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  • 1
    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.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    European radiology 9 (1999), S. 1113-1116 
    ISSN: 1432-1084
    Keywords: Key words: Breast ; Rhabdomyosarcoma ; Mammography ; Ultrasound ; MRI
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. The authors report a case of blood-borne bilateral metastatic breast disease of alveolar rhabdomyosarcoma (RMS) in a 21-year-old patient. The possibilities of mammography, ultrasound, and MRI in the early detection of breast metastases and their appearance on these modalities are discussed. Whereas mammography rendered no additional information due to dense breast parenchyma and ultrasound showed only a solitary tumor without definite criteria of malignancy, multifocal bilateral spread was verified with MRI and early ring-like enhancement suggested malignancy. Therefore, we conclude that MRI may provide useful information in evaluating patients with sarcomas, even when there is no clinical evidence for metastatic disease of the breast.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1432-1084
    Keywords: Key words: Breast – Electrical impedance – Diagnosis – Cycle – Hormones
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. The purpose of this study was to evaluate the influence of hormonal factors on electrical impedance measurement with a new device TS2000, which is a new method in diagnosis of breast disease. Twenty-one healthy pre-menopausal women volunteers (aged 24–39 years) were examined with the TS2000 once/week for two menstrual cycles. On average, at least one spot was present in 47 % of images of women not taking oral contraceptives and in 44 % of women taking oral contraceptives (OC). The number of spots varied over the menstrual cycle and had a maximum in week 3 and week 5. We found that after 1 week only 15 % of spots were present and no spots persisted for three consecutive weeks. These data, if further supported by observations on other populations of women, show that false-positive results are common in pre-menopausal women; however, these false-positive spots do not persist for long periods of time. This information may provide a basis for discrimination between true-positive and false-positive spots on the TS2000 image, since the latter would be expected to disappear on short-term follow up.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1432-2161
    Keywords: Key words Cartilage ; Cartilage thickness ; Patella ; Joints ; MR ; Knee ; MR ; Magnetic resonance technology
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Objective. The objective of this study was to analyse the potential of magnetic resonance imaging for valid determination of patellar cartilage thickness, comparing currently available pulse sequences. Design. In six patients and one cadaver the cartilage was repetitively imaged employing three spin-echo and six three-dimensional gradient-echo sequences. In the cadaveric specimen the total volume and the regional distribution of cartilage thickness were assessed and compared with the values obtained from anatomical sections by image analysis. Results and conclusions. The FLASH and fat-suppressed FLASH sequences allowed the most accurate determination of the cartilage volume and thickness. Fat-suppression considerably increased the contrast of the cartilage to the synovial fluid, fat and bone marrow, yielding higher reproducibility of the volumetric measurements. The remaining difference from the anatomical volume and thickness may be because the calcified cartilage is not delineated by magnetic resonance imaging.
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1432-2102
    Keywords: Key words Magnetic resonance imaging • MR systems • Dedicated MR systems • Open MR systems • Patient acceptance • Subjective condition ; Schlüsselwörter MRT • Hochfeldsystem • Offenes System • Dediziertes System • Patientenbefindlichkeit • Akzeptanz
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Vergleichende Untersuchungen zur Akzeptanz verschiedener MR-Geräte durch die Patienten sind bisher in der Literatur nicht bekannt. Daher wurden in dieser Arbeit verschiedene subjektive Kriterien erhoben, die Aufschlußüber die Patientenbefindlichkeit und Akzeptanz von MR-Untersuchungen an Hochfeldganzkörpersystemen mit 1,5 und 1,0 T Feldstärke, einem offenen 0,2-T-Niederfeldganzkörpersystem sowie einem 0,2 T dedizierten Niederfeldsystem für periphere Gelenke geben sollen. An jedem MR-System wurden 40 Patienten (Gesamtzahl 160 Patienten) standardisiert zu Aspekten der subjektiven Befindlichkeit sowie der Wahrnehmung und Akzeptanz von gerätebezogenen Faktoren befragt. Bei allen MR-Systemen wurde die Befindlichkeit und Akzeptanz als ganz überwiegend positiv eingeschätzt. Dennoch wurden Unterschiede in der Wahrnehmung von Lautstärke, Enge des Untersuchungsbereiches, Bequemlichkeit der Lagerung und Grad des Wohlbefindens ermittelt. Allerdings erscheinen diese Unterschiede nicht so gravierend, daß sie als entscheidende Kriterien für die Präferenz einer bestimmten Geräteart anzusehen sind. Die Gerätewahl sollte sich dementsprechend nach den untersuchungstechnischen Möglichkeiten richten.
    Notes: Summary To our knowledge no comparative studies investigating patients' acceptance of different MR systems have been published. We therefore studied a number of subjective criteria to evaluate both patients' acceptance of and subjective conditions during magnetic resonance imaging (MRI) studies. MRI studies were performed using four separate systems. Two were conventional body MR systems operating at 1.0 or 1.5 Tesla, another was a 0.2 Tesla open whole-body MR system, and the last was a 0.2 Tesla MR system dedicated to the study of extremities. Forty patients for each MR system (total of 160 patients) participated in a standardized, written interview focusing on aspects of their subjective condition, including their perception and acceptance of different factors relevant to the study on respective MR systems. The patients' subjective condition and acceptance was predominantly positive for all MR systems. Differences between MR systems were noted with respect to noise, width of patient gantry, comfort of patient positioning and degree of well-being. Such differences, however, do not lend preference to the use of one particular type of MR system. Therefore, the choice of MR system should be based on the technical features required for the intended studies.
    Type of Medium: Electronic Resource
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  • 6
    ISSN: 1432-2102
    Keywords: Key words MRI • Low-field • MRI • Dedicated • Diagnostic imaging • Hand • Wrist ; Schlüsselwörter MRT • Niederfeld-MRT • Hand • Handgelenk
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Ziel der Untersuchung war die Bestimmung der diagnostischen Wertigkeit eines dedizierten MRT-Niederfeldsystems (0,2 Tesla, Esaote, Genua, Italien) bei Untersuchungen von Hand und Handgelenk. 1996 wurden an unserem Institut insgesamt 308 Untersuchungen an einem dedizierten Niederfeld-MRT-System durchgeführt. Zusatzuntersuchungen am Hochfeld-MR-Tomographen (Magnetom Impact, 1,0 Tesla oder Magnetom Vision, 1,5 Tesla, Siemens AG, Erlangen) wurden bei 36 Fällen ergänzt. 64 (21 %) der Fälle wurden operativ behandelt. Die MR-tomographisch gestellten Diagnosen wurden mit den operativ erhobenen Befunden korreliert. 90 % aller mit dem Niederfeld-MRT-System durchgeführten Untersuchungen klärten die klinische Verdachtsdiagnose: Bei 62 % aller Patienten wurde die klinische Fragestellung beantwortet, bei weiteren 26 % zusätzliche Pathologien identifiziert. 2 % der durch die Niederfeld-MRT gestellten Diagnosen wichen vollständig von der klinischen Verdachtsdiagnose ab. Das Hochfeld-MRT (n = 36) lieferte im Vergleich zum dedizierten Niederfeld-MRT-System bei 6 Patienten diagnostische Zusatzinformationen. Bei 3 Patienten überschritt die Pathologie das „field-of-view“ des dedizierten Systems, und eine Hochfelduntersuchung wurde ergänzt. Bei weiteren 3 Patienten lieferten eine höher auflösende Matrix und die frequenz-selektive Fettunterdrückung, die dem Niederfeldsystem fehlt, zusätzliche diagnostische Information. Das Niederfeld-MRT ist eine wertvolle Hilfe bei der weiterführenden Diagnostik von Handgelenk und Hand. Knöcherne, Band- und Sehnenpathologien können zuverlässig abgeklärt werden. Große oder infiltrativ wachsende Tumoren sollten dem Hochfeld-MRT vorbehalten bleiben.
    Notes: Summary Purpose of this study was to evaluate the diagnostic value of a low field dedicated MRI system in hand and wrist imaging. All 308 exams of the hand and wrist, that were performed on a low-field dedicated MRI system (Artoscan, Esaote Biomedica, Italy) in our institution in 1996, and high-field MRI exams performed in addition as part of the diagnostic work-up, were evaluated and correlated to final operative (n = 64) and histologic (n = 12) reports. 90 % of all low-field MRI scans stated a diagnosis according to clinical suspicion. In 62 % the clinical question was answered, and in 26 % additional pathologies were identified. An MR-diagnosis completely different from the clinical suspicion was stated in 2 %. High field exams contributed additional information in 6 of 36 patients. In 3 patients a tumor was not shown completely in the limited field-of-view of the dedicated low-field MRI-system. Frequency-selective fat-suppression pulse sequences and a better spatial resolution were the reasons for the additional information obtained in the other three patients. Low-field dedicated MR-imaging is a valuable method in the extensive work-up of the hand and wrist. Osseous, ligamentous and tendinous pathologies are well depicted. Large or infiltrative tumors should be referred to a high-field system.
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  • 7
    Electronic Resource
    Electronic Resource
    Springer
    Der Radiologe 38 (1998), S. 570-577 
    ISSN: 1432-2102
    Keywords: Schlüsselwörter Phlebographie ; Kavographie ; Kontrastmittel ; Thrombose ; DSA ; Key words Phlebography ; Cavography ; Contrast media ; Thrombosis ; DSA
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Purpose: To give an overview of various diagnostic techniques and indications for phlebography in different parts of the body. Methods: Procedures of conventional phlebography of the lower and upper extremity and cavography are described and their indications in comparison to alternative techniques are discussed. The literature is reviewed with regard to specific advantages and disadvantages of the different methods. Results: Conventional phlebography with iodine contrast media is still considered to be the gold standard in many regards. The diagnosis of acute and chronic thrombotic disease, venous vascular occlusions, hemodynamic malfunctions and anatomic variants of the venous system can readily be established with contrast phlebography. Discussion: Main disadvantages of contrast studies of the venous system are radiation exposure and adverse effects of contrast media. Non-invasive methods such as ultrasound and MR-phlebography are becoming more and more popular and may replace venography. Other techniques such as CT-phlebography and the use of CO2 as contrast medium are under investigation. The latter can be indicated in the case of contraindications against iodine contrast media. Conclusion: When choosing diagnostic methods for the venous system, their sensitivity and specificity for specific diagnoses and vascular territories have to be balanced against the risks and disadvantages.
    Notes: Zusammenfassung Die konventionelle Phlebographie mit jodhaltigen Kontrastmitteln gilt in vieler Hinsicht noch als Goldstandard. Die Diagnose von akuten und chronischen Thrombosen, Gefäßverschlüssen, hämodynamischen Dysfunktionen oder angeborenen Anomalien im Venensystem gehört zu den Aufgaben von Phlebographie mit Kontrastmittel. Sie kann in nahezu allen venösen Gefäßabschnitten des Körpers eingesetzt werden. Nachteile sind die Exposition mit ionisierenden Strahlen und die mit jodhaltigen Kontrastmitteln verbundenen Nebenwirkungen. Nichtinvasive Verfahren wie der Ultraschall und die MR-Phlebographie gewinnen zunehmend an Bedeutung und können bei bestimmten Fragestellungen die Phlebographie ersetzen. Alternative Verfahren wie die CT-Phlebographie oder die Verwendung von CO2 als Kontrastmittel sind eher die Ausnahme. Letztere kommt bei Kontraindikationen gegen Kontrastmittelgabe zum Einsatz. Bei der Auswahl der Untersuchungsverfahren muß deren diagnostische Aussagekraft einerseits und mögliche Risiken und Limitationen andererseits berücksichtigt werden.
    Type of Medium: Electronic Resource
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  • 8
    ISSN: 1432-2102
    Keywords: Schlüsselwörter Computer ; Diagnostische Hilfe ; Radiologie ; computerunterstützte Mammographie ; Key words Computers ; Diagnostic aid ; Radiography ; Computer-assisted ; Mammography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Purpose: Computer-aided diagnosis in mammography is a topic many study groups have been concerned with since the first presentation of a system for computer-aided interpretation in 1967. Currently, there is only one system available for clinical use in mammaography, the CAD-System Image Checker (R2 Technology). The purpose of our prospective study was to evaluate whether the integration of the CAD-system into the routine of a radiological breast diagnosis unit is feasible. Results: After the installation of the CAD- system, 300 patients with 1110 mammograms were included for evaluation in the present study. In 54 of these cases histological examination was indicated due to suspect criteria on conventional mammography. In 39 of 54 cases (72,2%) malignancy could be proven histologically. The CAD-system marked 82,1% of the histologically verified carcinomas correctly. 94,3% of all 1797 marks made by the CAD-system indicated normal or benign structures. Routinely performed CAD analysis prolonged patients waiting time by about 15 min because the marks of the CAD system had to be interpreted in addition to the routine diagnostic investigations. Conclusion: Our experience with the use of the CAD-system in daily routine showed that CAD analysis can easily be integrated into a preexisting mammography unit. However, the diagnostic benefit is not yet clearly established. Since the rate of false negative marks by the CAD-system Image Checker is still high, the results of CAD analysis must be checked and corrected by an observer well experienced in mammography reading.
    Notes: Zusammenfassung Zielsetzung: Seit der Erstbeschreibung eines Systems zur computerassistierten Analyse von Mammographien 1967 haben sich zahlreiche Arbeitsgruppen mit dieser Problematik beschäftigt. Derzeit steht einzig das CAD-System ImageChecker (R2 Technology) für die breitere Anwendung zur Verfügung. Ziel unserer prospektiven Studie war es festzustellen, ob eine Integration des CAD-Systems in die klinische Routinediagnostik möglich ist. Ergebnisse: Nach Installation des CAD-Systems in der Routinediagnostik wurden die ersten 300 Patientinnen mit 1110 Mammographien in die vorliegende Auswertung eingeschlossen. Aufgrund einer suspekten Mammographie wurde in 54 Fällen eine histologische Sicherung des Befunds indiziert, wobei in 39 Fällen (72,2%) ein Malignom bestätigt werden konnte. Das CAD-System ImageChecker erkannte 82,1% der histologisch gesicherten Malignome, wobei 94,3% der 1797 vom System gesetzten Markierungen auf normale oder benigne Strukturen entfielen. Die routinemäßige CAD-Analyse der Mammographien verlängert die Wartezeit der Patientinnen um durchschnittlich 15 min und modifiziert die Arbeitsweise des Befundes dahingehend, als daß dieser eine Erklärung für die vom CAD-System gesetzten Markierungen erarbeiten muß. Schlußfolgerungen: Unsere Erfahrungen im Routinebetrieb zeigen, daß die CAD-Analyse problemlos in eine bereits bestehende Mammographieeinheit eingebunden werden kann. Der diagnostische Nutzen kann jedoch zu diesem Zeitpunkt noch nicht abschließend beurteilt werden. Da das CAD-System ImageChecker derzeit noch viele falsch-positive Befunde liefert, muß das Ergebnis der CAD-Analyse durch in der Mammographie erfahrene Untersucher überprüft werden.
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  • 9
    ISSN: 1432-2102
    Keywords: Schlüsselwörter Mammatumor ; MRT ; Markierung ; Biopsie ; Keywords Breast lesion ; MRI ; Localization ; Biopsy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Purpose. MRI-guided interventional maneuvers in the breast, when closed MRI scanners are employed are relatively complex and time consuming. The purpose of our investigations was to develop a special device for the localization and biopsy of breast lesions using an open low-field MRI Scanner (Magnetom Open, Siemens, Erlangen, Germany) permitting free access to the patient. Materials and Methods. Due to its particular material and construction characteristics, a newly developed device for localization and biopsy of breast lesions is appropriate to remain within the magnetic field during the examination without degrading image quality. We performed 125 tests in a phantom and 31 investigations in patients including 26 wire-localizations and 5 biopsies. Results. The interventional maneuvers in the phantom could be performed very precisely. In all 125 phantom studies, the needle (14G coaxial biopsy cannula, Bard) was positioned close to the simulated lesion. In 25 out of 26 patients the needle was positioned within a distance less than 5 mm from the lesion. When using the 14G coaxial biopsy cannula (Bard, Karlsruhe, Germany) the needle tip was found adjacent next to the lesion in all 12 cases (7 wire-localizations, 5 biopsies). Conclusions. Our results indicate that our device allows very precise preoperative localization of breast lesions within the Magnetom Open. Using MRI-compatible, large-core needles, biopsy under direct MRI control resulted in good results.
    Notes: Zusammenfassung Zielsetzung. Am geschlossenen MRT-Gerät sind Interventionen an der Mamma relativ aufwendig und zeitintensiv. Ziel unserer Untersuchungen war es, eine Lokalisations- und Biopsieeinrichtung für das offene MRT-Gerät (Magnetom Open, Siemens) zu entwickeln und zu erproben, das Patienten und Methode. Es wurde eine Lokalisations- und Biopsieeinrichtung entwickelt, die aufgrund ihrer Bauart während der Intervention im Magnetfeld des MRT-Gerätes verbleiben kann und die Bildgebung nicht nachteilig beeinflusst. Um die Tauglichkeit dieses Gerätes zu überprüfen wurden 125 Untersuchungen am Phantom und 31 Patientenuntersuchungen (26 Drahtlokalisationen, 5 Biopsien) durchgeführt. Ergebnisse. Die Interventionen am Phantom konnten sehr genau gesteuert werden. In allen 125 Fällen lag die Interventionsnadel (14 G-Coaxial-Biopsiekanüle, Bard) direkt der Läsion an. Bei den Patientenuntersuchungen lag die Interventionsnadel in 25 von 26 Fällen weniger als 5 mm von der Läsion entfernt. Bei Verwendung der 14 G-Coaxial-Biopsie-Kannüle (Bard, Karlsruhe, Germany) lag die Interventionsnadel in allen 12 Fällen direkt der Läsion an (7 Drahtlokalisationen, 5 Hochgeschwindigkeitsbiopsien). Schlussfolgerung. Die Untersuchungen zeigen, dass mit der von uns entwickelten Zieleinrichtung sehr genaue präoperative Lokalisationen am Magnetom Open durchführbar sind. Durch die stabile Nadelführung sind bei Verwendung lumenstarker Materialien (14G) zudem exakte MRT-kontrollierte Biopsien möglich.
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  • 10
    ISSN: 1432-2161
    Keywords: Key words Bone bruise ; Low field strength MRI ; MRI sequences ; Traumatic joints ; Musculoskeletal
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Objective and patients. One hundred and forty-one patients with recent joint trauma, aged 12–71 years, were imaged on a 0.2-T dedicated MRI system and evaluated for bone bruises. The most beneficial sequences were compared. Design. The diagnosis of post-traumatic bone marrow abnormalities was established in 20 of 141 patients on the basis of decreased signal intensity on T1-weighted SE and GRE sequences and increased signal intensity on T2-weighted TSE and fat-suppressed IRGE sequences. Signal changes within the bone marrow were evaluated and statistically correlated with normal bone. Results. The highest signal alteration was found on T1-weighted SE and GRE sequences, followed by IRGE, which detected smaller differences in signal intensity. T2-weighted TSE imaging showed the least contrast. The areas with bone marrow changes were approximately equal in size on T1-weighted SE and T2-weighted TSE sequences. The same areas depicted on IRGE and GRE sequences proved to be significantly larger (P〈0.01). Conclusion. Using a 0.2-T dedicated system T1-weighted SE, T1-weighted GRE and IRGE sequences were most effective in detecting conspicuous bone marrow alteration, while the T2-weighted TSE sequence was inferior. GRE and IRGE imaging showed areas about 4 times larger depicting bone marrow changes. On suspicion of bone bruise, a protocol including GRE and IRGE pulse sequences could be most beneficial.
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