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  • 1995-1999  (340)
  • 1905-1909
  • 1890-1899
  • 1999  (144)
  • 1995  (196)
  • Magnetic resonance imaging  (340)
Materialart
Erscheinungszeitraum
  • 1995-1999  (340)
  • 1905-1909
  • 1890-1899
Jahr
  • 101
    ISSN: 1432-1920
    Schlagwort(e): Key words Spinal subdural haematoma ; Magnetic resonance imaging ; Computed tomography
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Chronic spinal subdural haematoma is a uncommon. We describe the CT and MRI appearances of chronic spinal and intracranial subdural haematomas following minor trauma. The aetiology, pathogenesis and differential diagnosis are discussed.
    Materialart: Digitale Medien
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  • 102
    Digitale Medien
    Digitale Medien
    Springer
    Neuroradiology 41 (1999), S. 129-133 
    ISSN: 1432-1920
    Schlagwort(e): Key words Cryptococcosi ; Acquired immunodeficiency syndrome ; Computed tomography ; Magnetic resonance imaging
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract CT and MRI in one case of Cryptococcus neoformans infection showed contrast-enhancing parenchymal lesions resembling granulomata or abscesses. After an initial phase without contrast enhancement, the full extent of the lesions was visible within 2 weeks of presentation. The enhancing masses were assumed to represent intracerebral cryptococcomas. Despite evidence of massive meningeal infection on cerebrospinal fluid (CSF) examination, no radiological signs of meningitis, invasion of the Virchow-Robin spaces or ventriculitis could be demonstrated. With antimycotic treatment the contrast enhancement disappeared and cystic, partly calcified lesions remained. Recurrence of meningeal infection without radiological correlates was apparent in this stage. In a second case of proven cryptococcus meningitis, dilation of Virchow-Robin spaces or cysts in the adjacent parenchyma were the main abnormalities on MRI. Enhancing masses were not detected. These cases may represent two different reactions of the immunocompromised hosts to infection with C. neoformans: widening of the perivascular spaces as a correlate of the more typical meningeal infection and enhancing parenchymal lesions as a sign of further invasion from the CSF spaces. Enhancement of cryptococcomas, indicating an inflammatory response in the surrounding brain, is not typical in patients with impairment of immune function.
    Materialart: Digitale Medien
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  • 103
    Digitale Medien
    Digitale Medien
    Springer
    Neuroradiology 41 (1999), S. 158-162 
    ISSN: 1432-1920
    Schlagwort(e): Key words Midbrain ; tumours ; Magnetic resonance imaging
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract We diagnosed 60 cases of midbrain tumours by MRI between 1993 to 1997. There were 39 males and 21 females, aged 2–64 years, mean 25.6 years. We found 38 patients with true intramedullary midbrain tumours, 11 predominantly in the tectum, 20 in the tegmentum and 7 with a downward extension to the pons; there were 7 within the cerebral aqueduct. There were 22 patients with infiltrating midbrain tumours extending from adjacent structures, 11 cases each from the thalamus and pineal region. All patients received surgical treatment. Gross total resection was achieved in 42 cases, subtotal (〉 75 %) resection in 18. Pathological diagnoses included 16 low-grade and 15 high-grade astrocytomas; 5 oligodendroastrocytomas; 2 ependymomas; 11 glioblastomas; and 11 pineal parenchymal or germ-cell tumours. Midbrain tumours are a heterogeneous group of neoplasms, with wide variation in clinical and MRI features, related to the site and type of tumour. MRI not only allows precise analysis of their growth pattern, but also can lead to a correct preoperative diagnosis in the majority of cases.
    Materialart: Digitale Medien
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  • 104
    Digitale Medien
    Digitale Medien
    Springer
    Neuroradiology 41 (1999), S. 175-178 
    ISSN: 1432-1920
    Schlagwort(e): Key words Infarct ; cerebral ; Computed tomography ; Magnetic resonance imaging ; diffusion-weighted
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract We compared CT and MRI obtained within the first 3 h of onset of a cerebral infarct. Echo-planar diffusion-weighted MRI delineated the infarcted areas most clearly, and subtle low-density areas on CT were consistent with those shown to be abnormal by diffusion-weighted MR. The signal changes of affected areas on fast spin-echo proton-density, T2-weighted and fast FLAIR images were subtler than the low density on CT.
    Materialart: Digitale Medien
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  • 105
    ISSN: 1432-1920
    Schlagwort(e): Key words Shunt ; portosystemic ; Globus pallidus ; Manganese ; Magnetic resonance imaging
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract We report two toddlers with portosystemic shunts who had symmetrical high-signal globus pallidus lesions on T1- but not T2-weighted MRI, and measurement of whole blood manganese at 2 years of age. These cases suggest that portosystemic shunts can cause elevation of blood manganese and result in manganese accumulation in the globus pallidus, causing high signal on T1-weighted images even in asymptomatic toddlers.
    Materialart: Digitale Medien
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  • 106
    ISSN: 1432-1920
    Schlagwort(e): Key words Cerebral infarcts ; Magnetic resonance imaging ; Contrast enhancement
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract We compared contrast enhancement on T1-weighted MRI of acute cerebral infarcts after conventional bolus administration and continuous infusion of gadolinium. We examined 12 patients with a history of acute stroke with contrast-enhanced MRI once a week for a 1 month. Only ischaemic lesions were investigated after cerebral haemorrhage had been excluded by CT. Each MRI study included T2- and proton density-weighted sequences for determination of the size and site of the infarct, immediate postinjection T1-weighted imaging after bolus administration of 0.1 mmol/kg gadolinium-DPTA and delayed T1-weighted imaging after additional continuous infusion of 0.1 mmol/kg over 2 h. A total of 42 MRI studies was performed. In the first week after the onset of stroke, most infarcts (8 of 10) did not enhance after bolus administration, whereas all showed distinct contrast enhancement after the infusion. In the following weeks all but two infarcts showed contrast enhancement after bolus administration; after continuous infusion contrast enhancement could be seen in all cases. While contrast enhancement after bolus administration showed the typical gyriform pattern, enhanced areas were more extensive after the infusion and usually covered the entire infarcted area shown on T2- and proton density-weighted images. We presume that the disturbed blood-brain barrier in ischaemic areas favours delivery of contrast medium to the infarcted tissue if it is offered continuously so that a steady state can develop.
    Materialart: Digitale Medien
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  • 107
    Digitale Medien
    Digitale Medien
    Springer
    Neuroradiology 41 (1999), S. 428-432 
    ISSN: 1432-1920
    Schlagwort(e): Key words Tuberous sclerosis ; Magnetic resonance imaging ; Focal cortical dysplasia ; Cortical dysgenesis
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract There is immense variability in the clinical presentation of tuberous sclerosis and many incomplete forms (formes frustes) exist. To investigate the imaging characteristics of cortical tubers seen in tuberous sclerosis unaccompanied by other stigmata, we reviewed MRI and CT of six patients who met the criteria for a definitive diagnosis of TS, established solely by the presence of a histologically confirmed cortical tuber. Five of the patients had a solitary cortical tuber and the last had three lesions, one of which was resected and confirmed histologically. The other two lesions were included in our study. CT showed five tubers as low density, but three were not identified. No calcified or dense lesions were observed. MRI revealed peripheral components and inner cores of seven cortical tubers in five patients, with differing signal characteristics. The subcortical cores, with T1 and T2 prolongation, were separated from the overlying cortex. Abnormal inhomogeneous high signal was observed in both the cortex and subcortical white matter on proton-density weighted or FLAIR images. A radially orientated white-matter band was observed in one patient, and central depression of the expanded gyri in another. In one patient, a cortical tuber was atypical, with a thick cortex on T1-weighted images and a blurred grey/white matter junction with diffusely increased signal on T2-weighted images. Cortical tubers without other stigmata of tuberous sclerosis are shown to be distinct from focal cortical dysplasia.
    Materialart: Digitale Medien
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  • 108
    Digitale Medien
    Digitale Medien
    Springer
    Neuroradiology 41 (1999), S. 443-446 
    ISSN: 1432-1920
    Schlagwort(e): Key words Langerhans cell histiocytosis ; Magnetic resonance imaging
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Langerhans cell histiocytosis (LCH) is a disease of unknown cause characterised by proliferation of histiocytic granulomas in tissues; the primary cerebral manifestation is diabetes insipidus caused by hypothalamic infiltration. We present a patient in whom, except for the absence of high signal on T 1 weighting in the posterior pituitary, consistent with central diabetes insipidus, MRI showed no evidence of hypothalamic involvement by histiocytosis, despite the long duration of the disease. However, there was bilateral, symmetrical involvement of the cerebellum and globus pallidus in addition to a calvarial lesion. High signal in the cerebellar white matter on T 2-weighted images may represent demyelination, gliosis and cell loss, as previously reported on pathologic examination.
    Materialart: Digitale Medien
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  • 109
    ISSN: 1432-1920
    Schlagwort(e): Key words Dural arteriovenous fistula ; Craniocervical junction ; Magnetic resonance imaging ; Venous hypertension
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract We report a 62-year-old woman who presented with a myelopathy at the lower thoracic level. Left vertebral angiography revealed a dural arteriovenous fistula (DAVF) at the craniocervical junction, draining into an anterior spinal vein. Below the T 7 level, the spinal cord gave high signal on T 2-weighted images and enhanced with Gd-DTPA. The patient was successfully treated by simple clipping of vein draining the DAVF. The abnormal signal intensity and contrast enhancement rapidly regressed, except in the conus medullaris. Regression of the parenchymal abnormality on serial MRI following treatment corresponded closely with postoperative improvement of neurological function.
    Materialart: Digitale Medien
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  • 110
    Digitale Medien
    Digitale Medien
    Springer
    Der Radiologe 39 (1999), S. 828-837 
    ISSN: 1432-2102
    Schlagwort(e): Schlüsselwörter Zerebrovaskuläre Erkrankungen ; Intrazerebrale Blutung ; Magnetresonanztomographie ; Computertomographie ; Key Words Cerebrovascular diseases ; Intracerebral hemorrhage ; Magnetic resonance imaging ; Computed tomography
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Beschreibung / Inhaltsverzeichnis: Summary Intracerebral hemorrhage is a common cause of acute neurological deterioration and a frequent indication for emergency neuroimaging. Stroke symptoms are caused in 10 to 15% by intracerebral hemorrhage. It is often not possible to differentiate intracerebral hemorrhage from cerebral ischemia by clinical examination. The therapeutic decision between thrombolysis or conservative therapy is comprised by the etiology. To exclude intracerebral hemorrhage as the cause of clinical symptoms, a CT is usually performed. Localisation and extension of the acute intracerebral hemorrhage are easy to detect. Subacute and chronic intracerebral hemorrhage are better delineated with magnetic resonance imaging. The different signal of the hemorrhage can be used for the age of the intracerebral hemorrhage. The cause of a non-traumatic intracerebral hemorrhage is in over 60% hypertony, less frequent alcoholism, malformation, or amyloid angiopathy. Uncommon causes of hemorrhage are head trauma, blood dyscrasia, tumor or venous thrombosis. Non-traumatic intracerebral hemorrhage are most common in patients between 50 and 70 years. In younger patients a malformation should be excluded with a cerebral angiography. Intracerebral hemorrhages are usually conservatively treated, in some cases an operative decompression is performed.
    Notizen: Zusammenfassung Die intrazerebrale Blutung ist eine häufige Ursache akut auftretender neurologischer Symptome und führt oft zu einer notfallmäßigen neuroradiologischen Untersuchung. Etwa 15% der „Schlaganfälle” sind auf eine intrazerebrale Blutung zurückzuführen. Intrazerebrale Blutungen sind klinisch oft nicht von ischämischen Infarkten zu unterscheiden. Eine Computertomographie ist zur Zeit für die Diagnosesicherung – und damit auch zur weiterführenden Therapie – unerläßlich. Ausdehnung und Lokalisation der akuten intrazerebralen Blutung können damit schnell und sicher erfaßt werden. Subakute und chronische Blutungen sind dagegen verläßlicher mit der Magnetresonanztomographie nachweisbar. Aus der unterschiedlichen Signalgebung in den verschiedenen MR-Sequenzen kann auf das Alter der Blutung geschlossen werden. Die Ursache einer nicht-traumatischen intrazerebralen Blutung ist in über 60% der Fälle eine Hypertonie, weniger häufig die Folgen des Alkoholismus, Gefäßfehlbildungen oder die Amyloidangiopathie. Seltener sind Blutgerinnungsstörungen, Traumen, Tumoren, Venenthrombosen oder Intoxikationen die Ursachen einer intrazerebralen Blutung. Nicht-traumatische intrazerebrale Blutungen treten am häufigsten zwischen dem 5.–7. Lebensjahrzehnt auf. Bei jüngeren Patienten sind vor allem Gefäßfehlbildungen als Ursache zu berücksichtigen. Insbesondere bei jüngeren Patienten sollte zur ätiopathogentischen Klärung eine zerebrale Angiographie durchgeführt werden. Spontane intrazerebrale Blutungen werden in der Regel konservativ behandelt, außer man verspricht sich von der operativen Dekompression eine Verbesserung des klinischen Zustandes.
    Materialart: Digitale Medien
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  • 111
    Digitale Medien
    Digitale Medien
    Springer
    Der Radiologe 39 (1999), S. 889-893 
    ISSN: 1432-2102
    Schlagwort(e): Schlüsselwörter Sarkoidose ; Neurosarkoidose ; Magnetresonanztomographie ; Key words Sarcoidosis ; Neurosarcoidosis ; Magnetic resonance imaging
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Beschreibung / Inhaltsverzeichnis: Summary Neurological involvement is a significant cause of morbidity and mortality in patients with sarcoidosis. The aim of this study was to evaluate the role of magnetic resonance imaging (MRI) in the diagnosis of patients with neurosarcoidosis. The MRI brain scans of 22 patients with sarcoidosis were retrospectively reviewed, along with the clinical information provided in the request form. All patients had signs and symptoms referable to the head and were examined with gadolinium enhancement. Cranial (facial) nerve paralysis was the most common clinical manifestation identified in 10 patients. A wide spectrum of MR findings was noted: periventricular and white matter lesions on T2 W spin echo images, mimicking multiple sclerosis (46%); multiple supratentorial and infratentorial brain lesions, mimicking metastases (36%); solitary intraaxial mass, mimicking high-grade astrocytoma (9%); solitary extraaxial mass, mimicking meningioma (5%); leptomeningeal enhancement (36%). The diagnosis of neurosarcoidosis is often difficult, particularly so in patients who lack either pulmonary or systemic manifestations of sarcoidosis. MRI shows a wide spectrum of brain abnormalities associated with neurosarcoidosis. These findings, however, are not specific for sarcoidosis and one must consider appropriate clinical circumstances in arriving at the correct diagnosis. In selected cases with isolated brain involvement, meningeal or cerebral biopsy may be required.
    Notizen: Zusammenfassung Klinische Untersuchungen an Patienten mit systemischer Sarkoidose sprechen in 5%, Autopsieberichte in 25% für eine Beteiligung des Zentralnervensystems. Ziel der Studie ist eine Beurteilung der Beitrags der Magnetresonanztomographie (MRT) in der Diagnostik der Neurosarkoidose. Die MR-Tomogramme von 22 Patienten mit gesicherter Sarkoidose und neurologischer Symptomatik wurden retrospektiv ausgewertet. Häufigstes klinisches Symptom der Neurosarkoidose war eine Fazialisparese (10 Patienten). MR-tomographisch konnte eine Vielzahl verschiedener Befunde erhoben werden: periventrikuläre und Marklagerläsionen in T2-gewichteten Bildern in 46%, multiple bzw. miliare supratentorielle und infratentorielle Läsionen in 36%, solitäre intraaxiale Raumforderungen in 9%, solitäre extraaxiale Raumforderungen in 5% und meningeale Kontrastmittelanreicherung (nodulär oder diffus) in 36%. Schlußfolgerung: Die MR-tomographischen Befunde bei Neurosarkoidose sind oft wenig spezifisch. Die Diagnose wird meist bei gleichzeitigem Nachweis sarkoidosetypischer Granulome in anderen Organen gestellt, eine isolierte zerebrale Manifestation kann erhebliche diagnostische Schwierigkeiten bereiten. Die Neurosarkoidose sollte bei unklaren zerebralen Symptomen und Befunden stets in die Differentialdiagnose einbezogen werden, weil sie behandelbar ist.
    Materialart: Digitale Medien
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  • 112
    Digitale Medien
    Digitale Medien
    Springer
    Der Radiologe 39 (1999), S. 60-67 
    ISSN: 1432-2102
    Schlagwort(e): Schlüsselwörter Kalkaneus ; Talus ; Gelenkinstabilität ; Radiologische Diagnostik ; Ultraschall ; Magnetresonanztomographie ; Sprunggelenk ; Synovialmembran ; Arthritis ; Diagnose ; Bildgebende Diagnostik ; Key words Calcaneus ; Joint instability ; Plain film radiography ; Ultrasonography ; Magnetic resonance imaging ; Subtalar joint ; Ankle joint ; Arthritis ; Synovial membrane ; Synovitis ; Diagnosis ; Differential ; Diagnostic imaging ; Rheumatic disease
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Beschreibung / Inhaltsverzeichnis: Summary Diseases of the hindfoot are associated with considerable functional impairment and therefore may hamper patients’ movements during gait considerably. Because of biomechanical overload, articular structures, tendons and ligaments are prone to early degenerative changes during the course of rheumatic diseases as visible with plain film radiography, sonography (US), or magnetic resonance imaging (MRI). Findings may occur as arthritis of major joints or in the form of fibroostitis and bursitis of the os calcis. Despite the progressive course of rheumatic diseases and characteristic imaging findings, high variability of X-ray signs may occur. Plain film radiograms and high-resolution ultrasonography play a key role in imaging rheumatic diseases of the hindfoot. MRI supports imaging diagnosis in selected cases. The principal goals of diagnostic imaging are precise and reproducible documentation of morphologic abnormalities and differentiated analysis for planning proper conservative or surgical treatment.
    Notizen: Zusammenfassung Erkrankungen des Sprunggelenks und der Fußwurzel sind, da mit einer deutlichen Einschränkung der Beweglichkeit dieser Region einhergehend, für den Patienten meist sehr belastend. Bei rheumatischen Krankheitsbildern steht neben der Funktionseinschränkung vor allem in späteren Stadien die Destruktion biomechanisch stark beanspruchter Strukturen (hyaliner Knorpel, subchondraler Knochen, Bänder und Sehnen) im Vordergrund des klinischen wie auch des radiologischen Bildes. Grundsätzlich sind Arthritiden der großen Gelenke und die Calcaneopathia rheumatica zu beobachten. Trotz des meist stadienhaften Verlaufes mit charakteristischem Befallsmuster ist die bildgebende Diagnostik wegen der großen Formvariabilität der unterschiedlich ausgeprägten Veränderungen oft schwierig. Zusätzlich zu nativröntgenologischen Aufnahmen gehören die hochauflösende Sonographie, ergänzt durch die MRT, mit denen Gelenke und Sehnen direkt darstellbar sind, heute zur Standarddiagnostik. Ziel der Diagnostik ist einerseits die präzise reproduzierbare Dokumentation morphologischer Veränderungen zur Verlaufskontrolle, andererseits ihre möglichst differenzierte Analyse zur Einleitung adäquater konservativer oder operativer Therapiemaßnahmen, um Patienten zu einer aktiveren Lebensweise verhelfen zu können.
    Materialart: Digitale Medien
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  • 113
    ISSN: 1432-2102
    Schlagwort(e): Schlüsselwörter Intrazerebrale Blutung ; Kernspintomographie ; MR-Angiographie ; Key words Intracerebral hematoma ; Magnetic resonance imaging ; Magnetic resonance angiography
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Beschreibung / Inhaltsverzeichnis: Summary We review the signal characteristics of intracerebral hematomas (ICH) on magnetic resonance imaging (MRI), with special emphasis on the diagnosis of intracerebral hemorrhage within the first hours after stroke. The detection of peracute ICH was evaluated in 42 patients of a prospective, MR randomized stroke trial. These patients underwent a protocol of T1 and T2 weighted sequences, diffusion weigthed sequences and MR – angiography within 6 hours after onset of acute hemiparesis. The signal behaviour of ICH in any stage after bleeding was additionally reviewed in a retrospective series of 63 patients, who were submitted for MRI over a 12 months period because of known ICH. MRI correctly identified 4 hyperacute ICH in the prospective group and 4 hyperacute ICH in the retrospective group. These ICHs had high signal on T2 weighted images, were isointense in T1 weighted images and had signal voids on the diffusion weighted sequences. The signal intensities of acute, subacute and chronic ICHs correlated to previous experiences as reported in the literature. In conclusion, MRI reliably identified all hematomas even in the hyperacute stage. Diffusion weighted images were most sensitive to the presence of deoxyhemoglobine and helpful for the differentiation and characterization of acute ischemia. Therefore, MRI at 1.5 T can be employed as an alternative to CT for the emergency diagnosis of acute stroke.
    Notizen: Zusammenfassung In dieser Übersicht wird das kernspintomographische (KST) Erscheinungsbild der intrazerebralen Blutung (IZB) anhand eigener Erfahrungen und der Literatur diskutiert. Besonderes Gewicht wurde auf den KST Nachweis der hyperakuten IZB innerhalb der ersten Stunden gelegt. Es wurden einerseits die Befunde von 42 Patienten einer prospektiven, KST randomisierten Schlaganfallstudie ausgewertet, bei denen die KST als Erstuntersuchung innerhalb von 6 Stunden durchgeführt worden war. Andererseits werteten wir retrospektiv jene KST Untersuchungen aus, die im Jahr 1998 unter der Fragestellung einer IZB (n=63) erfolgten. Die KST erwies sich als sensitiv im Nachweis auch der hyperakuten IZB. Es wurden weder falsch-negative noch falsch-positive Befunde erhoben. Die hyperakute IZB kommt in der T2-Gewichtung hyperintens und in der T1-Gewichtung isointens zur Darstellung. Auf den diffusionsgewichteten Sequenzen führen minimale Deoxyhämoglobinkonzentrationen bereits in dieser Phase zu Signalauslöschungen. Das Erscheinungsbild der akuten, subakuten und chronischen IZB entsprach dem, in der Literatur mitgeteilten, Signalverhalten. Zusammenfassend waren alle IZB, unabhängig vom Stadium in der KST nachweisbar. Die Diffusionsgewichtung war in der hyperakuten Blutungsdiagnose und deren Abgrenzung von der akuten Ischämie hilfreich. Zumindest bei 1,5T erscheint die KST somit für die Diagnostik des akuten Schlaganfalls geeignet und sollte, da Ischämien besser als mit der Computertomographie charakterisiert werden können, für die Akutdiagnostik verfügbar gemacht werden.
    Materialart: Digitale Medien
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  • 114
    ISSN: 1432-2102
    Schlagwort(e): Schlüsselwörter Schlaganfall ; Intrazerebrale Blutung ; Magnetresonanztomographie ; Computertomographie ; Ratten ; Key words Cerebrovascular diseases ; Intracerebral hemorrhage ; Magnetic resonance imaging ; Rats
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Beschreibung / Inhaltsverzeichnis: Summary Background and Purpose: Stroke symptoms are caused in 10 to 15% by intracerebral hemorrhage. From the clinical examination it is often impossible to differentiate intracerebral hemorrhage from cerebral ischemia. To exclude intracerebral hemorrhage as the cause of clinical symptoms a CT is usually performed. The aim of our study was a direct comparison of the sensitivity of Computed Tomography and MRI using different MR sequences for the detection of acute intracerebral hemorrhage. Methods: In 8 male Wistar rats intracerebral hemorrhage was induced by infusion of collagenase into the caudate nucleus. After 1hour the brains were subsequently imaged with CT and MRI using T2- and T1-weighted Spin Echo sequences, diffusion-weighted sequences, T2*-weighted gradient echo sequences and FLAIR-sequences. Visibility of the intracerebral hemorrhage was examined using a scoring system from 1=not visible to 5=excellent visible. Finally, the intracerebral hemorrhage was verified by histological staining. Results: In all animals, intracerebral hemorrhage was visible in T2*-weighted gradient echo and diffusion weighted MR images 1 h after infusion of collagenase. T2- and PD-weighted SE images were positive in 7/8 rats. T1-weighted images revealed signal changes in 5/8 rats, and FLAIR sequence was positive in 8/8 rats. In CT intracerebral hemorrhage was only visible in 3/8 rats. When measuring the increase of Hounsfield units within the suspected hemisphere we saw a mean increase of 7% compared to the normal hemisphere in 3/8 rats. Conclusions: In this animal model, T2*-weighted magnetic resonance imaging proved to be the most sensitive imaging modality in the detection of acute intracerebral hemorrhage and is by far more sensitive than CT.
    Notizen: Zusammenfassung Hintergrund und Ziel: Die Symptome eines Schlaganfalls sind in 10 bis 15% durch eine intrazerebrale Blutung verursacht. Oft ist es in der klinischen Untersuchung nicht möglich, zwischen einer intrazerebralen Blutung und einer zerebralen Ischämie zu differenzieren. Um eine intrazerebrale Blutung bei Schlaganfallsymptomatik auszuschließen, wird in der Regel zuerst eine Computertomographie (CT) durchgeführt. Ziel der vorliegenden Studie ist ein direkter Vergleich der Sensitivität der CT mit verschiedenen magnetresonanztomographischen (MR) Sequenzen in der Diagnostik der akuten intrazerebralen Blutung. Material und Methoden: Durch intrazerebrale Applikation von Kollagenase wurde bei 8 männlichen Wistar-Ratten eine intrazerebrale Blutung im linken Nucleus caudatus induziert. Nach einer Stunde wurden die Gehirne zunächst im CT und direkt anschließend in einem klinischen MR-Tomographen unter Verwendung von Protonendiche-, T2- und T1-gewichteten Spinechosequenzen, T2*-gewichten Gradientenechosequenzen, FLAIR-Sequenzen sowie diffusions- und perfusionsgewichteten Gradientenechosequenzen untersucht. Die Visibilität der Blutung wurde anhand einer Skala von 1 (=nicht sichtbar) bis 5 (=klar sichtbar) bewertet. Die Größe der Blutungsherde wurde für jede Untersuchungstechnik bestimmt und mit der Histologie verglichen. Ergebnisse: Bei allen Tieren konnte die Blutung in den T2*-gewichteten Gradientenecho-, FLAIR- sowie diffusionsgewichteten MRT-Bildern 1 h nach Kollagenaseinfusion erkannt werden. Auch in den T2- und Protonendichte-gewichteten Bildern konnte die Blutung bei 8/8 Ratten erkannt werden, wohingegen sie in den T1-gewichteten Aufnahmen nur bei 5/8 Ratten zu erkennen war. In der CT war die intrazerebrale Blutung nur bei 3/8 Ratten sichtbar, wobei bei diesen Tieren eine Zunahme der Dichte in Hounsfield-Einheiten (HE) in der Läsion um 15% auftrat. Schlußfolgerung: In dem verwendeten Tiermodell erwiesen sich T2*-und diffusionsgewichtete Aufnahmen sowie FLAIR-Sequenzen als sehr sensitive Methode in der Diagnostik der akuten intrazerebralen Blutung. Sie waren hierbei sensitiver als die CT. Deshalb sollte ein MR-tomographisches Untersuchungsprotokoll zur Diagnostik des akuten Schlaganfalls T2*- und diffusionsgewichtete Sequenzen beinhalten. Hierdurch gelingt eine rasche Unterscheidung zwischen der akuten intrazerebralen Blutung und der Frühphase der zerebralen Ischämie.
    Materialart: Digitale Medien
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  • 115
    Digitale Medien
    Digitale Medien
    Springer
    Experimental brain research 125 (1999), S. 417-425 
    ISSN: 1432-1106
    Schlagwort(e): Key words Motor learning ; Motor cortex ; Magnetic resonance imaging ; Musicians ; Hand motor skill
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract  In this study, we investigated blood-flow-related magnetic-resonance (MR) signal changes and the time course underlying short-term motor learning of the dominant right hand in ten piano players (PPs) and 23 non-musicians (NMs), using a complex finger-tapping task. The activation patterns were analyzed for selected regions of interest (ROIs) within the two examined groups and were related to the subjects’ performance. A functional learning profile, based on the regional blood-oxygenation-level-dependent (BOLD) signal changes, was assessed in both groups. All subjects achieved significant increases in tapping frequency during the training session of 35 min in the scanner. PPs, however, performed significantly better than NMs and showed increasing activation in the contralateral primary motor cortex throughout motor learning in the scanner. At the same time, involvement of secondary motor areas, such as bilateral supplementary motor area, premotor, and cerebellar areas, diminished relative to the NMs throughout the training session. Extended activation of primary and secondary motor areas in the initial training stage (7–14 min) and rapid attenuation were the main functional patterns underlying short-term learning in the NM group; attenuation was particularly marked in the primary motor cortices as compared with the PPs. When tapping of the rehearsed sequence was performed with the left hand, transfer effects of motor learning were evident in both groups. Involvement of all relevant motor components was smaller than after initial training with the right hand. Ipsilateral premotor and primary motor contributions, however, showed slight increases of activation, indicating that dominant cortices influence complex sequence learning of the non-dominant hand. In summary, the involvement of primary and secondary motor cortices in motor learning is dependent on experience. Interhemispheric transfer effects are present.
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  • 116
    Digitale Medien
    Digitale Medien
    Springer
    European radiology 9 (1999), S. 457-459 
    ISSN: 1432-1084
    Schlagwort(e): Key words: Retroperitoneal neoplasms ; Retroperitoneal space ; Computed tomography ; Magnetic resonance imaging ; Ultrasonography
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract. We report a rare case of pseudomyxoma retroperitonei in a 58-year-old woman with a past history of severe appendicitis. The imaging showed a multicystic mass similar to pseudomyxoma peritonei, but the tumor was located in the retroperitoneal space.
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  • 117
    ISSN: 1432-1459
    Schlagwort(e): Key words Parkinson’s disease ; Depression ; Brainstem midline ; changes ; Transcranial sonography ; Magnetic resonance imaging
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Recent studies using transcranial sonography (TCS) have provided evidence of alterations in the mesencephalic midline structures in patients with unipolar depression and depression in Parkinson’s disease (PD), suggesting an involvement of the basal limbic system in primary and secondary mood disorders. This study tested the hypothesis of brainstem midline abnormality in depression and investigated 31 PD patients by magnetic resonance imaging (MRI) and TCS. Signal intensity of the pontine and mesencephalic brainstem midline was rated on T2-weighted images and measured by relaxometry. In addition, two blinded investigators assessed the echogenicity of the brainstem midline by TCS. The severity of motor symptoms and depression were graded independently using standard research scales. Rating of signal intensity and T2 relaxometry of the pontomesencephalic midline structures revealed significant difference between depressed and nondepressed PD patients (P 〈 0.05). This corresponded to a significant reduction in mesencephalic midline echogenicity of depressed PD patients on TCS images. No correlation was found between raphe signal intensity, T2 relaxation times, or TCS echogenicity and the severity of motor symptoms or depression. This study is the first to show changes in signal intensity and T2 relaxation time of the pontomesencephalic midline structures on MRI in depressed PD patients confirming previous TCS findings. As these midline structures comprise fiber tracts and nuclei of the basal limbic system, the findings may support the hypothesis of an alteration in the basal limbic system in mood disorders.
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  • 118
    ISSN: 1432-1459
    Schlagwort(e): Key words Multiple sclerosis ; Magnetic resonance imaging ; Enhancing lesions ; Interferon-β1a
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract. We investigated whether interferon-β1a modifies the course of new enhancing lesions in relapsing-remitting multiple sclerosis. Sixty-eight patients were studied by monthly magnetic resonance imaging (MRI) in a pretest-posttest design including 6 months of observation and 6 months of treatment. We examined the course of new Gd-enhancing lesions on two consecutive scans during observation and during treatment. Lesions detected during treatment were also analyzed by MRI 1 year later for persistence of enhancement, persistence of T2 hyperintensity, development of T1 hypointensity, or disappearance. Among the enhancing lesions detected by observation and treatment MRI, respectively, Gd-enhancement persisted at 2 months in 20% and 3% (P 〈 0.001), T2 hyperintensity persisted in 86% and 63% (P 〈 0.03), and T1 hypointensity developed in 49% and 15% (P 〈 0.01). Progression to T1 hypointensity was significantly more frequent in larger lesions during both the observation and treatment periods (P 〈 0.01). No reenhancement of plaques was present at 1-year follow-up; a further reduction in T2 hyperintensity (63% vs. 39%) was observed while T1 hypointensity remained unchanged. Both the duration of Gd enhancement and the short-term MRI course of new enhancing lesions benefited by treatment with recombinant interferon-β1a treatment.
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  • 119
    ISSN: 1432-1459
    Schlagwort(e): Key words Multiple sclerosis ; Magnetic resonance imaging ; Disease activity ; Fast spin echo ; Fast fluid-attenuated inversion ; recovery ; Reproducibility
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Previous studies have addressed the question of the precision in assessing multiple sclerosis (MS) activity by counting enhancing lesions on gadolinium enhanced brain magnetic resonance imaging (MRI). However, counting the active lesions on serial unenhanced MRI obtained by various pulse sequences has not been yet considered. We compared the interobserver levels of agreement in reporting active MS lesions on serial enhanced and unenhanced MRI to assess whether the use of various unenhanced techniques may change the degree of interobserver measurement reproducibility. Dual-echo conventional spin echo (CSE), dual-echo fast spin echo (FSE), fast fluid-attenuated inversion recovery (FLAIR) and Gd-enhanced T1-weighted brain MRI were obtained from five MS patients at baseline and monthly for 2 months. Six experienced observers independently identified and counted active MS lesions on the two follow-up MRI scans. Active lesions were considered to be all the enhancing lesions and any new or enlarging lesion on enhanced and unenhanced scans. Interobserver levels of agreement were calculated by weighted κ values. Very good agreement was reached only for counting total and new Gd-enhancing lesions. Good agreement was achieved for counting new lesions on the three unenhanced techniques, whereas the agreement for counting enlarging lesions was poor with all the MRI techniques. The level of agreement was significantly heterogeneous for various MRI techniques but not for various lesion sites. These results confirm that counting enhancing lesions is the most reliable method for assessing MS activity, but the use of any of the available unenhanced MRI techniques did not result in different levels of interobserver agreement when reporting new and enlarging MS lesions on serial scans.
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  • 120
    Digitale Medien
    Digitale Medien
    Springer
    Journal of neurology 246 (1999), S. 1169-1171 
    ISSN: 1432-1459
    Schlagwort(e): Key words European tick-borne encephalitis ; Magnetic resonance imaging ; Central nervous system
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract We report a case of central European tick-borne encephalitis with cervical myelitis presenting clinically as a lower motor neuron syndrome of the upper limbs with proximal asymmetrical pareses and atrophies. There were no sensory deficits nor signs of lesions of the spinal pathways or signs of encephalitis or meningitis. The affected motor fibers of the upper limbs were electrically inexcitable, but sensory findings were normal. Electromyography of the paralyzed muscles revealed pathological denervation activity without voluntary activation. The initial magnetic resonance imaging (MRI) showed a large hyperdense lesion in the anterior part of the cervical cord from C3 to T1. Despite the fact that MRI changes disappeared completely within 6 weeks the patient showed only little improvement in the paralyzed muscles after 6 months. To our knowledge, these MRI changes in patients with tick-borne encephalitis, consistent with an isolated anterior horn lesion, have never been reported previously. The course may have been aggravated by an initial antibiotic treatment with cephalosporins.
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  • 121
    ISSN: 1432-1459
    Schlagwort(e): Key words Temporal lobe epilepsy ; Hippocampus ; Magnetic resonance imaging ; Fluoro-2-deoxy-d-glucose positron-emission tomography ; Wada test
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract In refractory temporal lobe epilepsy (TLE) temporal lobe structures and functions are continuously or intermittently affected by abnormal brain electrical events, noxious neurochemical agents, and metabolic disturbances. There is conflicting evidence regarding the relationship between the duration of refractory mesial TLE and quantitative measures of temporal lobe functions and volumes of the hippocampi. Twenty patients (aged 28 ± 7 years, 14 males) with an initial precipitating injury before the age of 5 years were subjected to high-resolution magnetic resonance imaging, fluoro-2-deoxy-d-glucose positron-emission tomography (PET), and the Wada test. We investigated whether the duration of unilateral refractory TLE (12 left, 8 right) affects hippocampal volume, glucose metabolism, or Wada hemispheric memory performance. Ipsilateral to the epileptogenic zone the hippocampal volume, metabolism, and Wada hemispheric memory performance were reduced compared to the corresponding contralateral measures. The duration of epilepsy controlled for age at investigation, side of seizure origin, underlying cause, and sex were negatively correlated with ipsi- and contralateral hippocampal volume, hippocampal metabolism, and Wada hemispheric memory performance. Moreover, ipsilateral Wada hemispheric memory performance and contralateral hippocampal glucose metabolism were correlated with the frequency of habitual seizures. Refractory TLE seems to be associated with a slow but ongoing bilateral temporal lobe damage. These cross-sectional results require verification by longitudinal studies carried out over a period of more than two decades.
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  • 122
    ISSN: 1432-1459
    Schlagwort(e): Key words Multiple sclerosis ; Magnetic resonance imaging ; Gadolinium-DTPA ; Triple dose ; Blood-brain barrier
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract This study assessed whether dysfunction of the blood-brain barrier is an obligatory early event in lesion formation in multiple sclerosis. Dual-echo and T1-weighted magnetic resonance imaging after the injection of a triple dose (0.3 mmol/kg) of gadolinium-DTPA were obtained from ten patients with relapsing-remitting multiple sclerosis every week for 2 months. Sixty-four newly active lesions were detected by the two techniques. All the 44 new lesions seen on dual-echo scans enhanced during the early phases of their formation: 33 at their first appearance, 10 1 week before their appearance on the dual-echo scans, and one the week thereafter. When the every fourth (monthly) scan was analyzed, a total of 55 newly active lesions were detected (i.e., 14% active lesions would have been missed compared to the number found on weekly scanning). Thirty-one of them were detected by both dual-echo and triple-dose scans, 15 only by enhanced scans, and nine only by dual-echo scans. This study confirms that with highly sensitive magnetic resonance imaging techniques dysfunction of the blood-brain barrier is an obligatory early event in new lesion formation in relapsing-remitting multiple sclerosis.
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  • 123
    ISSN: 1432-1327
    Schlagwort(e): Gadolinium(III) complexes ; Contrast agents ; Magnetic resonance imaging ; Human serum albumin ; Proton relaxation enhancement
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Biologie , Chemie und Pharmazie
    Notizen: N,N′,N″,N‴ -pentaacetic acid) bearing different substituents for binding to human serum albumin (HSA) are compared. In spite of the structural differences of the recognition synthon and of the residual electric charge, the two chelates display an analogous binding affinity for the serum protein. Upon formation of the adducts with HSA, the exchange rates of the coordinated water appear slowed down by an amount corresponding to ca. 50% of the rates found for the free complexes. The relaxivity of [Gd(BOM)3DTPA (H2O)]2 −  is significantly higher than that of MS-325 either in the free complex or in the macromolecular adduct. Finally, the effect of pH on the stability of the HSA adducts and on the values of their relaxivities has been investigated.
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  • 124
    Digitale Medien
    Digitale Medien
    Springer
    Child's nervous system 15 (1999), S. 624-634 
    ISSN: 1433-0350
    Schlagwort(e): Key words Brain imaging ; Magnetic resonance imaging ; brain ; Magnetic resonance spectroscopy ; brain ; Computed tomography ; brain ; Diffusion imaging ; brain
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract  The last century has seen the evolution of neuroimaging from nonexistent to a group of techniques that, in our eyes, appears to be highly sophisticated. The rapidity of advancement in imaging has been concentrated in the last quarter century. There is no reason to expect this continual forward expansion of neuroradiology to abate; rather it seems likely that it will continue to increase at an even faster rate. The near future is one of refinement in imaging, faster and higher resolution as well as a much greater emphasis on physiology and biochemistry.
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  • 125
    ISSN: 1433-0350
    Schlagwort(e): Key words Abscess ; Spinal cord ; Dermal sinus ; Epidermoid ; Magnetic resonance imaging
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Intramedullary abscesses of the spinal cord are uncommon. Most of them occur in association with heart, pulmonary or urogenital infections. We report two cases of intramedullary spinal cord abscesses secondary to congenital dermal sinus. Only 14 cases of such an association have previously been reported. In our cases, dermal sinus was associated with an epidermoid tumour. The clinical presentation, pathogenesis, magnetic resonance imaging findings, surgical management and outcome are discussed.
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  • 126
    Digitale Medien
    Digitale Medien
    Springer
    Child's nervous system 15 (1999), S. 359-361 
    ISSN: 1433-0350
    Schlagwort(e): Key words Computerized tomography ; Intracranial tumor ; Magnetic resonance imaging ; Posterior fossa ; Teratoma
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract  In this study we report a rare case of a giant midline posterior fossa teratoma; its clinical presentation, radiological appearance, treatment and outcome, with an extensive review of the literature.
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  • 127
    Digitale Medien
    Digitale Medien
    Springer
    Skeletal radiology 28 (1999), S. 383-389 
    ISSN: 1432-2161
    Schlagwort(e): Key words Allografts ; Osteoarticular ; Magnetic resonance imaging
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract  Objective. To investigate the magnetic resonance imaging (MRI) features of allografts at various time intervals after surgery in patients with osteoarticular allografts. Design and patients. Sixteen patients who were treated with osteoarticular allografts and who were followed over time with MRI studies as part of their long-term follow-up were retrospectively selected for this study. T1-weighted images were obtained both before and after gadolinium administration along with T2-weighted images. All images were reviewed by an experienced musculoseletal radiologist, with two other experienced radiologists used for consultation. Imaging studies were organized into three groups for ease of discussion: early postoperative period (2 days to 2 months), intermediate postoperative period (3 months to 2 years), and late postoperative period (greater than 2 years). Results. In the early postoperative period, no gadolinium enhancement of the allograft was visible in any of the MR images. A linear, thin layer of periosteal and endosteal tissue enhancement along the margin of the allograft was visible in images obtained at 3–4 months. This enhancement apeared gradually to increase in images from later periods, and appears to have stabilized in the images obtained approximately 2–3 years after allograft placement. The endosteal enhancement diminished after several years, with examinations conducted between 6 and 8 years following surgery showing minimal endosteal enhancement. However, focal enhancement was noted adjacent to areas of pressure erosion or degenerative cysts. All the cases showed inhomogeneity in the marrow signal (scattered low signal foci on T1 with corresponding bright signal on T2), and a diffuse, inhomogeneous marrow enhancement later on. Conclusion. We have characterized the basic MRI features of osteoarticular allografts in 16 patients who underwent imaging studies at various time points as part of routine follow-up. We believe that the endosteal and periosteal enhancement observed on MRI during the first few months to 2 years following surgery represents vascular ingrowth and early skeletal repair. The zone of periosteal enhancement could also include the new bone laid on the surface of the allograft through which the soft tissues bind to the cortex. The exact reason for the inhomogeneity in the marrow signal, and the diffuse, inhomogeneous marrow enhancement is not clear. This may represent saponified and/or necrotic marrow fat interspersed with the fibrovascular tissue. The features noted here should provide radiologists with useful information regarding imaging characteristics they can expect to see in other allograft replacement patients.
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  • 128
    Digitale Medien
    Digitale Medien
    Springer
    Skeletal radiology 28 (1999), S. 447-452 
    ISSN: 1432-2161
    Schlagwort(e): Key words Plantar fascia ; aponeurosis ; Fasciitis ; Fasciotomy ; Magnetic resonance imaging
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract  Objective. To determine the postoperative appearance of the plantar fascia on MR imaging after a fasciotomy has been performed, and to compare the postsurgical appearance of the fascia after an open and endoscopic procedure.〈@head-abs-p1.lf〉Design and patients. Fifteen asymptomatic volunteers (12 women, 3 men; age range 22–49 years, mean age 33 years) with prior fasciotomies for treatment of longstanding plantar fasciitis were studied. Fourteen volunteers had a unilateral release and one volunteer had bilateral releases, allowing for assessment of 16 ankles. Eight fasciotomies were performed through an open incision and eight were performed endoscopically. The average time between surgery and imaging was 24 months (range 11–46 months). The site of surgery was established from the operative reports. Proton density (PD)-weighted and T2-weighted images in three orthogonal planes were obtained on a 1.5-T magnet. In eight studies, T1-weighted sagittal and STIR sagittal images were included. The fascia in each ankle was assessed for morphology and signal intensity. Perifascial soft tissues and bone marrow were assessed for edema. Preoperative MR studies were available in five volunteers.〈@head-abs-p1.lf〉Results. There was no apparent difference in the postoperative appearance of the ankle after an open or endoscopic procedure except for scar formation in the subcutaneous fat which was common after an open procedure (P〈0.05). Three ankles had a gap in the fascia (one open, two endoscopic). The plantar fascia measured a mean of 7.0 mm (range 5–10 mm) at the fasciotomy, and 8.3 mm (range 6–12 mm) at the enthesis. At the fasciotomy, 11 of 13 ankles had an indistinct deep contour and 9 of 13 had an indistinct superficial contour. At the enthesis, 13 of 16 ankles had an indistinct deep contour and 6 of 16 had an indistinct superficial contour. Compared with preoperative MR studies there was an average reduction in the fascial thickness at the enthesis of 14% (range 9–20%), but the thickness at the fasciotomy nearly doubled. No edema was evident in the fascia, perifascial tissues, deep plantar muscles, or calcaneal bone marrow.〈@head-abs-p1.lf〉Conclusions. The average thickness of the plantar fascia in asymptomatic volunteers after surgery is nearly 2–3 times that of normal. While there is increased thickness at the site of surgery, the changes in morphology and signal intensity were most prominent at the enthesis. The key observation was absence of edema in the fascia and perifascial soft tissues. This baseline information may be of value when assessing MR studies of symptomatic patients.
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  • 129
    ISSN: 1432-2161
    Schlagwort(e): Key words Hand ; Wrist ; Magnetic resonance imaging ; Soft tissue mass ; Neoplasm ; Tumour ; Tendon diseases
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract   Objective. To assess the utility of magnetic resonance imaging (MRI) in the investigation of palpable masses in the hand or wrist.〈@head-abs-p1.lf〉Design and patients. We retrospectively reviewed the MRI examinations and case records of 134 patients referred because of a palpable mass in the hand or wrist. MRI was performed on a 1.0 T magnet using an extremity coil. Intravenous gadolinium-DTPA was injected when considered appropriate.〈@head-abs-p1.lf〉Results and conclusions. MRI demonstrated the cause of the palpable mass in 126 cases (94.02%). Soft tissue neoplasms were found in 34 cases (25.37%). The majority were benign and included giant cell tumours of tendon sheath, lipomas and hemangiomas and had a characteristic appearance. There were three malignant tumours (myxoid liposarcoma, malignant fibroushistiocytoma and rhabdomyosarcoma). Ganglia were found in 36 cases (26.86%) and non-tumour tendon pathology in 31 cases (23.13%). Less common causes included articular diseases (5.97%) and anatomical variants (4.47%). No focal lesion was present in 8 cases (5.97%). In conclusion, MRI is an accurate diagnostic technique in patients who present with a palpable mass of the hand and wrist.
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  • 130
    Digitale Medien
    Digitale Medien
    Springer
    Skeletal radiology 28 (1999), S. 96-99 
    ISSN: 1432-2161
    Schlagwort(e): Key words Computed tomography ; Granular cell tumor ; Magnetic resonance imaging ; Subcutis
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract  Three cases of granular cell tumor (GCT) of the subcutis are presented. Computed tomography showed a mass isodense with muscle with an ill-defined margin. Magnetic resonance imaging showed a mass with inhomogeneous low signal intensity on both T1- and T2-weighted images. Another characteristic feature of subcutaneous GCT is its attachment in part to muscle. Histological examination confirmed the diagnosis in all cases.
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  • 131
    Digitale Medien
    Digitale Medien
    Springer
    Child's nervous system 15 (1999), S. 8-10 
    ISSN: 1433-0350
    Schlagwort(e): Key words Cavernous sinus ; Meningioma ; Child ; Ophthalmoplegia ; Magnetic resonance imaging
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Intracranial meningiomas in children are rare, representing 1–4.2% of central nervous system tumors and 1.5–1.8% of all intracranial meningiomas. Meningiomas arising from the lateral wall of the cavernous sinus account for less than 1% of all intracranial meningiomas. To our knowledge, only one case of a meningioma arising from the cavernous sinus has been reported in childhood. A 6-year-old boy presented with left ophthalmoplegia. A slight drooping of the left eyelid was noted at the age of 1 year. Magnetic resonance imaging (MRI) with contrast administration revealed an enhancing mass lesion located in the left cavernous sinus. The tumor, arising from the lateral wall of the cavernous sinus, was totally removed and the oculomotor nerve was reconstructed with a sural nerve graft. MRI displayed total tumor removal 1 month after the surgery. The pathological diagnosis was of a psammomatous meningioma.
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  • 132
    Digitale Medien
    Digitale Medien
    Springer
    Child's nervous system 15 (1999), S. 209-211 
    ISSN: 1433-0350
    Schlagwort(e): Key words Anterior sacral meningocele ; Epidermoid tumor ; Magnetic resonance imaging
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract A 2-year-old girl presented with an anterior sacral meningocele completely occupied by an epidermoid tumor. Preoperative magnetic resonance imaging had shown the meningocele with contents of the same intensity as cerebrospinal fluid. Surgery via a posterior sacral approach disclosed the tumor beneath an unexpected membrane inside the meningocele. Additionally, the presence of pus inside epidermoid tumor suggested that possible episodes of asymptomatic meningitis or other infection might have occurred before treatment, these being the major complication in anterior sacral meningocele. Therefore, we recommend that surgical treatment should be performed at the earliest possible stage in childhood, once the diagnosis is established, and dural plasty carried out to prevent infectious complications.
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  • 133
    Digitale Medien
    Digitale Medien
    Springer
    Der Radiologe 39 (1999), S. 847-854 
    ISSN: 1432-2102
    Schlagwort(e): Schlüsselwörter Zerebrale Amyloidangiopathie ; Intrazerebrale Blutung ; Computertomographie ; Kernspintomographie ; Key words Cerebral amyloid angiopathy ; Intracerebral hemorrhage ; Computed tomography ; Magnetic resonance imaging
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Beschreibung / Inhaltsverzeichnis: Summary The purpose of our study was to evaluate the characteristic findings of acute hemorrhage due to amyloid angiopathy with computed tomography. 14 patients of intracranial hemorrhage with histologically confirmed cerebral amyloid angiopathy were observed over a period of 4 years. Characteristic findings were a lobar hemorrhage in superficial localisation, cortical involvment, subarachnoid hemorrhage, the multiplicity of hemorrhages and repeated episodes. Severe cerebral amyloid angiopathy is often accompanied by multiple petechial hemorrhages, restricted to a cortical-subcortical distribution, detectable by magnetic resonance imaging. These findings suggest that cerebral amyloid angiopathy is not a rare cause of atraumatic lobar hemorrhage. Amyloid angiopathy should be considered in any elderly patient with superficial intracerebral hemorrhage in an atypical location.
    Notizen: Zusammenfassung In der Arbeit werden die computertomographischen Befunde der intrazerebralen Blutung im Rahmen der Amyloidangiopathie untersucht. 14 Patienten mit Massenblutung und histologisch bestätigter Amyloidangiopathie wurden in einem Zeitraum von 4 Jahren beobachtet. Charakteristische Befunde waren eine lobäre, oberflächlich gelegene Blutung, eine kortikale Beteiligung, eine begleitende Subarachnoidalblutung sowie ein mehrfaches und mehrzeitiges Auftreten der Blutungen. Eine schwere Amyloidangiopathie geht oft mit multiplen petechialen Blutungen in kortiko-subkortikaler Lokalisation einher, die sich kernspintomographisch nachweisen lassen. Die Befunde zeigen, daß die Amyloidangiopathie keine seltene Ursache einer nicht traumatischen lobären Blutung ist. Sie sollte daher bei jedem älteren Patienten mit einer intrazerebralen, oberflächlich gelegenen Blutung in atypischer Lokalisation in Betracht gezogen werden.
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  • 134
    ISSN: 1432-2102
    Schlagwort(e): Schlüsselwörter Staging thorakoabdominaler Tumoren ; Kinder ; Computertomographie (CT) ; Magnetresonanztomographie (MRT) ; Malignome ; Key words Staging of tumors ; Thoracoabdominal tumors ; Childhood ; Computed tomography ; Magnetic resonance imaging
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Beschreibung / Inhaltsverzeichnis: Summary Thoracoabdominal tumors in childhood can arise from all organs and affect children from the neonate to the adolescent. Better prognosis of childhood tumors, due to better biological understanding and improvement of chemotherapy, require sufficient radiological staging. Sufficiency in radiological staging needs modern cross-sectional techniques with high resolution, good availability and lower radiation dose. In general computed tomography (CT) is being used for radiological staging; increasingly MR imaging is being used because of multiplanar imaging techniques. Replacement of invasive techniques such as myelography and lymphography and modern cross-sectional techniques create painless staging conditions. Nevertheless, scintigraphy will always be a major examination technique, especially for evaluation of metastases and postoperative control examinations. The most common thoracoabdominal tumors in childhood and their staging are described.
    Notizen: Zusammenfassung Thorakale und abdominale Tumoren im Kindesalter nehmen ihren Ausgang von allen Organsystemen und können vom Neugeborenen bis zum Adoleszenten auftreten. Verbesserte Prognose, bedingt durch das bessere biologische Verständnis der Tumorerkrankung, sowie der effiziente Einsatz von Chemotherapeutika machen ein radiologisches Staging unumgänglich. Üblicherweise wird zum Staging die Computertomographie (CT) eingesetzt. Durch die Möglichkeit der multiplanaren Schnittführung und die bessere Auflösung bei Tumoren mit Beteiligung des ZNS wird in zunehmendem Maße die Magnetresonanztomographie (MRT) eingesetzt. Diese modernsten Schnittbildverfahren haben invasive Methoden wie Lymphographie und Angiographie in den Hintergrund gedrängt. Im weiteren werden die häufigsten thorakalen und abdominalen Tumoren im Kindesalter besprochen und deren Stagingsysteme erläutert.
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  • 135
    Digitale Medien
    Digitale Medien
    Springer
    Der Radiologe 39 (1999), S. 562-567 
    ISSN: 1432-2102
    Schlagwort(e): Schlüsselwörter Kolorektales Karzinom ; Präoperatives Staging ; Endosonographie ; CT ; MRT ; Key words Colorectal cancer ; Preoperative staging ; Endosonography ; Computed tomography ; Magnetic resonance imaging
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Beschreibung / Inhaltsverzeichnis: Summary Carcinoma of the colorectum is one of the most frequent neoplasias, with an incidence of 40 in 100 000. For the effective use of new, differentiated, less invasive treatment options, exact preoperative staging of the tumor is essential. The introduction of endosonography in rectal tumor staging allows for exact differentiation of the rectal wall layers and thus of tumor stages 1–3 with median accuracy of 89%. Magnetic resonance imaging of the rectum, especially in double-contrast technique, can also be employed in high and stenosing tumors and leads to an average accuracy of 85% for the stages 1–4. Computed tomography is the method of choice in screening for metastases. In lymph node staging, all modalities show only moderate accuracy around 75%.
    Notizen: Zusammenfassung Das kolorektale Karzinom stellt mit einer Inzidenz von 40 auf 100000 eine der häufigsten Neoplasien dar. Für den effektiven Einsatz neuer differenzierter Therapien mit geringerer Invasivität ist ein exaktes präoperatives Staging erforderlich. Die Einführung der Endosonographie im Tumorstaging erlaubt eine exakte Differenzierung der Wandschichten und damit der Tumorstadien 1–3 mit einer mittleren Genauigkeit von 89%, die Magnetresonanztomographie des Rektums, insbesondere in Doppelkontrasttechnik, kann auch bei hohen und stenosierenden Tumoren angewendet werden, bei einer Genauigkeit von durchschnittlich 85% für die Stadien 1–4. Die Computertomographie ist Methode der Wahl im Metastasenscreening. Im Lymphknotenstaging zeigen alle Modalitäten nur bescheidene Genauigkeiten um 75%.
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  • 136
    ISSN: 1433-7347
    Schlagwort(e): Key words Donor site morbidity ; Anterior cruciate ligament ; Magnetic resonance imaging
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin , Sportwissenschaft
    Notizen: Abstract The aim of this prospective study was to follow the development of repair tissue in the donor-site area using serial magnetic resonance imaging (MRI) evaluation and to assess whether the MRI findings were correlated with donor-site morbidity. Thirty-seven consecutive patients with unilateral anterior cruciate ligament injuries undergoing elective reconstruction of the ligament were included in the study. They were aged 27 (range 14–50) years. The graft was harvested through two 25-mm vertical incisions with the aim of protecting the infrapatellar nerve and sparing the paratenon. The tendon defect was left open. The patients underwent MRI evaluation at 6 weeks, 6 months and 27 months postoperatively. A final clinical follow-up was made 25 (range 23–29) months postoperatively. MRI demonstrated that the donor-site gap, i.e. the area corresponding to a pathological non-tendinous-like tissue signal, was 9 (range 4–18) mm at 6 weeks, 5 (range 2–14) mm at 6 months and 2 (range 0–5) mm at 27 months. The size of the donor-site gap had significantly decreased at 6 months compared with 6 weeks (P = 0.0001), as well as at 27 months compared with 6 months (P = 0.0001). We conclude that the patellar tendon at the donor site healed gradually, as expressed by a decrease in the area of non-tendinous-like tissue signal on the serial MRI evaluations.
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  • 137
    ISSN: 1433-7347
    Schlagwort(e): Key words Meniscus ; Degeneration ; Magnetic resonance imaging ; Histology ; Chronicity of the meniscal tear
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin , Sportwissenschaft
    Notizen: Abstract Signal anomalies observed in magnetic resonance imaging of the intrameniscal tissue adjacent to the tear were compared between stable knees (group 1, 54 menisci) and anterior cruciate ligament (ACL) deficient knees (group 2, 98 menisci). The histological significance of these signal anomalies was also studied (n = 25). The frequency of intrameniscal signal anomalies adjacent to the tear was significantly lower in ACL-deficient knees than in ACL-stable knees (P = 0.0022). There was a close correlation between the imaging anomalies and the presence of histological lesions (fissures, degeneration) within meniscal tissues adjacent to the tear (sensitivity: 0.95, specificity: 0.60). Our results suggest that the severity of intrameniscal degenerative changes adjacent to the tear are lower in ACL-deficient knees than in ACL-stable knees.
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  • 138
    Digitale Medien
    Digitale Medien
    Springer
    Journal of neurology 246 (1999), S. 16-20 
    ISSN: 1432-1459
    Schlagwort(e): Key words Dementia ; Alzheimer’s disease ; Neuroimaging ; Magnetic resonance imaging ; Single photon emission computed tomography ; Atrophy ; Hippocampus
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract The use of neuroimaging is reviewed in the diagnosis of dementia, especially Alzheimer’s disease (AD). Computed tomography (CT) may be used to exclude other causes of dementia than AD. The finding of cortical or subcortical atrophy on CT or magnetic resonance imaging (MRI) itself does not indicate AD. Hippocampal atrophy on CT/MRI provides a useful early marker, although further longitudinal and neuropathological study is required. CT- and MRI-based measurements of hippocampal atrophy show promise in providing useful diagnostic information for discriminating patients with probable AD from normal elderly individuals. Using a standardized imaging protocol, including some assessment of hippocampal atrophy, can save costs since patients with suspected AD must undergo a cross-sectional imaging study to exclude other (treatable) causes of dementia. Combining an assessment of hippocampal atrophy with cerebral blood flow measurements by single photon emission computed tomography is not warranted either from a clinical or from an economic point of view.
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  • 139
    ISSN: 1432-1459
    Schlagwort(e): Key words Spinocerebellar ataxia type 2 ; Magnetic resonance imaging ; Cerebral atrophy ; Disease duration
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract There have been only few studies of brain magnetic resonance imaging (MRI) in spinocerebellar ataxia (SCA) type 2. We investigated 20 SCA2 patients, from 11 Sicilian families, and 20 age-matched control subjects using MRI. Our data confirm that olivopontocerebellar atrophy (OPCA) is the typical pattern in SCA2. We found no significant correlation between infratentorial atrophy, disease duration, or the number of CAG repeats in our SCA2 patients, but there was supratentorial atrophy in 12 patients, with a significant correlation between supratentorial atrophy and disease duration. OPCA appears to represent the “core” of the SCA2: however, central nervous system involvement is not limited to pontocerebellar structures. We therefore consider central nervous system degeneration in SCA2 as a widespread atrophy. MRI is helpful in diagnosing SCA, but it is not diagnostic in the absence of clinical and molecular studies. We suggest that serial MRI may play a role in evaluating “in vivo” the progressive steps of neurodegeneration in SCA2, for a better comprehension of the pathophysiology of this disorder.
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  • 140
    ISSN: 1615-3146
    Schlagwort(e): Kerspintomographie ; Kollateralbandruptur ; Knorpelläsion ; Hochauflösende Oberflächenspule ; Magnetic resonance imaging ; Collateral ligament rupture ; Cartilage lesion ; High-resolution coil
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Beschreibung / Inhaltsverzeichnis: Abstract Aim of this study was the evaluation of a prototype of a new high-resolution MRI coil for the detection of finger trauma. The practicability of this new coil for the assessment of traumatic lesions of the finger joints and the diagnostic value of this new method in clinical practice was assessed. Twenty patients between 13 and 50 years of age (mean 28 years) were examined with a 1.5-T whole-body-imager Magnetom SP 63 scanner (Siemens, Erlangen, Germany). A prototype of a high-resolution MRI coil with a diameter of 2.5 cm was used. T1- and T2-weighted images with an in plane resolution of 0.I95 x 0.098 mm were acquired. Bone structures, joint cartilage and capsule, ligaments, tendons and soft tissue alterations were assessed. All 19 patients with pathological changes at the finger joints had a joint effusion. With MR imaging, fractures were detected in almost all patients, compared with the X-ray examinations. Cartilage contusion showed high signal intensity. The collateral ligaments could best be assessed in the transversal, and ligament ruptures in the coronal plane. Hemorrhage in the tendon showed an increased signal intensity in T1- and T2-weighted, edema only in T2-weighted images. Especially traumatic lesions of cartilage and of ligaments can be sufficiently assessed by the high-resolution MRI due to its high anatomic resolution compared to common methods like X-ray. High-resolution MRI is practicable in clinical routine.
    Notizen: Zusammenfassung Ziel der vorliegenden prospektiven Untersuchung war es, die Wertigkeit der hochauflösenden Kernspintomographie mittels einer speziellen Oberflächenspule in der Beurteilung von traumatischen Veränderungen der Fingergelenke zu evaluieren. Ferner sollte die Praktikabilität der Methode in der klinischen Routine überprüft werden. Es wurden 20 Patienten im Alter zwischen 13 und 50 Jahren (im Mittel 28 Jahre) an einem 1,5-T-Ganzkörpertomographen (Magnetom SP 63, Firma Siemens, Erlangen) untersucht. Als Spule wurde ein Prototyp einer hochauflösenden Oberflächenspule mit einem Durchmesser von 2,5 cm benutzt. T1- und T2-gewichtete Sequenzen mit einer maximalen Auflbsung in der Bildebene von 0,195 x 0,098 mm wurden zur Beurteilung von Knochen, Gelenkknorpel und -kapsel, der Sehnen und des Weichteilgewebes akquiriert. Kernspintomographisch fand sich bei 19 Patienten ein pathologischer Befund. Bei all diesen Patienten konnte ein Gelenkerguß nachgewiesen werden. Knöcherne Absprengungen, die anhand konventioneller Röntgenaufnahmen diagnostiziert wurden, zeigten sich kernspintomographisch als dislozierte signalreiche Strukturen. Gelenkknorpelkontusionen stellten sich hyperintens dar. Zur Beurteilung der Kollateralbānder eignete sich vor allem die koronare Schichtebene, da in dieser die Kollateralbdnder per continuitatem darstellbar sind. Sehneneinblutungen wiesen eine Signalerhöhung in T1- und T2-Wichtung auf. Ödeme der Weichteile und Bandstrukturen imponierten in T2-gewichteten Aufnahmen als signalreiche Strukturveränderungen. Aufgrund der hohen anatomischen Detailerkennbarkeit eignet sich die hochauflbsende Kernspintomographie als ergänzendes diagnostisches Verfahren zur nichtinvasiven Diagnostik von traumatischen Knorpel- und Bandläsionen. Unter Berücksichtigung des Zeitaufwandes handelt es sich dabei um eine im klinischen Alltag praktikable Methode.
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  • 141
    ISSN: 1619-7089
    Schlagwort(e): Key words: Autism ; Brain ; Technetium-99m ethyl cysteinate dimer ; Single-photon emission tomography ; Magnetic resonance imaging
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract. The neuro-anatomical substrate of autism has been the subject of detailed investigation. Because previous studies have not demonstrated consistent and specific neuro-imaging findings in autism and most such studies have been performed in adults and school-aged children, we performed a retrospective review in young children in search of common functional and anatomical abnormalities with brain single-photon emission tomography (SPET) using technetium-99m ethyl cysteinate dimer (ECD) and correlative magnetic resonance imaging (MRI). The patient population was composed of 23 children aged 28–92 months (mean: 54 months) who met the diagnostic criteria of autism as defined in the DSM-IV and CARS. Brain SPET was performed after intravenous injection of 185–370 MBq of 99mTc-ECD using a brain-dedicated annular crystal gamma camera. MRI was performed in all patients, including T1, T2 axial and T1 sagittal sequences. SPET data were assessed visually. Twenty patients had abnormal SPET scans revealing focal areas of decreased perfusion. Decreased perfusion of the cerebellar hemisphere (20/23), thalami (19/23), basal ganglia (5/23) and posterior parietal (10/23) and temporal (7/23) areas were noted on brain SPET. By contrast all patients had normal MRI findings without evidence of abnormalities of the cerebellar vermis, cerebellar hemisphere, thalami, basal ganglia or parietotemporal cortex. In conclusion, extensive perfusion impairments involving the cerebellum, thalami and parietal cortex were found in this study. SPET may be more sensitive in reflecting the pathophysiology of autism than MRI. However, further studies are necessary to determine the significance of thalamic and parietal perfusion impairment in autism.
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  • 142
    Digitale Medien
    Digitale Medien
    Springer
    European journal of applied physiology 79 (1999), S. 367-373 
    ISSN: 1439-6327
    Schlagwort(e): Key words Cerebral edema ; Cerebrospinal fluid ; Head-down tilt ; Intracranial pressure ; Magnetic resonance imaging
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Vascular and tissue fluid dynamics in the microgravity of space environments is commonly simulated by head-down tilt (HDT). Previous reports have indicated that intracranial pressure and extracranial vascular pressures increase during acute HDT and may cause cerebral edema. Tissue water changes within the cranium are detectable by T 2 magnetic resonance imaging. We obtained T 2 images of sagittal slices from five subjects while they were supine and during −13° HDT using a 1.5-Tesla whole-body magnet. The analysis of difference images demonstrated that HDT leads to a 21% reduction of T 2 in the subarachnoid cerebrospinal fluid (CSF) compartment and a 11% reduction in the eyes, which implies a reduction of water content; no increase in T 2 was observed in other brain regions that have been associated with cerebral edema. These findings suggest that water leaves the CSF and ocular compartments by exudation as a result of increased transmural pressure causing water to leave the cranium via the spinal CSF compartment or the venous circulation.
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  • 143
    ISSN: 1573-9686
    Schlagwort(e): Blood flow ; Magnetic resonance imaging ; Numerical flow modeling ; Carotid artery ; Three-dimensional ; Wall shear stress ; Atherosclerosis
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin , Technik allgemein
    Notizen: Abstract Purpose: Combining computational blood flow modeling with three-dimensional medical imaging provides a new approach for studying links between hemodynamic factors and arterial disease. Although this provides patient-specific hemodynamic information, it is subject to several potential errors. This study quantifies some of these errors and identifies optimal reconstruction methodologies. Methods: A carotid artery bifurcation phantom of known geometry was imaged using a commercial magnetic resonance (MR) imager. Three-dimensional models were reconstructed from the images using several reconstruction techniques, and steady and unsteady blood flow simulations were performed. The carotid bifurcation from a healthy, human volunteer was then imaged in vivo, and geometric models were reconstructed. Results: Reconstructed models of the phantom showed good agreement with the gold standard geometry, with a mean error of approximately 15% between the computed wall shear stress fields. Reconstructed models of the in vivo carotid bifurcation were unacceptably noisy, unless lumenal profile smoothing and approximating surface splines were used. Conclusions: All reconstruction methods gave acceptable results for the phantom model, but in vivo models appear to require smoothing. If proper attention is paid to smoothing and geometric fidelity issues, models reconstructed from MR images appear to be suitable for use in computational studies of in vivo hemodynamics. © 1999 Biomedical Engineering Society. PAC99: 8719Uv, 8761-c, 0705Pj, 8710+e
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  • 144
    ISSN: 1573-9686
    Schlagwort(e): Medical imaging ; Magnetic resonance imaging ; Biomechanics ; Tendon moment arm ; Functional neuromuscular stimulation ; Tendon transfer surgery ; Hand biomechanics
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin , Technik allgemein
    Notizen: Abstract New three-dimensional (3D) magnetic resonance imaging (MRI) methods for measuring the tendon moment arm were created and were evaluated on the tendon moment arm of the flexor digitorum profundus at the third metacarpophalangeal joint. Using an open magnet MRI system and a hand holder, a series of static images were acquired at four joint angles and analyzed using specially created computer programs. Three methods were evaluated: (1) a 3D tendon excursion method that extended the method of Landsmeer; (2) a 3D geometric method whereby the moment arm was the perpendicular distance between the joint axis of rotation and the tendon path, and (3) a two-dimensional (2D) geometric method whereby single image slices were analyzed. Repeating the imaging and measurement processes, the 3D tendon excursion method was more reproducible (6% variation) than the 3D geometric method (12%), and both were much more reproducible than the 2D geometric method (27%). By having three operators analyze a single set of image data, we found that the precision of the 3D tendon excursion method was much less affected by segmentation error than the 3D geometric method. With the 3D imaging methods, tendon bowstringing and a displacement of the joint center of rotation toward the dorsal side of the hand were evident, leading to as much as a 60% increase in moment arm with joint flexion. Because of the dependence on flexion and variation between subjects, we recommend patient-specific measurements for target applications in functional neuromuscular stimulation interventions and tendon transfer surgery. © 1999 Biomedical Engineering Society. PAC99: 8761Pk, 8719Rr, 0705Pj
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  • 145
    Digitale Medien
    Digitale Medien
    Springer
    Intensive care medicine 21 (1995), S. 679-681 
    ISSN: 1432-1238
    Schlagwort(e): Fat embolism ; Magnetic resonance imaging
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Fat embolism syndrome (FES) is one of the most important causes of morbidity and mortality following multiple fractures. Neurological involvement (cerebral fat embolism) has been reported frequently. A case of cerebral fat embolism is reported. While CT scan revealed no abnormalities, MRI, performed in this patient 8 days after trauma, showed relative lowintensity areas on T1-weighted images and high intensity areas on T2-weighted images involving cerebral white matter, corpus callosum and basal ganglia. MRI follow-up (1 and 3 months post-trauma) showed nearly complete resolution of the abnormal signal. MRI seems to be a useful diagnostic tool for detecting and quatifying lesions in fat embolism syndrome.
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  • 146
    Digitale Medien
    Digitale Medien
    Springer
    Skeletal radiology 24 (1995), S. 123-126 
    ISSN: 1432-2161
    Schlagwort(e): Patellar tendon ; Magnetic resonance imaging ; Gradient echo (GRE) sequence
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Thickening of the patellar tendon and foci of increased signal intensity have been described as characteristic features of “jumper's knee” (chronic patellar tendinitis) on magnetic resonance imaging (MRI). It was our impression that such appearances may be seen in the patellar tendons of patients without symptoms referable to the anterior part of the knee when using gradient echo images. The appearances of the asymptomatic patellar tendon on three-dimensional gradient echo sequences were studied by retrospectively reviewing the images of 60 patients, none of whom had symptoms related to the anterior part of the knee. The anteroposterior width of the patellar tendon was measured at three levels (superior, middle and inferior) on the central sagittal image of a gradient echo sequence. The relative signal intensities at the same levels were recorded. In 97% of subjects the superior part of the tendon was wider than the midpoint, and in 97% the inferior part was wider than the midpoint. The range of widths was wide, and there was no significant difference between sexes. Focal increased signal intensity in the superior part was shown in 75%, and in the inferior part in 43%. The asymptomatic patellar tendon shows uniform thickness throughout most of its length, but there are focal expansions at the proximal and distal ends. It usually demonstrates low signal on MRI, but may contain foci of increased signal intensity at either or both ends when imaged on gradient-echo sequences.
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  • 147
    ISSN: 1432-2161
    Schlagwort(e): Magnetic resonance imaging ; Gd-DTPA ; Contrast medium enhancement ; Rheumatoid arthritis ; Seronegative spondyloarthritis ; Differential diagnosis
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract A series of patients with clinically early inflammatory joint disease due to rheumatoid arthritis, psoriatic arthritis and Reiter's syndrome were examined by plain film radiography and magnetic resonance imaging (MRI). The spin echo T1-weighted precontrast, T2-weighted, and, especially, T1-weighted postcontrast images demonstrated distinct differences in the distribution of inflamatory changes, both within and adjacent to involved small hand joints. Two major subtypes of inflammatory arthritis were shown, thus providing a specific differential diagnosis between rheumatoid arthritis and some patients with seronegative spondyloarthritis. In particular, all the patients with Reiter's syndrome who were studied, and half of those with psoriatic arthritis, had a distinctive pattern of extra-articular disease involvement. The need for a new classification of clinical subsets in psoriatic arthritis has been recently suggested. The present findings suggest that magnetic resonance imaging could be useful in such a reclassification of seronegative spondyloarthritis, as well as offering considerable potential for a reappraisal of pathogenesis and therapy. In this series, it was also noted that juxta-articular osteoporosis on plain film did not correlate with bone marrow oedema on MRI. Hence the aetiology of this common radiographic finding also merits further consideration.
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  • 148
    Digitale Medien
    Digitale Medien
    Springer
    Skeletal radiology 24 (1995), S. 399-408 
    ISSN: 1432-2161
    Schlagwort(e): Spondyloarthropathy ; Juvenile ankylosing spondylitis ; Juvenile psoriatic arthritis ; Arthritis with IBD ; Reiter's syndrome ; Reactive arthritis ; Enthesitis ; Sacroiliitis ; Computed tomography ; Magnetic resonance imaging
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract The spondyloarthropathies comprise four distinct entities — ankylosing spondylitis, psoriatic arthritis, the arthritis associated with inflammatory bowel disease, and Reiter's syndrome and other related forms of reactive arthritis. Although these are distinct diseases, they have a number of clinical, radiologie, and genetic characteristics in common which permit them to be classified under the unifying term “spondyloarthropathy”. They are diseases of young adults, and when they present in patients under 16 years of age we refer to them as the “juvenile” spondyloarthropathies. They must be distinguished from juvenile rheumatoid arthritis, which is a totally separate entity; however the distinction may not always be obvious. Involvement of peripheral and sacroiliac joints commonly occurs in the juvenile spondyloarthropathies. The peripheral arthritis may be erosive and associated with bone apposition at the joint margins. Axial involvement is usually a late finding. Dactylitis and tenosynovitis are frequently present early on. Enthesitis, a highly specific feature, occurs much more often in the juvenile spondyloarthropathies than in the adult forms and it may be the only presenting feature. The plain radiograph is the primary and most important imaging modality for the assessment of these diseases. However, an expanding role of magnetic resonance imaging is evident.
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  • 149
    Digitale Medien
    Digitale Medien
    Springer
    Skeletal radiology 24 (1995), S. 437-440 
    ISSN: 1432-2161
    Schlagwort(e): Cat scratch disease ; Infectious lymphaden ; opathy ; Magnetic resonance imaging
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Cat scratch disease is an infectious lymphadenitis frequently occurring in children and adolescents. We present the magnetic resonance imaging findings of two patients with this disease. In both cases, lymphadenopathy was characterized by extensive stranding of the surrounding soft tissues, consistent with the inflammatory nature of this condition. Magnetic resonance imaging can be diagnostic and may obviate the need for invasive means of evaluation in patients suspected of having cat scratch disease.
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  • 150
    Digitale Medien
    Digitale Medien
    Springer
    Skeletal radiology 24 (1995), S. 511-514 
    ISSN: 1432-2161
    Schlagwort(e): Magnetic resonance imaging ; Injuries ; Tendons ; Muscles ; Popliteus
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Objective. Popliteal muscle and tendon injuries are thought to be unusual. This report describes the magnetic resonance (MR) appearances of popliteus muscle and tendon injuries. Design and patients. The study included 24 patients where the diagnoses of popliteal injuries were prospectively made based on MR appearances. The study group was taken from 2412 consecutive knee MRIs. The injuries were characterized as to involving the muscular or tendinous portions of the popliteus apparatus. Results. In 95.8% (23/24) of patients, the tears of the popliteus involved the muscular portion. The injuries were either partial and interstitial or complete. Three patients had tears of both the muscular and tendinous portions or the tendon alone. The anterior and posterior cruciate ligaments were torn in 16.7% (4/24) and 29.2% (7/24) of patients, respectively. There were medial and lateral meniscal tears in 45.8% (11/24) and 25% (6/24) of patients, respectively. There were injuries of the medial and lateral collateral ligaments in 8.3% (2/24) and 4.2% (1/24) of patients, respectively. Bone bruises and/or fractures were seen in 33.3% (8/24) patients. In 8.3% (2/24) of patients, the popliteus injury was an isolated finding. Conclusion. Popliteus muscle and tendon injuries are not uncommon. They usually occur in conjunction with other significant injuries of the knee and can be characterized with MR imaging.
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  • 151
    Digitale Medien
    Digitale Medien
    Springer
    Skeletal radiology 24 (1995), S. 543-545 
    ISSN: 1432-2161
    Schlagwort(e): Meniscus ; Meniscal ossicle ; Magnetic resonance imaging
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract We report the MR appearance of a meniscal ossicle, which is an unusual etiology for knee pain. The role of MR in differentiating a meniscal ossicle from a loose body is presented. The MR images also demonstrated associated tibial cartilage thinning and a possible meniscal tear. These MR findings led to arthroscopic treatment rather than conservative management. A review of the literature on meniscal ossicles is also presented.
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  • 152
    Digitale Medien
    Digitale Medien
    Springer
    Skeletal radiology 24 (1995), S. 579-581 
    ISSN: 1432-2161
    Schlagwort(e): Magnetic resonance imaging ; Knee ; Synovial hemangioma
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract The findings in two patients with histologically proven synovial hemangioma of the knee are described. Both cases emphasize the typical appearance of this unusual tumor on magnetic resonance imaging. Additional radiologic findings, such as adjacent osseous involvement, are discussed.
    Materialart: Digitale Medien
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  • 153
    Digitale Medien
    Digitale Medien
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    Skeletal radiology 24 (1995), S. 601-604 
    ISSN: 1432-2161
    Schlagwort(e): Muscle hernias ; Peroneus longus ; Fascial defects ; Magnetic resonance imaging
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Herniation of the left peroneus longus muscle was present in three male members of the same family, being the first reported case of this condition in a familial setting. The hernias were differentiated from other mass lesions and varices by magnetic resonance imaging. The images demonstrated a fascial defect originating in the area where vessels and nerves penetrate the fascia, suggesting that the three men had a congenital weakness in the fascia.
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  • 154
    ISSN: 1432-2161
    Schlagwort(e): Vascular lesions ; Hemangioma ; Synovial hemangioma ; Soft tissue tumors ; Magnetic resonance imaging
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Objective This study was undertaken to describe the imaging characteristics of synovial hemangioma, with the goal of improving the disappointing rate (22%) of clinical diagnosis of this condition. A review of the literature and the differential diagnosis of intra-articular lesions, including synovial osteochondromatosis and pigmented villonodular synovitis, are also presented. Patients The subjects of the study were 8 patients (4 males, 4 females; age range: 5–47 years; mean age: 19 years) with histologically confirmed synovial hemangioma involving the knee (n=7) or wrist (n=1). We retrospectively examined the imaging studies performed in these patients, including plain radiography (n=8), magnetic resonance imaging (MRI; n=4), angiography (n=3), arthrography (n=2), and contrast-enhanced computed tomography (CT; n=2). Results Plain radiographs showed a soft tissue density suggesting either joint effusion or a mass in all patients. Phleboliths and bone erosions on plain films in four patients with extra-articular soft tissue involvement pointed to the correct diagnosis. Angiography, showing fine-caliber, smooth-walled vessels, contrast pooling in dilated vascular spaces, and early visualization of venous structures, was diagnostic in two patients. Neither arthrography nor CT yielded specific enough findings. MRI was consistently effective in allowing the correct diagnosis to be made preoperatively, showing an intra-articular or juxta-articular mass of intermediate signal intensity on T1-weighted images and of high signal intensity on T2or T2*-weighted images with low-signal channels or septa within it. A fluid-fluid level was found in two patients with a cavernous-type lesion. Conclusion Despite the limited nature of this study, it shows clearly that MRI is the procedure of choice whenever an intra-articular vascular lesion such as synovial hemangioma is suspected. Nonetheless, phleboliths and evidence of extra-articular extension on plain radiographs point to angiography as an effective procedure of first resort because it can be combined with embolotherapy.
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  • 155
    ISSN: 1432-2161
    Schlagwort(e): Arthritis ; Rat ; Knee ; Magnetic resonance imaging ; Radiography ; Histology
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract High-resolution magnetic resonance imaging (MRI) was used to investigate antigen-induced monoarticular arthritis (AIMA) in the rat. In sagittal, spin-echo images of the knee, characteristic parallel bands, in the order dark-light-dark, were consistently observed 5–8 days after arthritis induction; the bands ran concentric with, and just beneath, the femoral and tibial articular surfaces. Concurrent radiology, histology and MRI (chemical shift-selective imaging and contrast enhancement with magnetisation transfer and gadolinium) established that the phenomenon reflected subchondral erosion, not artefact. The outer hypointense band corresponded to calcified cartilage underlying the articular surface. The central hyperintense band reflected inflammatory matrix displacing normal haematopoietic tissue immediately subchondrally; here, trabecular bone had mostly disappeared, but adjacent articular cartilage, although under attack and lacking proteoglycan, appeared structurally normal. The inner hypointense band reflected deeper, truncated trabeculae within inflammatory matrix, layered with pallisading osteoblast-like cells. This study exemplifies the power of MRI for revealing localised joint pathology non-invasively, and shows that rat AIMA shares many pathological features with arthritis in human beings.
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  • 156
    ISSN: 1432-2161
    Schlagwort(e): Elbow ; Osteonecrosis ; Osteochondritis dissecans ; Magnetic resonance imaging ; Gadopentetate dimeglumine
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Magnetic resonance imaging (MRI) was performed on seven patients with aseptic osteonecrosis (n=4) and osteochondritis dissecans (OCD;n=3) of the elbow. Precontrast MRI was superior to plain radiographs, which did not show any abnormality in three cases of osteonecrosis. On gadopentetate-dimeglumine-enhanced T1-weighted images, which were obtained in three patients with osteonecrosis and three patients with OCD, all cases of osteonecrosis demonstrated homogeneous enhancement of the lesions. All cases of OCD were diagnosed on plain radiographs. On MRI one showed significant enhancement of the loose body. In another case an incompletely enhancing loose body was surrounded by a diffusely enhancing region. In the third patient only a small marginal enhancement of the defect was observed. Our results suggest that MRI can improve the accuracy in diagnosis of aseptic osteonecrosis of the elbow. The use of gadopentetate dimeglumine allows the viability of the lesions or the loose bodies to be demonstrated and reparative tissue to be detected.
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  • 157
    Digitale Medien
    Digitale Medien
    Springer
    Skeletal radiology 24 (1995), S. 37-41 
    ISSN: 1432-2161
    Schlagwort(e): Intraosseous lipoma ; Magnetic resonance imaging
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Four patients with intraosseous lipomas were studied with magnetic resonance imaging. The imaging features and histology of each tumor were compared. Magnetic resonance imaging was very helpful in establishing a pathologic diagnosis. If a severe degree of involution was present, then the magnetic resonance findings could be ambiguous, making diagnosis more difficult.
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  • 158
    Digitale Medien
    Digitale Medien
    Springer
    Acta neuropathologica 89 (1995), S. 552-559 
    ISSN: 1432-0533
    Schlagwort(e): Key words Pes cavus ; Magnetic resonance imaging ; Pathology ; Morphometry ; Peroneus longus hypertrophy
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Enlargement of the peroneus longus muscle is a common occurrence in patients with forefoot pes cavus, and may contribute to the cavus deformity. The present study compares the morphology of up to five lower leg muscles from 17 patients with forefoot pes cavus with those of normal muscles. Eight cases had an identifiable neurogenic cause for the cavus. In four cases of hereditary motor-sensory neuropathy, the tibialis anterior showed more severe damage than the peroneus longus. In two cases of cerebral palsy, fibre atrophy and increased oxidative enzyme activity were observed. In nine clinically idiopathic cases, the histological appearances ranged from normal to generalised fibre atrophy or hypertrophy in individual muscles. There was a trend for the mean fibre area to be greater in peroneus longus than in tibialis anterior in six of the idiopathic group of patients. The muscle cross-sectional area on magnetic resonance imaging was correlated closely with the mean fibre area measured on tissue sections. In idiopathic forefoot pes cavus, fibre hypertrophy in peroneus longus (relative to tibialis anterior) may contribute to the cavus deformity. Muscle fibre hyperplasia may contribute to the peroneal muscle enlargement in Friedreich's ataxia. In none of the cases was peroneus longus enlargement due to fat or fibrous tissue replacement.
    Materialart: Digitale Medien
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  • 159
    Digitale Medien
    Digitale Medien
    Springer
    Acta neuropathologica 89 (1995), S. 552-559 
    ISSN: 1432-0533
    Schlagwort(e): Pes cavus ; Magnetic resonance imaging ; Pathology ; Morphometry ; Peroneus longus hypertrophy
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Enlargement of the peroneus longus muscle is a common occurrence in patients with forefoot pes cavus, and may contribute to the cavus deformity. The present study compares the morphology of up to five lower leg muscles from 17 patients with forefoot pes cavus with those of normal muscles. Eight cases had an identifiable neurogenic cause for the cavus. In four cases of hereditary motor-sensory neuropathy, the tibialis anterior showed more severe damage than the peroneus longus. In two cases of cerebral palsy, fibre atrophy and increased oxidative enzyme activity were observed. In nine clinically idiopathic cases, the histological appearances ranged from normal to generalised fibre atrophy or hypertrophy in individual muscles. There was a trend for the mean fibre area to be greater in peroneus longus than in tibialis anterior in six of the idiopathic group of patients. The muscle cross-sectional area on magnetic resonance imaging was correlated closely with the mean fibre area measured on tissue sections. In idiopathic forefoot pes cavus, fibre hypertrophy in peroneus longus (relative to tibialis anterior) may contribute to the cavus deformity. Muscle fibre hyperplasia may contribute to the peroneal muscle enlargement in Friedreich's ataxia. In none of the cases was peroneus longus enlargement due to fat or fibrous tissue replacement.
    Materialart: Digitale Medien
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  • 160
    Digitale Medien
    Digitale Medien
    Springer
    Annals of hematology 71 (1995), S. 143-146 
    ISSN: 1432-0584
    Schlagwort(e): Myelodysplasic syndrome ; Leukemia ; Magnetic resonance imaging ; Bone marrow biopsy
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract A 47-year-old male patient with myelodysplasia showed increasing values of serum lactate dehydrogenase (up to 3500 units/l) and an increasing blast count. Several biopsies (taken from the posterior iliac crest) revealed marked hypocellularity. In contrast, magnetic resonance imaging of the marrow demonstrated an inhomogeneous distribution of marrow with hypocellular and also large hypercellular areas not detected by cytological and histological analysis. A location for biopsy of hypercellular marrow was provided by T1-weighted and water-selective magnetic resonance imaging. The findings in the patient were compared with those in a matched healthy volunteer.
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  • 161
    Digitale Medien
    Digitale Medien
    Springer
    Annals of hematology 71 (1995), S. 143-146 
    ISSN: 1432-0584
    Schlagwort(e): Key words Myelodysplasic syndrome ; Leukemia ; Magnetic resonance imaging ; Bone marrow biopsy
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract  A 47-year-old male patient with myelodysplasia showed increasing values of serum lactate dehydrogenase (up to 3500 units/l) and an increasing blast count. Several biopsies (taken from the posterior iliac crest) revealed marked hypocellularity. In contrast, magnetic resonance imaging of the marrow demonstrated an inhomogeneous distribution of marrow with hypocellular and also large hypercellular areas not detected by cytological and histological analysis. A location for biopsy of hypercellular marrow was provided by T1-weighted and water-selective magnetic resonance imaging. The findings in the patient were compared with those in a matched healthy volunteer.
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  • 162
    Digitale Medien
    Digitale Medien
    Springer
    Dysphagia 10 (1995), S. 167-171 
    ISSN: 1432-0460
    Schlagwort(e): Dysphagia ; Osteophyte ; Cervical spine ; Magnetic resonance imaging ; Carcinoma ; Surgery ; Deglutition ; Deglutition disorders
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Anterior cervical osteophytes impinging upon the pharynx or esophagus constitute a rare cause of dysphagia. In severe cases, surgical removal of these osteophytes can provide symptomatic relief. We describe a patient of this type who failed to improve postoperatively, only to be found subsequently to have a carcinoma of the base of the tongue. To assist other clinicians in evaluating similar patients, and also to emphasize the great utility of modern radiologic techniques in these cases, we propose a diagnostic algorithm that incorporates magnetic resonance or computerized tomographic imaging.
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  • 163
    Digitale Medien
    Digitale Medien
    Springer
    Abdominal imaging 20 (1995), S. 566-568 
    ISSN: 1432-0509
    Schlagwort(e): Genitourinary tract abnormalities ; Magnetic resonance imaging ; Pelcic cysts ; Congenital anomalies
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Gartner duct cysts derive from remnants of the vaginal portion of the mesonephric (Wolffian) ducts. In cases of incomplete regression of these ducts, cysts can develop due to secretory activity [1]. Clinically, those cysts are usually asymptomatic, their size not exceeding 2 cm in diameter. In rare cases with larger cysts, the presence of dyspareunia and problems in obstetric delivery are described [2, 3]. We present a case of a histologically proven symptomatic Gartner duct cyst with a size of 16 ×15×8 cm. To my knowledge, this is the largest Gartner duct cyst ever reported in the imaging literature.
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  • 164
    ISSN: 1432-0509
    Schlagwort(e): Magnetic resonance imaging ; Flow dynamics ; Portal vein ; Liver cirrhosis ; Chronic hepatitis
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Background: In patients with diffuse liver disease, the portal flow dynamics change markedly in accordance with disease progression and would provide a useful index of progression of stage. Methods: Portal blood flow (PBF) was measured by phase contrast magnetic resonance imaging (MRI) in 21 patients with diffuse liver disease and 20 healthy volunteers. The MRI method was validated by a flow phantom study. The mean PBF could be measured in 6.8 min without breath-holding. Results: Doppler ultrasound measurements of PBF volume were obtained reproducibly in all the healthy volunteers and were shown to correlate with the MRI values (Doppler: 12.5 ±3.2 cm3/s, MRI: 12.0 ± 3.3 cm3/s; mean ± SD). The PBF volume of patients with chronic hepatitis showed no significant difference from that of the healthy volunteers. In patients with liver cirrhosis, the PBF volume ranged from 5.01 to 32.3 cm3/s. A significant increase in PBF volume was caused in one patient by massive intrahepatic shunting and a significant decrease was caused in two patients by massive extrahepatic shunting. Conclusions: The measurement of PBF by phase contrast MRI is clinically useful in predicting intrahepatic or extrahepatic shunting in patients with liver cirrhosis, and may be of value in detecting the progression of stage in diffuse liver diseases.
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  • 165
    Digitale Medien
    Digitale Medien
    Springer
    Abdominal imaging 20 (1995), S. 505-515 
    ISSN: 1432-0509
    Schlagwort(e): Prostate neoplasms ; Ultrasound ; Doppler ultrasonography ; Radionuclide studies ; Computerized tomography ; Magnetic resonance imaging ; Monoclonal antibodies
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Prostate cancer diagnosis and treatment is fast emerging as a major health care issue in the United States. However, there are great uncertainties about the value of specific tests and therapies. Imaging modalities play a major role in the current management of patients with prostate cancer and this role is likely to expand in the future. Transrectal ultrasound is used to identify non-palpable lesions, direct systematic biopsies, determine gland volume and stage prostate cancers. For staging skeletal metastases, the bone scan is acknowledged as the best method, however controversy surrounds its routine use in patients with low prostate specific antigen (PSA) values. Computed tomography (CT) and transrectal ultrasound have limited value in detecting extracapsular disease but CT can be used in conjunction with percutaneous biopsy to identify nodal metastases. The role of Endorectal coil MRI is currently evolving in the wake of a disappointing multiinstitutional trial but MRI still holds the most promise for accurately detecting local extent of prostate cancer. New radiolabeled techniques with monoclonal antibodies and peptide imaging are also having early but promising results. The role of imaging in prostate cancer is continuing to evolve as technology and knowledge about prostate cancer biology improves and health care economics force a more judicious use of imaging resources.
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  • 166
    Digitale Medien
    Digitale Medien
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    Abdominal imaging 20 (1995), S. 379-380 
    ISSN: 1432-0509
    Schlagwort(e): Paratesticular ; Fibrous pseudotumor ; Tunica vaginalis ; Magnetic resonance imaging ; Ultrasound ; Hemiscrotum
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Fibrous pseudotumor is a benign paratesticular tumor that typically presents as a painless mass of the hemiscrotum. Because this tumor can mimic a malignant process, it is usually not diagnosed preoperatively. We describe a case of fibrous pseudotumor of the tunica vaginalis, demonstrating the ultrasound and magnetic resonance image (MRI) appearance with pathologic correlation.
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  • 167
    Digitale Medien
    Digitale Medien
    Springer
    Abdominal imaging 20 (1995), S. 176-178 
    ISSN: 1432-0509
    Schlagwort(e): Magnetic resonance imaging ; Neurofibroma ; Prostate
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Pelvic neurofibromatosis is a rare disease and rarely involves the prostate. A 19-year-old male presented with irritative and obstructive voiding symptoms. Magnetic resonance imaging showed a large mass extending from the sacral promontory to the perirectal and perivesical spaces and to the proximal root of the penis. The mass also involved the prostate. The characteristics of the mass were highly suggestive for neurofibroma. Prostate biopsy showed neurofibroma, and the immunohistochemistry stain for S-100 protein was positive.
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  • 168
    Digitale Medien
    Digitale Medien
    Springer
    Abdominal imaging 20 (1995), S. 486-488 
    ISSN: 1432-0509
    Schlagwort(e): Rupture, uterine ; Pregnancy, complications ; Magnetic resonance imaging
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Gravid uterine rupture can be a difficult diagnosis, both clinically and radiologically. Ultrasound has been successful in detection of some indirect signs of uterine rupture but thus far has shown little success in demonstrating the myometrial defect. We present the MR findings in a case of gravid uterine dehiscence in which the actual uterine wall defect was well demonstrated. Gross pathologic correlation is provided.
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  • 169
    Digitale Medien
    Digitale Medien
    Springer
    Abdominal imaging 20 (1995), S. 489-490 
    ISSN: 1432-0509
    Schlagwort(e): Adrenal glands ; Adrenocortical adenoma ; Adipose tissue ; Computed tomography ; Magnetic resonance imaging
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract A case of adrenocortical adenoma containing small adipose foci is presented. A small amount of fat within the mass led to an erroneous preoperative diagnosis of myelolipoma. Adrenal adenoma should be included in the differential diagnosis of adrenal mass containing fat.
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  • 170
    Digitale Medien
    Digitale Medien
    Springer
    European radiology 5 (1995), S. 669-671 
    ISSN: 1432-1084
    Schlagwort(e): Peyronie's disease (IPP) ; Endoluminal ultrasound ; Magnetic resonance imaging ; Corpus spongiosum ; Corpus cavernosum
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract We report the case of a 44-year-old male presenting with deviation of the penis during erection. Upon physical and clinical examination the patient did not have the typical findings of Peyronie's disease, therefore he was admitted for further evaluation by conventional sonography, duplex Doppler ultrasound, endourethral ultrasound and magnetic resonance imaging (MRI). Endourethral ultrasound and MRI provided evidence of Peyronie's disease with atypical involvement of the corpus spongiosum and, in addition, demonstrated nonpalpable plaques in the septum of the penis.
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  • 171
    ISSN: 1432-1920
    Schlagwort(e): Key words Meningioangioma-tosis ; Magnetic resonance imaging ; Malignant meningioma
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Meningioangiomatosis (MA) is a rare benign intracranial tumour of uncertain pathogenesis, with only 33 cases reported in the literature. Imaging features have been described in 21 cases, only 3 with contrast-enhanced MRI. We present two cases of MA with MRI and/or CT findings and gross, ultrastructural, and immunohistochemical characteristics. MRI is particularly helpful for establishing the origin of the lesion and its anatomical location, while CT shows calcification, if present. The pathological characteristics establish the diagnosis and underline the differences from other entities such as malignant meningioma, one of the most important differential diagnostic considerations.
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  • 172
    Digitale Medien
    Digitale Medien
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    Neuroradiology 37 (1995), S. 127-128 
    ISSN: 1432-1920
    Schlagwort(e): Key words Central nervous sys- ; tem ; Siderosis ; Magnetic resonance imaging
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract We describe a rare entity, superficial siderosis of the central nervous system, due to multiple small episodes of subarachnoid haemorrhage from any source. Nonspecific neurological findings are associated with deposition of iron-containing pigments in the leptomeninges and superficial layers of the cortex. T2-weighted magnetic resonance imaging demonstrates characteristic low signal in the meninges.
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  • 173
    ISSN: 1432-1920
    Schlagwort(e): Key words Corpus callosum ; Hydrocephalus ; Dementia ; Magnetic resonance imaging
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract To investigate morphological changes in the corpus callosum in hydrocephalus and to correlate them with clinical findings we studied sagittal T2*-weighted cine MR images of 163 patients with hydrocephalus. The height, length and cross-sectional area of the corpus callosum were measured and related to the type of cerebrospinal fluid flow anomaly and to clinical features, especially dementia. With expansion of the lateral ventricles the corpus callosum showed mainly elevation of its body and, to a lesser degree, increase in length. Upward bowing was more pronounced in noncommunicating than in communicating hydrocephalus. Dorsal impingement on the corpus callosum by the free edge of the falx correlated with the height of the corpus callosum. Cross-sectional area did not correlate with either height, length or impingement; it was, however, the strongest anatomical discriminator between demented and nondemented patients. The area of the corpus callosum was significantly smaller in patients with white matter disease. Our findings suggest that, due to its plasticity, the corpus callosum can to some degree resist distortion in hydrocephalus. Dementia, although statistically related to atrophy of the corpus callosum, is possibly more directly related to white matter disease.
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  • 174
    Digitale Medien
    Digitale Medien
    Springer
    Neuroradiology 37 (1995), S. 297-302 
    ISSN: 1432-1920
    Schlagwort(e): Angiographically occult malformation ; Spinal arteriovenous malformation ; Cavernous malformation ; Magnetic resonance imaging
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract We reviewed 11 cases of intramedullary cavernous haemangiomas (IMCH) studied by MRI, to assess its diagnostic value in these lesions. Follow-up MRI was obtained in five patients 7 days-2 years following the initial study. In one case a postoperative examination was obtained. The diagnosis was pathologically proven in ten cases, and supported in the last by a family and personal history of cavernous haemangiomas. A reticulate appearance with areas of mixed signal intensity in both T1-and T2-weighted images was the most common finding. Homogeneous high, low or intermediate signal intensity was each found in one case, Two small lesions gave low signal. A rim of low signal was less common than in cerebral cavernous haemangiomas. In one case, the brain showed more than 20 lesions with the MRI appearances of cavernous haemangiomas. In two of five patients, serial preoperative MRI showed progressive disappearance of high-signal areas on both T1-and T2-weighted images. To find a haemorrhagic intramedullary lesion on MRI is not rare. Although the appearances are not pathognomonic, an IMCH can be suggested. We suggest that the following characteristics may help: (1) a personal and/or family history of cavernous haemangiomas; (2) typical MRI appearances of mixed acute, subacute and chronic haemorrhage; (3) a tendency for signal intensity to decrease on follow-up; (4) normal spinal angiography; and (5) associated brain lesions.
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  • 175
    Digitale Medien
    Digitale Medien
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    Neuroradiology 37 (1995), S. 303-307 
    ISSN: 1432-1920
    Schlagwort(e): Key words Spine ; neoplasm ; Lymphoma ; Magnetic resonance imaging
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract We reviewed the MRI features in eight patients with spinal epidural lymphoma (clinically primary in 4 patients); one patient had multiple lesions. The cervical spine was involved in one patient, the thoracolumbar spine in 5 and the sacrum in two. Mean longitudinal extension of the epidural lesion was 2.6 vertebral segments. The tumours were homogeneously isointense with the spinal cord on T1-weighted images and isointense or hyperintense on proton-density and T2-weighted images. The spinal cord was compressed in four patients but showed signal changes in only one. In five patients the lesions communicated through the intervertebral foramina with paravertebral soft tissue masses. In all but one of the patients diffuse signal changes in the vertebral body marrow consistent with osteolytic or osteoblastic changes were identified adjacent to or at distance from the epidural lesion. Vertebral collapse was observed in two patients.
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  • 176
    ISSN: 1432-1920
    Schlagwort(e): Key words Myelopathy ; Demyelinating disease ; Multiple sclerosis ; Magnetic resonance imaging
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract The role of cerebral and spinal cord MRI was investigated in 65 patients with myelopathy suspected of having demyelinating disease. Cerebral MRI demonstrated lesions compatible with demyelination in 80 % and spinal cord MRI in 68.6 %. In 28.5 % of our patients brain lesions were present with normal spinal cord images, but in 17 % spinal cord lesions were depicted with a normal brain MRI. The combination of the two examinations demonstrated lesions in 97 % of the patients. The frequency of coexistent cerebral lesions in patients with spinal cord lesions was over 85 % in patients with chronic disease but only 28.5 % in patients with acute myelitis.
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  • 177
    Digitale Medien
    Digitale Medien
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    Neuroradiology 37 (1995), S. 438-439 
    ISSN: 1432-1920
    Schlagwort(e): Key words Progressive dysphasia ; Status epilepticus ; Computed tomography ; Magnetic resonance imaging
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Status epilepticus is usually a straightforward diagnosis when a patient has two or more seizures without regaining consciousness. However, when status is nonconvulsive and, in particular, has a temporal lobe flavour the clinical presentation may be misleading. Presentation with automatic or psychic behaviour is well recorded. We report a patient with nonconvulsive status who presented with progressive dysphasia with widespread CT and MRI changes. The dysphasia and imaging changes led to a diagnosis of a probable neoplastic brain process but reversed with anticonvulsant treatment.
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  • 178
    ISSN: 1432-1920
    Schlagwort(e): Creutzfeldt-Jacob disease ; Magnetic resonance imaging ; Prion protein
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract We report a 66-year-old woman with histologically diagnosed Creutzfeldt-Jacob disease (CJD), followed with MRI from an early clinical stage. MRI demonstrated expansion of the high cortical signal on T2-weighted images, which differs from previous MRI reports of CJD. This patient followed an atypical clinical course: 16 months had passed before she developed akinetic mutism, and periodic sharp waves had not been detected on EEG after 2 years in spite of her akinetic mutism. Brain biopsy showed primary spongiform changes in the grey matter, and a point mutation of the prion protein gene at codon 180 was discovered using polymerase chain reaction direct sequencing and Tth 111 I cutting. This is the first case with the point mutation of the codon 180 variant with an atypical clinical course and characteristic MRI findings.
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  • 179
    ISSN: 1432-1920
    Schlagwort(e): Head injury ; Magnetic resonance imaging ; Neural networks
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract An automatic, neural network-based approach was applied to segment normal brain compartments and lesions on MR images. Two supervised networks, backpropagation (BPN) and counterpropagation, and two unsupervised networks, Kohonen learning vector quantizer and analog adaptive resonance theory, were trained on registered T2-weighted and proton density images. The classes of interest were background, gray matter, white matter, cerebrospinal fluid, macrocystic encephalomalacia, gliosis, and “unknown.” A comprehensive feature vector was chosen to discriminate these classes. The BPN combined with feature conditioning, multiple discriminant analysis followed by Hotelling transform, produced the most accurate and consistent classification results. Classifications of normal brain compartments were generally in agreement with expert interpretation of the images. Macrocystic encephalomalacia and gliosis were recognized and, except around the periphery, classified in agreement with the clinician's report used to train the neural network.
    Materialart: Digitale Medien
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  • 180
    Digitale Medien
    Digitale Medien
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    Neuroradiology 37 (1995), S. 557-558 
    ISSN: 1432-1920
    Schlagwort(e): Meninges ; Contrast enhancement ; Magnetic resonance imaging
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract We describe thickening and contrast enhancement of the intracranial pachymeninges, revealed by MRI in a patient with presumed low-pressure headache following dural puncture and a blood patch. The clinical and radiological abnormalities resolved within 2 weeks.
    Materialart: Digitale Medien
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  • 181
    Digitale Medien
    Digitale Medien
    Springer
    Neuroradiology 37 (1995), S. 576-577 
    ISSN: 1432-1920
    Schlagwort(e): Sjögren-Larsson syndrome ; Spastic diplegia ; Conduction aphasia ; Magnetic resonance imaging
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract We report a case of Sjögren-Larsson syndrome with spastic diplegia and conduction aphasia. MRI demonstrated the white matter changes deep in the cerebral hemispheres. We analyse the MRI findings and compare the results with neuropsychological signs.
    Materialart: Digitale Medien
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  • 182
    Digitale Medien
    Digitale Medien
    Springer
    Neuroradiology 37 (1995), S. 578-581 
    ISSN: 1432-1920
    Schlagwort(e): Lyme disease ; Magnetic resonance imaging ; Gadopentetate dimeglumine
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract We report the cranial CT and MRI findings in three children with Lyme disease (neuroborreliosis). The neuroimaging findings in children have been rarely reported. We found cranial MRI far superior to cranial CT. Ring-enhancing lesions have been described in acute disseminating encephalomyelitis and multiple sclerosis but not in neuroborreliosis. Although orther infectious and inflammatory diseases cannot be excluded, Lyme disease should be included in the differential diagnosis and put forward as being the most likely diagnosis in the appropriate clinical setting. Gadopentetate dimeglumine is helpful in assessing the response to antibiotic treatment.
    Materialart: Digitale Medien
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  • 183
    ISSN: 1432-1920
    Schlagwort(e): Magnetic resonance imaging ; Spatial autocorrelation ; Cerebral HIV disease
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract This study was carried out using MRI (proton density-and T2-weighted) on 16 HIV-negative controls, 9 symptom-free HIV-positive patients and 25 with CDC IV HIV disease. The studies from this last group had previously been allocated by a radiologist to the following categories: 8 with focal mass lesions and normal-appearing white matter; 9 with diffuse encephalopathy (high signal on T2-weighted images, affecting most or all of the white matter) and 8 with patchy encephalopathy (high signal affecting only one or two areas within the white matter). Moran'sI, a statistic of spatial autocorrelation, was calculated for the grey-scale values of a sampled pixel array from a central white matter region of each of the images. All values of Moran'sI calculated in this study showed a large positive excess over the expected value under randomisation, indicating highly significant positive autocorrelation in the spatial arrangement of the grey-scale values. On T2-weighted images a statistically significant increase in the mean value of Moran'sI, compared with controls, was found in the diffuse encephalopathy group, indicating that quantifiable changes in the spatial autocorrelation of pixel data can be related to recognised qualitative changes in the appearance of white matter in subjects with HIV disease. A lesser, but significant, rise in the mean value of Moran'sI was also found in the focal mass lesion group, suggesting that changes in spatial autocorrelation may indicate pathological change in advance of qualitative MRI changes.
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  • 184
    Digitale Medien
    Digitale Medien
    Springer
    Neuroradiology 37 (1995), S. 449-450 
    ISSN: 1432-1920
    Schlagwort(e): Pituitary Cryptococcosis ; Magnetic resonance imaging
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract We describe a rare pituitary cryptococcoma in an immunocompetent patient, with radiological features similar to those of a pituitary macroadenoma. Although unusual, it should be added to the list of differential diagnosis of pituitary masses. Contrast enhancement of adjacent meninges differentiated the lesion from an adenoma.
    Materialart: Digitale Medien
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  • 185
    Digitale Medien
    Digitale Medien
    Springer
    Neuroradiology 37 (1995), S. 465-467 
    ISSN: 1432-1920
    Schlagwort(e): Leiomyosarcoma, bone ; Spine ; Magnetic resonance imaging
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract We present a 39-year-old man with tumour of the eighth thoracic vertebra, causing compression of the spinal cord. The tumour proved to be a primary leiomyosarcoma (LMS) of bone, an uncommon neoplasm; to our knowledge this is the first report of primary LMS in the spine. The lesion was documented by plain radiography, myelography, CT, MRI and digital subtraction angiography. These investigations did help to focus on the differential diagnosis and demonstrated the extent of the bony lesion, the findings were nonspecific, and the correct diagnosis was established by pathological examination.
    Materialart: Digitale Medien
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  • 186
    ISSN: 1432-1920
    Schlagwort(e): Idiopathic orbital inflammatory syndrome ; Orbital pseudotumour ; Fat saturation ; Gadolinium ; Magnetic resonance imaging
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Idiopathic orbital inflammatory syndrome encompasses a group of inflammatory conditions for which no systemic or local cause can be found, and is commonly referred to as orbital pseudotumour. On conventional MRI sequences subtle areas of inflammation or enhancing tissue can easily be masked by the high signal intensity of orbital fat and involvement of the fat itself may not be appreciated. We describe the MRI features of three patients with idiopathic orbital inflammation using frequency-selective fat saturation and Gd-DTPA.
    Materialart: Digitale Medien
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  • 187
    Digitale Medien
    Digitale Medien
    Springer
    Neuroradiology 37 (1995), S. 515-521 
    ISSN: 1432-1920
    Schlagwort(e): Magnetic resonance imaging ; Brain neoplasms ; Tissue characterisation ; Magnetisation transfer contrast ; Gadolinium-DTPA
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract We performed MRI on 85 patients with intracranial tumours to evaluate quantitative analysis in tumour characterisation. Signal intensities were measured on standard T2-and T1-weighted images, Gd-enhanced T1-weighted images and magnetisation transfer (MT) images. Statistically significant differences between tumour types were observed, but overlapping reduces their value. T2-weighted imaging was superior to T1-weighted imaging for tumour characterisation. Quantification of Gd enhancement was useful in the diagnosis of pituitary adenomas and haemangioblastomas, but of minor importance in other tumours, because of large nonspecific variation. The contribution of MT contrast to tumour characterisation resembled that of T2 contrast. However, MT imaging was superior to other sequences in the classification of intra-axial tumours. Low-grade astrocytomas, haemangioblastomas and craniopharyngiomas could be differentiated from other tumours on the basis of MT contrast. Reliable discrimination between meningiomas, high-grade astrocytomas and metastases was not possible by any of the methods.
    Materialart: Digitale Medien
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  • 188
    ISSN: 1432-1920
    Schlagwort(e): Sinus thrombosis ; Reperfusion ; Cerebral infarction ; Computed tomography ; Magnetic resonance imaging
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract A 50-year-old woman with idiopathic deep cerebral sinus and vein thrombosis (DCVT) had cerebellar disturbance prior to impaired consciousness. CT and MRI revealed haemorrhagic infarction in the cerebellum and signal changes suggesting infarction in the thalamus and basal ganglia bilaterally. The straight sinus and internal cerebral vein (ICV) were dense on CT. On angiography, the vein of Galen (VG) and straight sinus were not seen. Following clinical recovery, CT and MRI became normal, and angiography showed recanalization of the VG and ICV. The relationship between cerebellar infarction and DCVT, and signal changes on CT and MRI are discussed.
    Materialart: Digitale Medien
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  • 189
    Digitale Medien
    Digitale Medien
    Springer
    Neuroradiology 37 (1995), S. 649-652 
    ISSN: 1432-1920
    Schlagwort(e): Carmofur ; 5-Fluorouracil ; Leukoencephalopathy ; Magnetic resonance imaging
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Carmofur, a derivative of 5-fluorouracil, has recently been noted to have an infrequent but serious association with leukoencephalopathy. To our knowledge, there has been no report of early MRI findings in this leukoencephalopathy. We describe a case in which diffuse high signal intensity of the entire cerebral white matter, including the corpus callosum, was seen on T2-weighted magnetic resonance images. Although similar findings can be seen in many other diseases, carmofur-induced leukoencephalopathy should be suspected in a patient treated with carmofur. It is important to know the clinical and MRI characteristics of this condition, for early diagnosis and better prognosis.
    Materialart: Digitale Medien
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  • 190
    ISSN: 1432-1920
    Schlagwort(e): Leukoencephalopathy ; White matter swelling ; Magnetic resonance imaging
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract In children, several neurological disorders are characterised by spongiform leukoencephalopathy. MRI of the brain typically shows white matter swelling, but does not enable differentiation of the various underlying disorders. The aim of this article is optimisation of the diagnostic value of MRI in leukoencephalopathy accompanied by swelling. MRI-based inclusion criteria were met by 20 patients in our database. The images were analysed using a detailed scoring list. In 13 of the 20 patients the clinical diagnosis was known (11 definite and 2 probable diagnoses). Characteristic MRI abnormalities could be defined in these patients. Of the 7 patients without a diagnosis, 5 had identical MRI abnormalities: difuse hemisphere swelling and typical cysts in frontoparietal subcortical white matter and the tips of the temporal lobes. The clinical picture was also similar in these patients, suggesting a similar disease.
    Materialart: Digitale Medien
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  • 191
    ISSN: 1432-1920
    Schlagwort(e): Astrocytoma ; Neural network ; Magnetic resonance imaging ; Brain neoplasms
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Several MRI features of supratentorial astrocytomas are associated with high histologic grade by statistically significant p values. We sought to apply this information prospectively to a group of astrocytomas in the prediction of tumor grade. We used 10 MRI features of fibrillary astrocytomas from 52 patient studies to develop neural network and multiple linear regression models for practical use in predicting tumor grade. The models were tested prospectively on MR images from 29 patient studies. The performance of the models was compared against that of a radiologist. Neural network accuracy was 61% in distinguishing between low and high grade tumors. Multiple linear regression achieved an accuracy of 59%. Assessment of the images by a radiologist yielded 57% accuracy. We conclude that while certain MRI parameters may be statistically related to astrocytoma histologic grade, neural network and linear regression models cannot reliably use them to predict tumor grade.
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  • 192
    Digitale Medien
    Digitale Medien
    Springer
    Neuroradiology 37 (1995), S. 104-108 
    ISSN: 1432-1920
    Schlagwort(e): Brain neoplasm diagnosis ; Magnetic resonance imaging ; Medulloblastoma
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Medulloblastomas are generally associated with childhood, but 14–30% occur in adults, accounting for 1% of adult central nervous system tumors. While approximately one third of adult medulloblastomas present as vermian tumors similar to those seen in childhood, the majority differ substantially from the childhood variety. In this series of 13 patients, 5 had lateral, seemingly extra-axial masses in the cerebellopontine angle or at the tentorium, simulating meningiomas or acoustic neuromas, but angiographic hypovascularity in 2 of the latter suggested a diagnosis other than meningioma. Of 4 paramedian tumors, 3 diffusely infiltrated the cerebellar white matter, showed little or no gadolinium enhancement and were not associated with hydrocephalus. Hydrocephalus was present in less than half of our patients; in childhood the reported incidence is 85–100%. A possible association with pregancy was noted.
    Materialart: Digitale Medien
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  • 193
    ISSN: 1432-1920
    Schlagwort(e): Corpus callosum ; Hydrocephalus ; Dementia ; Magnetic resonance imaging
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract To investigate morphological changes in the corpus callosum in hydrocephalus and to correlate them with clinical findings we studied sagittal T2*-weighted cine MR images of 163 patients with hydrocephalus. The height, length and cross-sectional area of the corpus callosum were measured and related to the type of cerebrospinal fluid flow anomaly and to clinical features, especially dementia. With expansion of the lateral ventricles the corpus callosum showed mainly elevation of its body and, to a lesser degree, increase in length. Upward bowing was more pronounced in noncommunicating than in communicating hydrocephalus. Dorsal impingement on the corpus callosum by the free edge of the falx correlated with the height of the corpus callosum. Cross-sectional area did not correlate with either height, length or impingement; it was, however, the strongest anatomical discriminator between demented and nondemented patients. The area of the corpus callosum was significantly smaller in patients with white matter disease. Our findings suggest that, due to its plasticity, the corpus callosum can to some degree resist distortion in hydrocephalus. Dementia, although statistically related to atrophy of the corpus callosum, is possibly more directly related to white matter disease.
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  • 194
    Digitale Medien
    Digitale Medien
    Springer
    Neuroradiology 37 (1995), S. 238-243 
    ISSN: 1432-1920
    Schlagwort(e): Ependymoma ; Posterior cranial fossa ; Children ; Magnetic resonance imaging ; Computed tomography ; Brain tumours
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract We studied nine children with posterior cranial fossa ependymomas to identify specific neuroradiological features. Patients were studied preoperatively with CT and MRI; T1-, T2-and proton-density (PD)-weighted images were obtained. All children underwent surgery and a definite histopathological diagnosis was made. All the tumours grew into the fourth ventricle and caused dilatation of its upper part, which resembled a cap. All but one were separated from the vermis by a cleavage plane. In eight cases there was desmoplastic development through the foramina of the fourth ventricle, and five were heterogeneous due to necrosis and cystic change; one had a haemorrhagic area. In most cases the solid portion was isointense with grey matter on T1-weighted images, hyperintense on PD weighting, and isointense on T2-weighted images. On CT the tumour was isodense in six cases and calcification was detected in four. The presence of both desmoplastic development and a tumour/vermis cleavage plane in a posterior cranial fossa tumour isodense on CT is highly suggestive of ependymoma.
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  • 195
    ISSN: 1432-1920
    Schlagwort(e): Internal auditory canal ; Acoustic schwannoma ; Magnetic resonance imaging
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Prospective baseline MRI was obtained on 31 patients who had “total” removal of acoustic schwannoma 6 months to 9 years previously. Follow-up MRI was performed after 1–2 years on patients with questionable abnormalities. We found four patterns (1) internal auditory canals (IAC) with nonenhancing soft-tissue strands, possibly scars or distorted residual nerves (8); (2) IAC with marginal enhancement-reactive dura mater (16); (3) IAC with contrast-enhancing globular tissues suggesting residual or recurrent tumour (5); (4) high-signal intensity in the IAC before contrast medium administration, probably related to graft with fat/fascia/muscle (2). Prospective 1-to 2-year follow-up studies were available in 8, 5, and 1 patients in groups 2, 3, and 4 respectively. In group 2, dural enhancement remained unchanged in 5 patients and decreased in 3. In group 3 follow-up showed 1 tumor recurrence (surgically confirmed) and 4 stable abnormalities. In group 4, follow-up in 1 of the 2 patients was stable. In groups 1 and 2, the MRI features correlate well with complete tumor removal. Whether follow-up in these groups is indicated needs to be determined. In group 3 residual or recurrent tumor cannot be excluded. In group 4, grafts may prevent adequate visualization of the IAC.
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  • 196
    Digitale Medien
    Digitale Medien
    Springer
    Neuroradiology 37 (1995), S. 331-333 
    ISSN: 1432-1920
    Schlagwort(e): Mineralizing microangiopathy ; Chemotherapy R ; Radiotherapy ; Computed tomography ; Magnetic resonance imaging
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Mineralizing microangiopathy, a distinctive histopathologic process involving the microvasculature of the central nervous system (CNS), is usually seen following combined radiation and chemotherapy for the treatment of CNS neoplasms in childhood. CT typically demonstrates calcification within the basal ganglia and subcortical white matter. The areas of calcification may give paradoxically increased signal on T1-weighted MRI due to a surface-relaxation mechanism, and decreased signal on T2-weighted images.
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  • 197
    Digitale Medien
    Digitale Medien
    Springer
    Neuroradiology 37 (1995), S. 297-302 
    ISSN: 1432-1920
    Schlagwort(e): Key words Angiographically occult malformation ; Spinal arteriovenous malformation ; Cavernous malformation ; Magnetic resonance imaging
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract We reviewed 11 cases of intramedullary cavernous haemangiomas (IMCH) studied by MRI, to assess its diagnostic value in these lesions. Follow-up MRI was obtained in five patients 7 days–2 years following the initial study. In one case a postoperative examination was obtained. The diagnosis was pathologically proven in ten cases, and supported in the last by a family and personal history of cavernous haemangiomas. A reticulate appearance with areas of mixed signal intensity in both T1- and T2-weighted images was the most common finding. Homogeneous high, low or intermediate signal intensity was each found in one case. Two small lesions gave low signal. A rim of low signal was less common than in cerebral cavernous haemangiomas. In one case, the brain showed more than 20 lesions with the MRI appearances of cavernous haemangiomas. In two of five patients, serial preoperative MRI showed progressive disappearance of high-signal areas on both T1- and T2-weighted images. To find a haemorrhagic intramedullary lesion on MRI is not rare. Although the appearances are not pathognomonic, an IMCH can be suggested. We suggest that the following characteristics may help: (1) a personal and/or family history of cavernous haemangiomas; (2) typical MRI appearances of mixed acute, subacute and chronic haemorrhage; (3) a tendency for signal intensity to decrease on follow-up; (4) normal spinal angiography; and (5) associated brain lesions.
    Materialart: Digitale Medien
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  • 198
    Digitale Medien
    Digitale Medien
    Springer
    Neuroradiology 37 (1995), S. 326-327 
    ISSN: 1432-1920
    Schlagwort(e): Key words Osteoblastoma ; Skull ; Magnetic resonance imaging
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract We investigated a 27-year-old woman with a retroauricular tumour. MRI revealed a signal void on T1- and T2-weighted images, and irregular enhancement with gadolinium-DTPA. The underlying dura mater also enhanced. The tumour was resected completely, and histological examination showed a benign osteoblastoma.
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  • 199
    Digitale Medien
    Digitale Medien
    Springer
    Neuroradiology 37 (1995), S. 356-361 
    ISSN: 1432-1920
    Schlagwort(e): Moyamoya disease ; Magnetic resonance imaging ; Cerebral angiography
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Our purpose was to evaluate the diagnostic accuracy of MRI in moyamoya disease. We studied 30 patients with this disease, comparing MRI and angiographic findings. The diagnostic value of MRI was evaluated for occlusive lesions, collateral vessels, and parenchymal lesions. In all patients bilateral occlusion or stenosis of the supraclinoid internal carotid artery and proximal anterior and middle cerebral arteries was clearly shown by MRI, and staging of the extent of occlusion agreed with angiographic staging in 44 (73%) of 60 arteries. MRI, particularly coronal images, clearly showed basal cerebral moyamoya vessels in 54 hemispheres, and 45 of a total of 71 large leptomeningeal and transdural collateral vessels were identified. MRI also showed parenchymal lesions in 48 (80%) hemispheres, and the extent of occlusion in the anterior and posterior circulations respectively correlated with white matter and cortical and/or subcortical infarcts.
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  • 200
    Digitale Medien
    Digitale Medien
    Springer
    Neuroradiology 37 (1995), S. 378-383 
    ISSN: 1432-1920
    Schlagwort(e): Lumbar disc herniation ; Conservative treatment ; Magnetic resonance imaging
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Using serial MRI, we studied 32 patients with herniated lumbar discs, treated conservatively, to clarify the natural history of this condition. MRI was performed in the acute stage, then 6 months and 1 year later. On axial images, the proportion of the cross-sectional area of the spinal canal occupied by the herniated disc was 31.9% on the average on the initial scan, 28.7% 6 months and 25.3% 1 year later. The size of the herniation decreased by more than 20% in 11 patients (34%), by 10–20 % in 8 (28%) and was unchaged in 12 (38%). The height of the disc slightly decreased with time, but there was no significant change in the angle of lordosis in the affected segment. The initial MRI revealed degeneration of all affected discs, and progressive degeneration was observed in 9 patients. The more degenerate the disc and the larger the initial herniation the more the size of the herniated fragment decreased.
    Materialart: Digitale Medien
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