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  • 1
    ISSN: 1279-8517
    Keywords: Shoulder ; Impingement syndrome ; Subacromial space ; MR imaging ; 3D reconstruction
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé Les objectifs de ce travail étaient de déterminer les modifications de la hauteur de l'espace sub-acromial normal pendant l'abduction et la rotation, et d'analyser les rapports dans l'espace du m. supra-épineux avec l'acromion et la clavicule. L'étude a été réalisée sur une IRM ouverte chez 12 volontaires sains dans 5 positions différentes d'abduction et 3 de rotation. Après reconstruction tridimensionnelle (3D) et mesure euclidienne de distance dans l'espace, les distances minimales entre l'humérus et l'acromion d'une part et la clavicule d'autre part ont fait l'objet d'un traitement informatique. La distance acromiohumérale minimale diminuait de façon significative à partir de 30° (moyenne 7.0 mm;+1.6 mm.) jusqu'à 120° (moyenne 3.9 mm;+1.8 mm; p〈0.0001) d'abduction. A 30°, le vecteur de la distance minimale traversait le m. supra-épineux alors qu'à 120° et au-delà, il était en situation latérale par rapport à son tendon chez tous les volontaires. A 90°, la distance acromio-humérale minimale était plus grande en rotation interne (7.6 mm,+2.3 mm) qu'en rotation neutre (5.4 mm,+2.3 mm) ou externe (4.4 mm,+2.2 mm; p〈0.05), mais son vecteur traversait le tendon des m. supra-épineux dans sa partie la plus vulnérable et atteignait l'acromion à son bord antérieur et inférieur. Ainsi, la hauteur de l'espace subacromial se modifie pendant l'abduction et la rotation et le m. supra-épineux vient au contact étroit du bord antérieur et inférieur de l'acromion à 90° d'abduction avec 45° de rotation interne. Ces chiffres obtenus chez des volontaires sains constituent des valeurs de références pour des travaux ultérieurs chez des patients souffrant d'un conflit sub-acromial.
    Notes: Summary The objectives of this study were to determine systematic changes of the normal subacromial space width during abduction and rotation, and to analyze the spatial relationship of the supraspinatus muscle with the acromion and clavicle. 12 healthy volunteers were imaged by an open MR scanner in 5 different positions of abduction and in 3 positions of rotation. After three dimensional (3D) reconstruction and 3D Euclidian distance transformation, the minimal spatial distances between the humerus and the acromion and the humerus and clavicle were computed. The minimal acromio-humeral distance decreased significantly from 30° of abduction (mean 7.0 mm±1.6 mm) to 120° (mean 3.9 mm;±1.8 mm; p〈0.0001). At 30°, the minimal distance penetrated the supraspinatus, whereas at 120° it was always located lateral to the supraspinatus tendon. At 90° with internal rotation (7.6 mm,±2.3 mm) the minimal acromio-humeral distance was larger than in neutral rotation (5.4 mm,±2.3 mm) or external rotation (4.4 mm,±2.2 mm; p〈0.05), but it penetrated the supraspinatus tendon at its most vulnerable part, reaching the acromion at its anterior inferior border. We conclude that the subacromial space width changes during abduction and rotation and that the supraspinatus is in closest contact to the anterior inferior border of the acromion in 90° of abduction with 45° internal rotation. These values obtained in volunteers can be used as a basis for further investigations in patients with the impingement syndrome.
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Surgical and radiologic anatomy 16 (1994), S. 429-438 
    ISSN: 1279-8517
    Keywords: Articular cartilage ; Magnetic resonance imaging ; Cartilage thickness ; Patella ; Knee joint
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé L'évaluation quantitative de l'épaisseur et du volume du cartilage de patellas humaines, fixées dans un mélange d'alcool et de formol, a été réalisée en imagerie par résonance magnétique (IRM) car on ne sait encore avec exactitude si l'aspect morphologique du cartilage normal ou lésé peut être parfaitement démontré par cette technique. L'IRM a été réalisée sur un appareil 1.0 T (épaisseur de coupe : 2 mm, résolution : 0,39–0,58 mm) avec les séquences suivantes : 1) séquence en spin écho pondéré T1, 2) 3D-MRAGE, 3) 3D-FISP, 4) 3D-MTC-FISP, 5) 3D-DESS, 6) 3D-FLASH. Après la réalisation de l'IRM, la patella était sectionnée tous les 2 mm, perpendiculairement à sa surface articulaire, à l'aide d'une scie à ruban. Le volume de son cartilage était déterminé sur les coupes anatomiques et les images IRM grâce à un système d'analyse d'images Vidas IPS 10 (Kontron). Les mesures étaient réalisées avec et sans la couche en hyposignal correspondant à la zone transitionnelle située entre le cartilage articulaire et l'os sous-chondral. Lorsque cette couche en hyposignal était prise en compte, le volume était surestimé par l'IRM de 16 à 19%. Lorsque cette couche en hyposignal n'était pas prise en compte, les volumes étaient inférieurs à ceux déterminés par les coupes anatomiques : T1-SE : −18,2%, MPRAGE : −22,6%, FISP : − 17,1%, MTC-FISP : − 9,5%, DESS : − 9,3% et FLASH : −6,1%. La séquence FLASH permettait l'appréciation la plus correcte et la plus reproductible de la morphologie du cartilage. La différence persistante par rapport au volume réel du cartilage peut être due au fait que la zone calcifiée du cartilage n'est pas délimitée par l'IRM.
    Notes: Summary Quantitative assessment of cartilage volume and thickness in a formalin-alcohol fixed specimen of a human patella was conducted with magnetic resonance imaging (MRI), as it is still unclear whether the morphology of normal and damaged cartilage can be accurately demonstrated with this technique. MR imaging was carried out at 1.0 T (section thickness 2 mm, in-plane-resolution 0.39 – 0.58 mm) with the following pulse sequences: 1) T1-weighted spin-echo, 2) 3D-MPRA-GE, 3) 3D-FISP, 4) 3D-MTC-FISP, 5) 3D-DESS, 6) 3D-FLASH. Following imaging, the patella was sectioned perpendicular to the articular surface at intervals of 2 mm with a diamond band-saw. The volume of its cartilage was determined from the anatomical sections and the MR images, using a Vidas IPS 10 image analysing system (Kontron). Measurements were carried out with and without the low-signal layer in the transitional zone between the articular cartilage and the subchondral bone. If the low-signal layer was included, the volume was overestimated with MRI by 16 to 19 %. Without the low-signal layer the volumes were less than those determined from the anatomical sections: T1-SE −18,2 %, MPRAGE −22.6 %, FISP −17.1 %, MTC-FISP −9.5 %, DESS −9,3% and FLASH −6.1 %. The coefficient of variation for a 6-fold determination of the volume amounted to between 6.2 % (T1-SE) and 2.6 % (FLASH). The FLASH sequence allowed the most valid and reproducible assessment of the cartilage morphology. The remaining difference from the real volume of the cartilage may be due to the fact that the calcified zone of the cartilage is not delineated by MRI.
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  • 3
    ISSN: 1279-8517
    Keywords: Shoulder ; Impingement syndrome ; Subacromial space ; MR imaging ; 3D reconstruction
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The objectives of this study were to determine systematic changes of the normal subacromial space width during abduction and rotation, and to analyze the spatial relationship of the supraspinatus muscle with the acromion and clavicle. 12 healthy volunteers were imaged by an open MR scanner in 5 different positions of abduction and in 3 positions of rotation. After three dimensional (3D) reconstruction and 3D Euclidian distance transformation, the minimal spatial distances between the humerus and the acromion and the humerus and clavicle were computed. The minimal acromio-humeral distance decreased significantly from 30° of abduction (mean 7.0 mm ± 1.6 mm) to 120° (mean 3.9 mm; ± 1.8 mm; p 〈 0.0001). At 30°, the minimal distance penetrated the supraspinatus, whereas at 120° it was always located lateral to the supraspinatus tendon. At 90° with internal rotation (7.6 mm, ± 2.3 mm) the minimal acromio-humeral distance was larger than in neutral rotation (5.4 mm, ± 2.3 mm) or external rotation (4.4 mm, ± 2.2 mm; p 〈 0.05), but it penetrated the supraspinatus tendon at its most vulnerable part, reaching the acromion at its anterior inferior border. We conclude that the subacromial space width changes during abduction and rotation and that the supraspinatus is in closest contact to the anterior inferior border of the acromion in 90° of abduction with 45° internal rotation. These values obtained in volunteers can be used as a basis for further investigations in patients with the impingement syndrome.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1432-1440
    Keywords: Secretin (natural, synthetic) ; Insulin ; “entero-insular axis” ; Secretin (natürliches, synthetisches) ; Insulin ; „entero-insular axis“
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Die Wirkung von natürlichem Secretin (G.I.H.) und synthetischem Secretin (Wünsch) auf die Insulinsekretion wurde untersucht. Sowohl natürliches als auch synthetisches Secretin verursacht eine kurzzeitige uniphasische Insulinfreisetzung, die ohne Einfluß auf die Glucosekonzentration im Serum bleibt. Durch die insulinfreisetzende Wirkung von synthetischem Secretin ist erwiesen, daß die in der Literatur beschriebene Insulinfreisetzung durch natürliche Secretinpräparationen nicht auf Verunreinigung mit anderen Peptiden beruht.
    Notes: Summary The effect of natural secretin (G.I.H.) and synthetic secretin (Wünsch) on the secretion of insulin was investigated. Natural as well as synthetic secretin causes a short uniphasic release of insulin without influence on the concentration of glucose in the serum. Since the insulin releasing effect of synthetic secretin was demonstrated, it is clear, that the release of insulin by preparations of natural secretin mentioned in medical literature is not due to contamination by other peptides.
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1432-1084
    Keywords: Liver neoplasm ; Magnetic resonance imaging ; Tissue characterisation ; Turbo spin echo sequences
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract To determine whether turbo spin echo (TSE) sequences can replace conventional T2-weighted spin echo (SE) sequences in MRI of the liver, 40 patients with focal liver lesions were imaged at 0.5 T. A T2-weighted SE sequences (TR/TE 1800/90 ms, number of signals averaged [NEX]=2, scan time=7:16 min), a TSE sequence (TR/TE 1800/90 ms, NEX=4, number of echos per excitation=13, echo spacing=12.9 ms, scan time=4:16 min) and a T1-weighted SE sequence (TR/TE 350/15 ms, NEX=2, scan time=4:21 min) were obtained and image quality, lesion detectability and lesion differentiation were evaluated qualitatively by subjective assessment using scores and quantitatively by lesion-liver contrast-to-noise (CNR) and tumour/liver signal intensity (SI) ratios. The image quality of the TSE sequence was substantially better compared with the T2-weighted SE sequence due to a reduction in motion artefacts and better delineation of anatomical details. Of a total of 158 visible lesions the T1-weighted SE, TSE, and T2-weighted SE sequences showed 91%, 81% and 65% of the lesions, respectively. Thus the TSE sequence depicted 24% (P〈 0.001) more lesions than the T2-weighted SE sequence. In all types of pathology the lesion-liver CNR of the TSE sequence was significantly (P〈 0.001) higher compared to the CNR of the T2-weighted SE sequence (+ 55–65%), indicating superior lesion conspicuity. Lesion characterization was equally good on the two T2-weighted sequences with no difference in the tumour/liver SI ratio. Using a criterion of tumour/liver SI ratio equal to or higher than 2, haemangiomas larger than 1 cm in diameter could be differentiated from other lesions with a sensitivity and specificity of 95% and 96%, respectively. Our results indicate that the TSE sequence is suitable for replacing the conventional T2-weighted SE sequence in MRI of focal liver lesions.
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  • 6
    ISSN: 1432-1084
    Keywords: Key words: Cartilage – MR imaging – Precision – Joint – Osteoarthritis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. The aim of this study was to analyze the precision of tibial cartilage morphometry, by using a fast, coronal water-excitation sequence with high spatial resolution, to compare the reproducibility of 3D thickness vs volume estimates, and to test the technique in patients with severe osteoarthritis. The tibiae of 8 healthy volunteers and 3 patients selected for total knee arthroplasty were imaged repeatedly with a water-excitation sequence (image time 6 h 19 min, resolution 1.2 × 0.31 × 0.31 mm3), with the knee being repositioned between each replicate acquisition. After 3D reconstruction, the cartilage volume, the mean, and the maximal tibial cartilage thickness were determined by 3D Euclidean distance transformation. In the volunteers, the precision of the volume measurements was 2.3 % (CV%) in the medial and 2.6 % in the lateral tibia. The reproducibility of the mean cartilage thickness was similar (2.6 and 2.5 %, respectively), and that of the maximal thickness lower (6.5 and 4.4 %). The patients showed a considerable reduction in volume and thickness, the precision being comparable with that in the volunteers. We find that, using a new imaging protocol and computational algorithm, it is possible to determine tibial cartilage morphometry with high precision in healthy individuals as well as in patients with osteoarthritis.
    Type of Medium: Electronic Resource
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  • 7
    ISSN: 1432-1084
    Keywords: Key words: Heart neoplasm – Heart valves – Magnetic resonance imaging – Tomography, X-ray computed, echocardiography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. We describe the findings from various cross-sectional imaging modalities in patients with cardiac valve adherent masses. The techniques are discussed, and imaging findings are compared with the results of cardiac surgery. All three patients had neurological symptoms and/or cardiac murmurs. Transthoracic and/or transesophageal echocardiography revealed the cardiac mass in all three. For differentiation of thrombus and cardiac neoplasm magnetic resonance imaging (MRI) was also performed in all three patients and electron-beam computed tomography (EBCT) in two. Fast segmented cine gradient-echo MRI techniques provided mass depiction in all patients, while T1-weighted spin-echo imaging failed in mass detection in one patient. None of the patients showed evidence of valve regurgitation or stenosis in flow sensitive cine MRI. EBCT excluded mass calcifications in both patients and reliably demonstrated the valve attached lesions. Although echocardiography is the modality of choice in evaluating cardiac masses and especially valve attached masses, MRI and EBCT provide additional information about tissue characteristics and allows an excellent overview of the cardiac and paracardiac morphology. Fast segmented cine gradient-echo MRI is especially able to depict even small tumors attached to rapidly moving cardiac valves, and valve competence can be easily assessed within the same examination.
    Type of Medium: Electronic Resource
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  • 8
    ISSN: 1432-1084
    Keywords: Computer tomography ; Insufficiency fracture ; Sacral bone ; Vacuum phenomenon
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Sacral insufficiency fractures develop over a period of time and show time-dependent changes. We report on 15 CT examinations of 5 patients with early-stage insufficiency fractures of the sacrum. In 4 patients only irregular sclerosis without distinct fracture lines was present in 7 of 8 fractures. Of these 4 patients; 3 exhibited intraosseous gas inclusions in a ventral part of a lateral mass; 5 of 8 fractures disclosed a ventral cortical break. When distinct fracture lines had developed in 1 patient, intraosseous vacuum phenomenon had disappeared. Fracture lines evolve over weeks to months and show central bone absorption. The fractures can heal as demonstrated in 4 of 6 fractures in 3 patients, can persist over 1 year without significant changes or can progress to pseudoarthrosis with bone destruction similar to neuropathic joint disease. Intraosseous vacuum phenomena can persist to this stage. Intraosseous vacuum phenomenon is recognized as a potential finding in the early stage of sacral insufficiency fracture, which also is true for irregular sclerosis and ventral cortical disruption.
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  • 9
    ISSN: 1432-1084
    Keywords: Key words: Spinal cord herniation ; MRI ; Ankylosing spondylitis ; Spinal trauma
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. The aim of this paper is to describe clinical and imaging findings in three patients with ventral dural defects and herniation of the spinal cord or cauda equina. The literature is reviewed and the clinical, radiological and operative findings are compared. Three patients with ventral dural defects of different etiologies are presented. One patient gave a longstanding history of ankylosing spondylitis, the second patient presents 37 years after spinal trauma, and the third patient presents with spontaneous spinal cord herniation. All patients had typically slowly progressive neurological symptoms with multiple hospitalizations until diagnosis was made. Characteristic findings in postmyelographic CT included a ventral or ventrolateral displacement with deformation of the spinal cord or the cauda equina. Sagittal MRI showed this abrupt and localized anterior deviation of the spinal cord or the cauda equina to the posterior portions of a vertebral body with or without a bony vertebral defect optimally. Additionally, due to the ventral displacement of the spinal cord, the dorsal subarachnoid space was relatively enlarged without evidence of an arachnoid cyst, in all patients. Magnetic resonance imaging and postmyelographic CT can diagnose ventral dural defects with spinal cord herniation or nerve root entrapment. Dural defects must be considered in the presence of neurological symptoms in cases of longstanding ankylosing spondylitis, late sequelae of fractures of vertebral bodies, and without history of spinal trauma or surgery.
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  • 10
    ISSN: 1432-1084
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
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