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  • 1
    Electronic Resource
    Electronic Resource
    MR mammography: influence of menstrual cycle on the dynamic contrast enhancement of fibrocystic disease (1999)
    Springer
    European radiology 9 (1999), S. 1107-1112 
    Details
    ISSN: 1432-1084
    Keywords: Key words: Breast ; Parenchymal pattern ; MR imaging ; Contrast enhancement ; MR mammography ; Menstruation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. Magnetic resonance mammography (MRM) provides data regarding the nature of tumours based on contrast medium dynamics; fibrocystic changes in the breast, however, may lead to false-positive results. This study investigated whether the contrast medium dynamics of fibrocystic changes are dependent on the menstrual cycle. Twenty-four patients with palpable lumps but normal mammographies and ultrasound studies were examined. The MRM technique was performed during the first and second part of the menstrual cycle using a FLASH 3D sequence, both native and at 1, 2, 3 and 8 min after intravenous application of 0.15 mmol/kg body weight of gadodiamide. The calculated time–intensity curves were evaluated based on the following criteria: early percentage of contrast medium uptake in relation to the native value; formation of a plateau phenomenon after the second minute; the point of maximal contrast medium uptake; and calculation of the contrast enhancing index. During the second half of the menstrual cycle, a generally greater contrast medium uptake was observed. Nevertheless, when further diagnostic criteria, such as continuous contrast medium increase as a function of time, were considered, there was no increased rate of false-positive findings. The phase of the menstrual cycle may affect the specificity of the examination, if only the quantitative contrast medium uptake and the percentage of contrast medium uptake in the first 2 min are considered. A control MRM during the other half of the cycle may then be indicated and additional diagnostic criteria may improve specificity.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003300050800
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  • 2
    Electronic Resource
    Electronic Resource
    Diagnostic imaging in Crohn’s disease: comparison of magnetic resonance imaging and conventional imaging methods (2000)
    Springer
    International journal of colorectal disease 15 (2000), S. 176-181 
    Details
    ISSN: 1432-1262
    Keywords: Keywords MRI ; Abdomen ; Crohn’s disease ; Inflammatory small bowel disease
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Conventional enteroclysis remains the method of choice in the diagnosis of inflammatory small bowel disease. The reported sensitivity rates, however, for the diagnosis of extraintestinal processes, such as fistulae and abscesses, are moderate. Computed tomography (CT) is the method of choice for the diagnosis of extraintestinal complications. The anatomical designation of the affected bowel segment may, however, prove difficult due to axial slices, and the applied radiation dose is high. The use of magnetic resonance imaging (MRI) in the diagnosis of inflammatory small bowel disease is a relatively new indication for the method; prerequisites were the development of breathhold sequences and phased array coils. Optimized magnetic resonance tomographic imaging requires a combined method of enteroclysis and MRI, which guarantees an optimal filling and distension of the small bowel. The high filling volume leads to a secondary paralysis of the small bowel and avoids motion artifacts. In a trial of 84 patients with histological and endoscopic correlation the sensitivity in diagnosing inflammatory bowel disease was 85.4% for enteroclysis and 95.2% for MRI, and the specificity was 76.9% for enteroclysis and 92.6% for MRI. As none of the abscesses was diagnosed with enteroclysis, the sensitivity was 0% for enteroclysis, but 77.8% for MRI. The sensitivity in diagnosing fistulae was 17.7% for enteroclysis and 70.6% for MRI. In summary, MRI can detect the most relevant findings in patients with inflammatory small bowel disease with an accuracy superior to that of enteroclysis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003840000219
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  • 3
    Electronic Resource
    Electronic Resource
    MRI in the diagnosis of small bowel disease: use of positive and negative oral contrast media in combination with enteroclysis (2000)
    Springer
    European radiology 10 (2000), S. 1377-1382 
    Details
    ISSN: 1432-1084
    Keywords: Key words: MR imaging – Gastrointestinal tract – Contrast agent – Inflammatory bowel disease – Crohn's disease
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. The aim of the study was to evaluate the additional findings of MRI following small bowel enteroclysis and to compare the efficacy of negative and positive intraluminal contrast agents. Fifty patients with inflammatory or tumorous small bowel disease were investigated by small bowel enteroclysis and consecutive MRI using breathhold protocol (T1-weighted fast low-angle shot, T2-weighted turbo spin echo). Patients were randomly assigned to either receiving a positive oral (Magnevist, Schering, Berlin, Germany) or a negative oral MR contrast media (Abdoscan, Nycomed, Oslo, Norway). The pattern of contrast distribution, the contrast effect, presence of artifacts, as well as bowel wall and extraluminal changes, were determined and compared between the contrast type using Fischer's exact test. Sensitivity, specificity, and diagnostic accuracy for MRI and enteroclysis were calculated. Twenty-seven patients had clinically proven Crohn's disease and two patients surgically proven small bowel tumours. Magnetic resonance imaging had important additional findings as abscesses and fistulae in 20 patients. Surgically compared sensitivities were 100 and 0 % for MRI and enteroclysis, for the detection of abscesses, and 83.3 and 17 % for the diagnosis of fistulae, respectively. Bowel wall thickening was more reliably detected with use of positive oral contrast media without intravenous enhancement (p 〈 0.001), whereas postcontrast negative oral contrast media allow for a superior detection (p 〈 0.001). T2-weighted sequences were necessary with use of negative oral contrast media, because loop abscesses may be masked. Magnetic resonance imaging should be performed in all patients with suspicion of extraintestinal complications, because the complications are more reliably detected by MRI. Negative oral contrast media show advantages with the use of intravenous contrast but can mask loop abscesses using only T1-weighted imaging.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003300000354
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  • 4
    Electronic Resource
    Electronic Resource
    MRT of the abdomen in combination with enteroclysis in Crohn disease with oral and intravenous Gd-DTPA (1998)
    Springer
    Der Radiologe 38 (1998), S. 23-28 
    Details
    ISSN: 1432-2102
    Keywords: Key words Crohns' disease • MRI in Crohns' disease • Enteroclysis • MRI ; Schlüsselwörter M. Crohn • MRT bei M. Crohn • Enteroklyse • MRT
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Trotz der Verbesserung der MR-tomographischen Diagnostik wird die MRT weiterhin nur selten in der Routinediagnostik bei entzündlichen Dünndarmerkrankungen eingesetzt. Ziel der Untersuchung war die Korrelation der Befunde von Enteroklyse und MRT bei Patienten mit bekanntem M. Crohn nach Optimierung der Darmkontrastierung. Ferner wurde untersucht, ob die MRT Zusatzinformationen zur Enteroklyse liefern kann. 60 Patienten im Alter von 17–72 Jahren wurden untersucht. Zunächst wurde eine Enteroklyse in konventioneller Technik durchgeführt, wobei der Methylzellulose in einer Mischung von 1:10 positives orales MR-Kontrastmittel (Magnevist enteral) zugesetzt wurde. Nach Abschluß der Enteroklyse erfolgte die MRT unter Verwendung T1- und T2-gewichteter Sequenzen (Flash 2D vor und nach i. v. Gd-DTPA bzw. TSE) in Atemanhaltetechnik in koronarer und axialer Schnittführung. Die in der Enteroklyse nachweisbaren Schleimhautveränderungen und Stenosenlänge entsprachen einer nachweisbaren Darmwandverdickung bzw. Stenose in der MRT. Mit der MRT konnten bei 28 Patienten Zusatzbefunde wie Fisteln, Abszesse oder Hydronephrosen diagnostiziert werden, oder die Stenose war wegen der überlagerungsfreien Darstellung in der MRT besser beurteilbar als mittels Enteroklyse. Mit der MRT kann ein wesentlicher Beitrag in der Diagnostik von entzündlichen Darmerkrankungen geleistet werden. Grundvoraussetzung scheint vor allem ein hohes Füllungsvolumen des Dünndarmes zu sein, um eine homogene Kontrastierung und gute Distension zu erreichen.
    Notes: Summary In spite of the improved MR-diagnosis of the abdomen, MRI is not used as a routine method for the diagnosis of inflammatory small bowel disease. The aim of this study was – after optimazation of the bowel opacification – the correlation of the findings obtained with enteroclysis and MRI in patients with known Crohns' disease. 60 patients beween 17 and 72 years of age were investigated. First, an enteroclysis was performed in typical manner. The applicated methylcellulosis was blended with positive oral MR contrast media (Magnevist oral, Schering). After enteroclysis, MRI of the abdomen was performed using T1- and T2-weighted breathhold sequences (Flash 2D pre- and postcontrast and TSE) in axial and coronal planes. The lenght of the affected bowel and the stenosis seen with enteroclysis correlated well with the visible thickening of the small bowel wall and the stenosis seen in MRI. Using MRI, additional findings could be obtained in 28 patients, such as fistulas, abscesses or a hydronephrosis, or a better assessment of the stenosis was possible with MRI, because of the avoidance of overshadowing of the affected bowel loop with MRI. A brilliant MR-tomographic imaging of the small bowel is possible under the condition, that the small bowel contrast is optimal. The main prerequisite is a large filling volume of the small bowel to reach a homogeneous contrast and a good distension of the small bowel lumen.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001170050319
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