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  • 1
    ISSN: 1432-0509
    Keywords: Key words: MRI—Liver—Focal nodular hyperplasia—SPIO—Gd-DOTA—Gd-EOB-DTPA.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. Background: To demonstrate the improved specificity of liver MRI in diagnosis of focal nodular hyperplasia (FNH) using liver specific contrast agents. Methods: In a patient after resected adenosarcoma of the uterus a focal nodular hyperplasia was followed. Serial MRI of the liver was performed using first Gd-DOTA, followed by superparamagnetic iron oxide (SPIO) as well as Gd-EOB-DTPA. Results: During the follow-up of FNH specificity of liver MRI improved using liver specific contrast agents. The central scar as well as the pseudocapsule showed different typical contrast uptake using all three methods. Conclusion: Serial MRI of the liver with Gd-DOTA, SPIO and Gd-EOB-DTPA can exclude a malignant liver lesion. Liver biopsy of FNH can be avoided with increased specificity of MRI for FNH.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-1084
    Keywords: Key words: Stereolithography ; Rapid prototyping ; Computed tomography ; Calcaneal fracture ; ROC curves
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. The purpose of this study was to evaluate and compare the diagnostic performance of stereolithography vs workstation-based three-dimensional (3D) reformations in intra-articular calcaneal fractures. A total of 30 intra-articular calcaneal fractures were examined using standard radiographs, coronal CT scans, and 2D and 3D reformations. The CT data were transferred to an outside institution, and stereolithograms were produced from photopolymer resin employing a laser beam system. 3D reformations and stereolithograms were analyzed in a blinded fashion by two staff radiologists. Receiver-operating-characteristic (ROC) curves were obtained for six clinically significant fracture components. Standard radiographs, coronal CT scans, and 2D reformations served as the standard of reference. The area under the ROC curves for 3D reformations and stereolithograms were 1.0 and 0.98 for abnormal tuber angles, 0.91 and 0.91 for anterior and middle talo-calcaneal joint involvement, 0.90 and 0.95 for involvement of the posterior talo-calcaneal joint, 0.65 and 0.78 for the presence of a lateral bulge, 0.80 and 0.81 for the involvement of the calcaneocuboidal joint, and 0.62 and 0.67 for the presence of a “tongue-type” fracture. No statistically significant difference was demonstrated for the two methods (Wilcoxon signed-rank test, p = 0.138). Based on our results stereolithograms did not prove to be statistically superior to workstation-based 3D reformations. Stereolithograms may still be useful for teaching purposes and for surgical planning at a thinking-efficacy level.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1432-1084
    Keywords: Key words: Breast MRI ; Mammography ; Breast neoplasm ; Contrast-enhanced MRI
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. The aim of this study was to compare the diagnostic performance of conventional mammography and dynamic contrast-enhanced fast 3D gradient-echo (GRE) MRI regarding the detection and characterization of breast lesions relative to histopathologic analysis and to assess the results of a combined evaluation of both methods. fifty consecutive patients with 63 histopathologically verified breast lesions underwent dynamic contrast-enhanced GRE MRI in addition to routine conventional mammography. All lesions were classified by both methods on a five-point scale as benign or malignant, and the results were correlated to histopathology. Conventional mammography and dynamic MRI yielded a sensitivity and specificity of 82 and 64 %, and 92 and 76 %, respectively. The difference between the results was statistically not significant (p 〉 0.05) with areas under the receiver-operating-characteristics curves of 0.807 for mammography and 0.906 for MR imaging. Combination of the results of both methods slightly increased the sensitivity for detection of breast cancer to 95 % but decreased specificity to 52 %. In this selected patient subset, including only patients referred for excisional biopsy, contrast-enhanced dynamic MRI proved more sensitive and specific than conventional mammography regarding the detection of malignancy. While a combination of both methods yields a slightly improved sensitivity, specificity is vastly reduced.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1432-1084
    Keywords: Key words: Thyroid ; Biopsy ; Interventional MR ; MR guidance ; Stereotaxis ; Ultrasound
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. The aim of this study was to demonstrate the clinical feasibility and utility of an interactive MR-guidance system to target and biopsy thyroid lesions, and to compare resolution between ultrasound and interventional MR imaging in the evaluation of thyroid lesions. Twenty thyroid lesions of 18 patients were interactively biopsied using a 0.5-T superconducting open magnet system. Stereotactic localization of the needle and imaging was accomplished using T1-weighted gradient-recalled-echo (GRE) images. Representative cytological material was retrieved in 16 of 20 lesions (benign cystic or colloid goiter: n = 14; one de Quervain's thyroiditis and one follicular neoplasia). Lesions smaller than 1.5 cm detected by ultrasound could not be visualized adequately on GRE images. Lesions smaller than 1.5 cm were successfully biopsied by ultrasound (three colloid and haemorrhagic goiters and one adenoma). Magnetic-resonance-guided interactive biopsies and positioning of non-ferromagnetic needles in the thyroid gland are technically feasible and safe. Compared with high-resolution ultrasound, lesions larger than 1.5 cm can be adequately visualized and biopsied. Magnetic-resonance-guided placement of non-ferromagnetic needles is no substitute for high-resolution ultrasound in clinical work-up of thyroid lesions.
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1432-1084
    Keywords: Key words: MR-guided biopsy ; Ameloblastoma ; Non-Hodgkin's lymphoma ; Dental cysts ; Head and neck biopsy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. The purpose of this study was to explore the potential of interactive MR-guided biopsies in the maxillary and skull base region using a 0.5-T open-configuration scanner in patients with tumours affecting the maxilla or skull base. Ten patients with cystic or solid tumours affecting the maxillary and skull base regions underwent MR-guided biopsy in a superconducting, open 0.5-T MR system equipped with an optical frameless stereotaxic system. T2-weighted spin-echo images were acquired prior to and following biopsy, which was performed with 18- or 22-G needles using an enoral or percutaneous approach following infiltration of the skin, mucosa and periosteum with local anaesthetics. The position of the needle tip was continuously updated on fast T1-weighted gradient-recalled-echo images (TR 19 ms, TE 7.1 ms, flip angle 30 °, slice thickness 1 cm, field of view 24 × 24 cm) using the frameless stereotaxic system. In addition, the needle was identified based on the associated susceptibility artefact in all three planes. Once the target lesion had been reached, cytology material was aspirated. All ten patients tolerated the interactive MR-guided biopsies well without complications. Vital structures, including the brain, neurovascular bundles, vessels and eyes, were visualized on MR imaging and could be spared. There was no difference in the use of 18- or 22-G non-ferromagnetic needles concerning the susceptibility artefact. Sufficient material for cytological analysis was obtained in nine of ten cases. The mean biopsy time was 15 min. Interactive MR-guided biopsies of the head and neck in an open system are technically feasible and safe. Monitoring of the needle path in multiple planes permits the interactive adjustment of the needle course in near real time. Interactive MR-guided biopsies may well replace open surgical procedures in the maxillary region in selected patients.
    Type of Medium: Electronic Resource
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  • 6
    ISSN: 1432-2102
    Keywords: Schlüsselwörter Endometriose ; Biopsie ; Nadel ; Magnetresonanztomographie ; Interventionelle Radiologie ; Key words Endometriosis ; Biopsy ; needle ; Magnetic resonance imaging ; Interventional radiology
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Introduction and Methods: A 0.5 T open-configuration MR system allows free access to the patient via a 58-cm-wide opening on both sides of the machine. A newly developed system for needle guidance enables the examiner to perform biopsies in combination with real-time imaging and to position laser fibers in the human body. For imaging, a 2D gradient echo sequence is used (TR 19 ms, TE 9 ms, flip angle 30 °, FOV 24 × 24 cm, slice thickness 10 mm matrix 256 × 128). The acquired images are displayed on two LCD screens localized within the MR system, thus allowing an interactive needle guidance. This procedure is illustrated by a case report. Discussion: The handling of the system for needle guidance was simple, mainly due to a real-time adaption of the scan plane to the needle direction. The possibility of multi-angulated approaches makes biopsies of hardly accessible anatomic regions feasible. Conclusion: We think that MR-guided needle positioning will play an important role in combination with thermosensitive therapies. Thermosensitivity of MR imaging allows extensive monitoring of such interventions.
    Notes: Zusammenfassung Ein offenes, interventionelles MR-Gerät (0,5 Tesla) erlaubt durch eine 58 cm breite Öffnung den Zugang zum im Gerät liegenden Patienten. Ein spezielles Punktionssystem ermöglicht es, unter Echtzeitbildgebung Punktionen vorzunehmen sowie auch Laserfasern im menschlichen Körper zu plazieren. Zur Bildgebung wird eine 2d-Gradientenechosequenz verwendet (TR 19 ms, TE 9 ms, Flipwinkel 30 °, FOV 24 × 24 cm, Schichtdicke 10 mm, Matrix 256 × 128). Die akquirierten Bilder werden dem punktierenden Radiologen auf 2 im Gerät angebrachten LCD-Monitoren angezeigt, wodurch eine interaktive Nadelführung ermöglicht wird. Es wurden bereits zahlreiche Punktionen an Patienten durchgeführt. Wichtig wird die MR-gesteuerte Punktion von Läsionen in Kombination mit der Durchführung thermosensitiver Therapien. Die der MR-Bildgebung inhärente Temperatursensitivität ermöglicht ein umfassendes Monitoring solcher Eingriffe in Echtzeit.
    Type of Medium: Electronic Resource
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