2004

Purpose: To investigate the value and limitation of Gianturco expandable metallic stenting for patients with dyspnea due to stenotic tracheobronchial lesions associated with malignancies. Material and Methods: We treated 55 lesions of 44 patients with obstructing stenotic tracheobronchial lesions related to end-stage malignancies by Gianturco expandable metallic stents (EMSs). Results: In 42 of 44 patients, the dyspnea subjectively improved after the procedure (95.5%). An improvement over one grade of the Hugh-Jones classification was shown in 79.5% (35/44); in 80% (20 of 25 patients) with intraluminal tumor and in 78.9% (15 of 19 patients) with extrinsic compression. Seven of the 44 patients developed dyspnea related to re-stenosis of 10 lesions and 1 of these patients developed dyspnea related to re-re-stenosis during follow-up. The mean duration of survival was 4.3 months in patients who underwent stenting. No significant differences in survival rates and primary patency rates were seen in patients with extrinsic compression compared to patients with intraluminal tumors. Conclusion: Gianturco EMS therapy was valuable in patients who suffered from dyspnea due to airway stenosis causing obstruction.
Proton MR spectroscopy of the brain in patients treated with tips
Authors: Hamuro M. , Nakamura K. , Matsuoka T. , Kaminou T. , Higashida M. , Yamada R. 
Published: July 2004

Purpose: To evaluate the utility of proton MR spectroscopy (MRS) for the early detection of hepatic encephalopathy (HE) after transjugular intrahepatic portosystemic shunting (TIPS). Material and Methods: Six patients, who underwent TIPS for treatment of portal hypertension, were examined by MRS 1 week before and 1 week after TIPS. They were simultaneously clinically examined for number connection test, blood NH3 level, liver function test and the Fischer ratio. Result: Three of 6 patients showed overt HE 1 to 5 weeks after TIPS and the other 3 patients did not show overt HE. The overt HE group showed the larger ratio of the amounts of glutamine and glutamate/myo-inositol (Glx/MI) than that of non-overt HE group ( p<0.05). Conclusion: The Glx/MI ratio estimated by MRS was useful for early detection of HE after TIPS.
Morphology and hemodynamics in dissection of the descending aorta: Assessment with MR imaging
Authors: Strotzer M. , Aebert H. , Lenhart M. , Nitz W. , Wild T. , Manke C. , Völk M. , Feuerbach S. 
Published: July 2004

Purpose: To obtain morphologic and functional information in patients with dissection of the descending aorta using contrast-enhanced MR angiography (MRA) and MR blood flow quantification of the true and false lumina. Material and Methods: Fourteen patients were studied prospectively using a 1.5 T unit. MRA was performed with a 3D FISP sequence (TR/TE/flip angle 4.7/1.9 ms/30°) after injection of 0.2 mmol Gd-DTPA per kg b.w. Flow quantification with phase velocity mapping was done at the level of the diaphragm using a 2D FLASH technique (TR/TE/flip angle 28/6.5 ms/30°) with an average temporal resolution of 23 frames per cardiac cycle (34 ms). A spectral broadening index was applied to quantify the amount of flow irregularity within both channels of the aorta. Extension of the dissection and involvement of the major branch vessels were analyzed. Results: The mean flow volume per minute was 1982 ml (SD 1083 ml) in the true and 1052 ml (SD 763 ml) in the false lumen. Average peak-velocities were 98 cm/s (SD 33 cm/s) in the true channel and 47 cm/s (SD 26 cm/s) in the false channel. Ten patients had bidirectional flow in the false lumen with a reflux volume ranging between 6.8% and 98%. Only 1 patient presented with bidirectional flow in the true lumen (reflux volume 15%). A significantly higher degree of flow irregularity was found in the false lumen compared with the true channel. Conclusion: Different hemodynamic patterns were found in aortic dissection. Their prognostic value and the impact on therapy, specifically percutaneous interventional procedures, have to be further studied.
A new stent designed for carotid artery application: An experimental study
Authors: Cwikiel W. , Harnek J. 
Published: July 2004

Purpose: To evaluate a new stent developed for treating arterial stenoses located adjacent to the bifurcation of the carotid artery. Material and Methods: Eight 4-cm-long nitinol stents, each with a diameter of 6 mm in its distal half and 9 mm in its proximal half, were tested in 4 pigs. In each animal, the abdominal aorta was catheterized through the left common carotid artery, and 2 stents were inserted into the right and left iliac arteries, respectively, with the wider portion in the common iliac artery and the narrower portion in the corresponding external iliac artery. The pigs were killed after 24 hours, or 1, 4 or 8 weeks, following control angiography. The arteries were examined macroscopically and by scanning electron microscopy. Results: All stents remained in the intended position, fitting the arterial wall, following successive expansion to their maximum diameter and after 4 weeks were completely covered by endothelium. The arteries remained patent, with preserved flow to the side branches through the stent mesh. A small thrombus was found in 1 artery. Conclusion: In animal experiments, the new stent was safely inserted over the arterial bifurcation, remained in place and was covered by endothelium while flow through side branches was preserved.
Scoring of extensive deep leg vein thrombosis displayed as wide-spread non-filling of contrast on phlebography: A comparison with colour Doppler ultrasonography
Authors: Björgell O. , Nilsson P.E. , Jarenros H. , Nylander G. 
Published: July 2004

Purpose: To evaluate whether wide-spread non-filling of contrast in vein segments, displayed on phlebography, is interpreted as deep venous thrombosis (DVT) on colour Doppler ultrasonography (CDU) and if the same score value is obtained. Material and Methods: Twenty consecutive patients were analysed by both phlebography and CDU with a scoring system. Results: One hundred and fifty-one venous segments were initially analysed, but 19 (12.6%) were excluded because their entire extent could not be interpreted by CDU. The total score was 366 (mean 18.3) according to the phlebograms and 298 (mean 14.9) when interpreted by CDU, p=0.0001. The difference was due mainly to the scoring of the anterior tibial vein found to be open on CDU in most cases, and then the thrombotic burden percentage was 84% and 75%, respectively. In 19 of the 20 patients (95%) a DVT was confirmed by CDU. The great saphenous vein, the femoropopliteal vein, and the deep femoral vein, formed the main collateral circulation. Conclusion: Wide-spread non-filling of vein segments is due to an extensive DVT in the vast majority of cases. Scoring is possible by both phlebography and CDU and the difference in the results of the scoring is generally of minor importance.
Added value of cea scintigraphy in the detection of recurrence of rectal carcinoma
Authors: Järv V. , Blomqvist L. , Holm T. , Ringertz H. , Jacobsson H. 
Published: July 2004

Purpose: To explore the diagnostic value of immunoscintigraphy compared to CT and/or MR imaging in the diagnosis of local recurrence (LR) of rectal cancer. Material and Methods: Forty-six patients suspected of having LR of rectal cancer were retrospectively studied. Carcinoembryonic antigen (CEA) scintigraphy findings were compared to CT and/or MR in all patients, and with data from surgery and morphology (31 patients), biopsy (7 cases) and follow-up (8 patients). Results: CEA scintigraphy was not complementary to CT and/or MR in the detection of LR. Two false-positive and 14 false-negative diagnoses of LR occurred with CEA scintigraphy. Distant metastases including metastatic lymph nodes were found by this method in only 7 of 27 patients with proven metastases. CT/MR were able to demonstrate these metastases in 21 of 27 patients. Conclusion: Accuracy and sensitivity of CEA scintigraphy in the detection of LR and distant metastases is lower than that of CT and/or MR. However, CEA scintigraphy seems to have a high specificity and could therefore be used in patients with a strong clinical suspicion of LR but negative CT/MR investigations. Available diagnostic methods have limitations in differentiating between benign, post-treatment changes and LR of rectal cancer and in staging of malignant disease.
Ultrasonographic evaluation of bilateral groins in children with unilateral inguinal hernia
Authors: Kervancioglu R. , Bayram M.M. , Ertaskin I. , Ozkur A. 
Published: July 2004

Purpose: The presence of hernia was investigated prospectively by US in both groins of children with clinically suspected or apparent unilateral inguinal hernia. Material and Methods: One hundred and twenty-eight (103 boys, 25 girls) were classified into three groups according to age: 0-2, 3-5 and 6-15 years. The widest diameter of the inguinal canal was measured in the longitudinal plane while the children were in the supine position and at rest. The patent processus vaginalis (PPV) values of 4 mm and higher were accepted as hernia. The groins diagnosed clinically and/or ultrasonographically as hernia were explored surgically. The clinical and US findings were compared with surgical results. The relations between hernia diameters and the age groups, sex, right/left and inguinal/scrotal hernias were analyzed statistically. Results: In 128 children, 138 groins were treated with surgery. One hundred and eleven cases were unilateral hernia (73 right, 38 left) and 10 were bilateral. Seven cases were found to be normal. Ten cases with clinically unilateral hernia were bilateral at US and surgery. One hundred and thirty-one of 138 groins were correctly diagnosed by US. The accuracy, specificity and sensitivity of US were 94.9%, 85.7% and 95.4%, respectively. The accuracy of physical examination was 87.7%. There were no significant differences between hernia diameters and the age groups, sex and right/left side except the difference between inguinal and scrotal hernia diameters ( p<0.0001). Conclusion: US can be used routinely in the pre-operative diagnosis of inguinal hernia in children. PPV values higher than 4 mm, with a high accuracy indicate hernia.
Radiographic evaluation of anterior dislocation of the shoulder
Authors: Ceroni D. , Sadri H. , Leuenberger A. 
Published: July 2004

Purpose: To establish radiographic criteria to choose the most appropriate technique of reduction for each type of anterior glenohumeral dislocation, and to determine the type of dislocation which requires general anesthesia. Material and Methods: Radiography in two different projections was performed in 67 patients with antero-inferior shoulder dislocations before a reduction attempt. The method proposed by Boss-Holzach-Matter was used as the primary technique for all shoulder dislocations. Results: Most subcoracoid dislocations (84.4%) could be reduced by the Boss-Holzach-Matter method while only a few subglenoid dislocations (15.8%) were reducible by this technique. Displaced associated fractures significantly reduced the success rate of the reduction attempts. Conclusion: Anterior dislocations of the shoulder require different methods of reduction depending upon the type (sub-group) of dislocation. Reduction of subglenoid dislocations with associated greater tuberosity fracture should be performed under general anesthesia to avoid head-splitting fracture.
Incidence of adverse events after I.V. injection of MR contrast agents in a chinese population: A comparison between gadopentetate and gadodiamide
Authors: Chu W.C.W. , Lam W.W.M. , Metreweli C. 
Published: July 2004

Purpose: To study the incidence of adverse events after i.v. injection of MR contrast agents in a Chinese population. A comparison was made between an ionic contrast agent (dimeglumine gadopentetate, Magnevist) and a non-ionic contrast agent (gadodiamide, Omniscan). Material and Methods: During a 24-month period, 2,049 Chinese patients who randomly received an i.v. bolus injection of either Magnevist or Omniscan were investigated. All patients were questioned for the presence of any generalized or localized adverse reaction on the following day after the MR examination according to a standardized questionnaire. Results: Three hundred and nine out of 2,049 patients (15%) reported an adverse event. There was a higher incidence of adverse events in patients receiving Magnevist as compared to those receiving Omniscan injection. All reported adverse events were clinically mild and required neither treatment nor hospitalization. Conclusion: There was a higher incidence of adverse reaction in patients receiving Magnevist than in those receiving Omniscan.