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  • Magnetic resonance imaging  (281)
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  • 2005-2009
  • 1995-1999  (281)
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  • 101
    ISSN: 1432-1920
    Keywords: Key words Spinal subdural haematoma ; Magnetic resonance imaging ; Computed tomography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: 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.
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  • 102
    Electronic Resource
    Electronic Resource
    Springer
    Neuroradiology 41 (1999), S. 129-133 
    ISSN: 1432-1920
    Keywords: Key words Cryptococcosi ; Acquired immunodeficiency syndrome ; Computed tomography ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: 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.
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  • 103
    Electronic Resource
    Electronic Resource
    Springer
    Neuroradiology 41 (1999), S. 158-162 
    ISSN: 1432-1920
    Keywords: Key words Midbrain ; tumours ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: 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.
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  • 104
    Electronic Resource
    Electronic Resource
    Springer
    Neuroradiology 41 (1999), S. 175-178 
    ISSN: 1432-1920
    Keywords: Key words Infarct ; cerebral ; Computed tomography ; Magnetic resonance imaging ; diffusion-weighted
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: 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.
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  • 105
    ISSN: 1432-1920
    Keywords: Key words Shunt ; portosystemic ; Globus pallidus ; Manganese ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: 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.
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  • 106
    ISSN: 1432-1920
    Keywords: Key words Cerebral infarcts ; Magnetic resonance imaging ; Contrast enhancement
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: 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.
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  • 107
    Electronic Resource
    Electronic Resource
    Springer
    Neuroradiology 41 (1999), S. 428-432 
    ISSN: 1432-1920
    Keywords: Key words Tuberous sclerosis ; Magnetic resonance imaging ; Focal cortical dysplasia ; Cortical dysgenesis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: 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.
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  • 108
    Electronic Resource
    Electronic Resource
    Springer
    Neuroradiology 41 (1999), S. 443-446 
    ISSN: 1432-1920
    Keywords: Key words Langerhans cell histiocytosis ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: 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.
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  • 109
    ISSN: 1432-1920
    Keywords: Key words Dural arteriovenous fistula ; Craniocervical junction ; Magnetic resonance imaging ; Venous hypertension
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: 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.
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  • 110
    Electronic Resource
    Electronic Resource
    Springer
    Der Radiologe 39 (1999), S. 828-837 
    ISSN: 1432-2102
    Keywords: Schlüsselwörter Zerebrovaskuläre Erkrankungen ; Intrazerebrale Blutung ; Magnetresonanztomographie ; Computertomographie ; Key Words Cerebrovascular diseases ; Intracerebral hemorrhage ; Magnetic resonance imaging ; Computed tomography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: 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.
    Notes: 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.
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  • 111
    Electronic Resource
    Electronic Resource
    Springer
    Der Radiologe 39 (1999), S. 889-893 
    ISSN: 1432-2102
    Keywords: Schlüsselwörter Sarkoidose ; Neurosarkoidose ; Magnetresonanztomographie ; Key words Sarcoidosis ; Neurosarcoidosis ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: 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.
    Notes: 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.
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  • 112
    ISSN: 1432-2102
    Keywords: 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
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: 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.
    Notes: 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.
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  • 113
    ISSN: 1432-2102
    Keywords: Schlüsselwörter Intrazerebrale Blutung ; Kernspintomographie ; MR-Angiographie ; Key words Intracerebral hematoma ; Magnetic resonance imaging ; Magnetic resonance angiography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: 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.
    Notes: 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.
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  • 114
    ISSN: 1432-2102
    Keywords: Schlüsselwörter Schlaganfall ; Intrazerebrale Blutung ; Magnetresonanztomographie ; Computertomographie ; Ratten ; Key words Cerebrovascular diseases ; Intracerebral hemorrhage ; Magnetic resonance imaging ; Rats
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: 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.
    Notes: 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.
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  • 115
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    Springer
    Experimental brain research 125 (1999), S. 417-425 
    ISSN: 1432-1106
    Keywords: Key words Motor learning ; Motor cortex ; Magnetic resonance imaging ; Musicians ; Hand motor skill
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: 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
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    European radiology 9 (1999), S. 457-459 
    ISSN: 1432-1084
    Keywords: Key words: Retroperitoneal neoplasms ; Retroperitoneal space ; Computed tomography ; Magnetic resonance imaging ; Ultrasonography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: 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
    Keywords: Key words Parkinson’s disease ; Depression ; Brainstem midline ; changes ; Transcranial sonography ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: 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
    Keywords: Key words Multiple sclerosis ; Magnetic resonance imaging ; Enhancing lesions ; Interferon-β1a
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: 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
    Keywords: Key words Multiple sclerosis ; Magnetic resonance imaging ; Disease activity ; Fast spin echo ; Fast fluid-attenuated inversion ; recovery ; Reproducibility
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: 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
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    Journal of neurology 246 (1999), S. 1169-1171 
    ISSN: 1432-1459
    Keywords: Key words European tick-borne encephalitis ; Magnetic resonance imaging ; Central nervous system
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: 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
    Keywords: Key words Temporal lobe epilepsy ; Hippocampus ; Magnetic resonance imaging ; Fluoro-2-deoxy-d-glucose positron-emission tomography ; Wada test
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: 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
    Keywords: Key words Multiple sclerosis ; Magnetic resonance imaging ; Gadolinium-DTPA ; Triple dose ; Blood-brain barrier
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: 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
    Keywords: Gadolinium(III) complexes ; Contrast agents ; Magnetic resonance imaging ; Human serum albumin ; Proton relaxation enhancement
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Chemistry and Pharmacology
    Notes: 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
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    Child's nervous system 15 (1999), S. 624-634 
    ISSN: 1433-0350
    Keywords: Key words Brain imaging ; Magnetic resonance imaging ; brain ; Magnetic resonance spectroscopy ; brain ; Computed tomography ; brain ; Diffusion imaging ; brain
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: 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
    Keywords: Key words Abscess ; Spinal cord ; Dermal sinus ; Epidermoid ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: 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
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    Child's nervous system 15 (1999), S. 359-361 
    ISSN: 1433-0350
    Keywords: Key words Computerized tomography ; Intracranial tumor ; Magnetic resonance imaging ; Posterior fossa ; Teratoma
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: 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
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    Skeletal radiology 28 (1999), S. 383-389 
    ISSN: 1432-2161
    Keywords: Key words Allografts ; Osteoarticular ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: 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
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    Skeletal radiology 28 (1999), S. 447-452 
    ISSN: 1432-2161
    Keywords: Key words Plantar fascia ; aponeurosis ; Fasciitis ; Fasciotomy ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: 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
    Keywords: Key words Hand ; Wrist ; Magnetic resonance imaging ; Soft tissue mass ; Neoplasm ; Tumour ; Tendon diseases
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: 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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    Skeletal radiology 28 (1999), S. 96-99 
    ISSN: 1432-2161
    Keywords: Key words Computed tomography ; Granular cell tumor ; Magnetic resonance imaging ; Subcutis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: 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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    Child's nervous system 15 (1999), S. 8-10 
    ISSN: 1433-0350
    Keywords: Key words Cavernous sinus ; Meningioma ; Child ; Ophthalmoplegia ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: 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
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    Child's nervous system 15 (1999), S. 209-211 
    ISSN: 1433-0350
    Keywords: Key words Anterior sacral meningocele ; Epidermoid tumor ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: 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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    Der Radiologe 39 (1999), S. 847-854 
    ISSN: 1432-2102
    Keywords: Schlüsselwörter Zerebrale Amyloidangiopathie ; Intrazerebrale Blutung ; Computertomographie ; Kernspintomographie ; Key words Cerebral amyloid angiopathy ; Intracerebral hemorrhage ; Computed tomography ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: 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.
    Notes: 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
    Keywords: Schlüsselwörter Staging thorakoabdominaler Tumoren ; Kinder ; Computertomographie (CT) ; Magnetresonanztomographie (MRT) ; Malignome ; Key words Staging of tumors ; Thoracoabdominal tumors ; Childhood ; Computed tomography ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: 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.
    Notes: 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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    Der Radiologe 39 (1999), S. 562-567 
    ISSN: 1432-2102
    Keywords: Schlüsselwörter Kolorektales Karzinom ; Präoperatives Staging ; Endosonographie ; CT ; MRT ; Key words Colorectal cancer ; Preoperative staging ; Endosonography ; Computed tomography ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: 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%.
    Notes: 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
    Keywords: Key words Donor site morbidity ; Anterior cruciate ligament ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine , Sports Science
    Notes: 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
    Keywords: Key words Meniscus ; Degeneration ; Magnetic resonance imaging ; Histology ; Chronicity of the meniscal tear
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine , Sports Science
    Notes: 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
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    Journal of neurology 246 (1999), S. 16-20 
    ISSN: 1432-1459
    Keywords: Key words Dementia ; Alzheimer’s disease ; Neuroimaging ; Magnetic resonance imaging ; Single photon emission computed tomography ; Atrophy ; Hippocampus
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: 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
    Keywords: Key words Spinocerebellar ataxia type 2 ; Magnetic resonance imaging ; Cerebral atrophy ; Disease duration
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: 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
    Keywords: Kerspintomographie ; Kollateralbandruptur ; Knorpelläsion ; Hochauflösende Oberflächenspule ; Magnetic resonance imaging ; Collateral ligament rupture ; Cartilage lesion ; High-resolution coil
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: 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.
    Notes: 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
    Keywords: Key words: Autism ; Brain ; Technetium-99m ethyl cysteinate dimer ; Single-photon emission tomography ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: 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
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    European journal of applied physiology 79 (1999), S. 367-373 
    ISSN: 1439-6327
    Keywords: Key words Cerebral edema ; Cerebrospinal fluid ; Head-down tilt ; Intracranial pressure ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: 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
    Keywords: Blood flow ; Magnetic resonance imaging ; Numerical flow modeling ; Carotid artery ; Three-dimensional ; Wall shear stress ; Atherosclerosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine , Technology
    Notes: 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
    Keywords: Medical imaging ; Magnetic resonance imaging ; Biomechanics ; Tendon moment arm ; Functional neuromuscular stimulation ; Tendon transfer surgery ; Hand biomechanics
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine , Technology
    Notes: 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
    ISSN: 1530-0358
    Keywords: Rectal cancer ; Computed tomography ; Radiotherapy ; Endorectal ultrasound ; Staging ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract PURPOSE: The postradiation preoperative staging results of 25 patients with rectal cancer who were found to have Stage T0,N0 lesions after surgery were examined. Our aim was to assess the ability of preoperative staging following radiation therapy to predict the absence of disease. METHODS: From 1983 to 1994, 25 patients treated with preoperative radiation therapy for biopsy-proven rectal cancer were found to have no pathologic evidence of disease in the resected specimen (T0,N0). The preoperative postradiation disease staging results of these patients were compared with the postoperative pathologic findings. Each patient received 4,500 to 5,580 cGy during a five-week to six-week period, and four patients had preoperative chemotherapy. Surgical resection was performed six to eight weeks after completion of radiation therapy. All 25 patients were staged by digital rectal examination before surgery. In addition, 13 patients were assessed using computed tomography, 6 by endorectal ultrasound, and 1 by magnetic resonance imaging. RESULTS: Most irradiated lesions were overstaged by radiologic assessment and physical examination. No technique could reliably distinguish between postradiation fibrosis and residual cancer. The negative predictive value for digital rectal examination was 24 percent. Computed tomography accurately staged 23 percent of lesions, and endorectal ultrasound predicted 17 percent of lesions correctly. The single patient evaluated by magnetic resonance imaging was overstaged and thought to have a T2 lesion. CONCLUSIONS: Our ability to assess local eradication of rectal cancer following radiation therapy remains poor. Conventional imaging and clinical examination techniques are unable to safely predict which patients do not require surgical excision following curative radiation therapy for rectal cancer.
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  • 146
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    Surgical and radiologic anatomy 19 (1997), S. 105-109 
    ISSN: 1279-8517
    Keywords: Brain asymmetry ; Fornix ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract This article reports the observation that there is a left/right asymmetry of the anterior columns of the fornix in the human brain. This asymmetry is present in the position of the two columns of the fornix in relation to the septum pellucidum. The left columna fornicis was found to be located caudal to the right, and this can be readily visualized on axial MRI scans. This difference was seen in most of the subjects, but in some subjects there was no left/right-difference and in a few the asymmetry was inverse. The asymmetry of the fornix with respect to the anterior-posterior axis was independent of the well-known dissimilar lateral ventricular volumes. However, the left/right difference in the position of the fornix was evident in subjects with or without differences in ventricular volumes. This suggests that the mechanism underlying the development of asymmetry of the fornix is independent of the mechanism leading to ventricular asymmetry. So far, no functional relevance has been ascribed to such differences in location. The finding is gaining interest in connection with recent reports of asymmetries in hippocampal subfields. Studies of fornical lesions should therefore give attention to possible side-to-side differences.
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  • 147
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    Surgical and radiologic anatomy 19 (1997), S. 105-109 
    ISSN: 1279-8517
    Keywords: Brain asymmetry ; Fornix ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé Cet article rapporte l'existence d'une asymétrie droite/gauche des colonnes du fornix chez l'Homme. Cette asymétrie apparaît dans les plans en relation avec le septum pellucidum. Le pilier gauche du fornix apparaît en position plus caudale que le droit et ceci peut être bien visualisé sur des coupes IRM axiales. Cette différence existait chez la plupart des sujets. Chez certains, il n'y avait pas de différence gauche/droite et chez quelques sujets, l'asymétrie était inversée. L'asymétrie du fornix dans le sens antéropostérieur était indépendante de l'asymétrie bien connue des volumes ventriculaires latéraux. Quoi qu'il en soit, l'asymétrie droite/gauche de la position des piliers du fornix était évidente chez les sujets qui présentaient où ne présentaient pas de différence de volume ventriculaire. Ceci suggère que le mécanisme sousjacent du développement de l'asymétrie du fornix est indépendante du mécanisme conduisant à l'asymétrie ventriculaire. De plus, aucune conséquence fonctionnelle n'a été décrite en rapport avec de telle différence. Ces résultats sont rapprochés aux études récentes concernant les asymétries des champs hippocampiques. Les études de lésions du fornix devraient par la suite tenir compte de ces différences droite ou gauche.
    Notes: Summary This article reports the observation that there is a left/right asymmetry of the anterior columns of the fornix in the human brain. This asymmetry is present in the position of the two columns of the fornix in relation to the septum pellucidum. The left columna fornicis was found to be located caudal to the right, and this can be readily visualized on axial MRI scans. This difference was seen in most of the subjects, but in some subjects there was no left/right-difference and in a few the asymmetry was inverse. The asymmetry of the fornix with respect to the anterior-posterior axis was independent of the well-known dissimilar lateral ventricular volumes. However, the left/right difference in the position of the fornix was evident in subjects with or without differences in ventricular volumes. This suggests that the mechanism underlying the development of asymmetry of the fornix is independent of the mechanism leading to ventricular asymmetry. So far, no functional relevance has been ascribed to such differences in location. The finding is gaining interest in connection with recent reports of asymmetries in hippocampal subfields. Studies of fornical lesions should therefore give attention to possible side-to-side differences.
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  • 148
    ISSN: 1438-1435
    Keywords: Cervical vertebrae ; Facet dislocation ; Computed tomography ; Magnetic resonance imaging ; Diagnostic imaging ; Joint injury
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We describe neural foraminal enlargement as a radiologic sign indicating bilateral interfacetal dislocation or subluxation injuries (BID/S) of the lower cervical spine on axial images. Axial neural formainal width was measured by computed tomography or magnetic resonance imaging in 10 patients with BID/S and compared with measurements in 20 control patients. In both the BID/S patients and controls, the size of the foramina at the injured level was compared with the foramina at levels immediately above and below the injury. These measurements were compared for statistical significance using Student's t-test. The width of the injured foramina averaged 10.4 mm in BID/S and 5.3 mm in controls (P〈0.001). The enlargement in the BID/S cases relative to foramina above and below the injured level was statistically significant. The sign was also assessed qualitatively for detection of BID/S by three reviewers blindly analyzing 19 cases (9 BID/S and 10 controls) for signs of widened neural foramina. The pooled blinded review yielded a sensitivity of 81% and a specificity of 83% for neural foraminal enlargement as a sign indicative of BID/S. We describe enlargement, of neural foramina as a radiologic sign corroborative of BID/S on axial images.
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  • 149
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    Emergency radiology 4 (1997), S. 249-254 
    ISSN: 1438-1435
    Keywords: Infarction ; Stroke ; Transient ischemic attack ; Diffusion imaging ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract This article attempts to answer the most common questions on the use of diffusion magnetic resonance imaging to distinguish between acute cerebral infarction and transient ischemic attack in patients who present with the symptoms of stroke.
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  • 150
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    Der Orthopäde 26 (1997), S. 59-66 
    ISSN: 1433-0431
    Keywords: Schlüsselwörter Hüftluxation ; Kernspintomographie ; Computertomographie ; Reposition ; Normalwerte ; Key words Hip dysplasia ; Magnetic resonance imaging ; Computed tomography ; Reduction
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Magnetic resonance imaging (MRI) and computed tomography (CT) are useful techniques for the objective documentation of the relation between the femoral head and the acetabulum after closed or open reduction of a developmental dislocation of the hip joint. Before the ossification nucleus of the femoral head is sufficiently developed, MRI is preferred. For the evaluation of reduction from the 2nd year on, MRI and CT are equivalent. However, in older children MRI may also be indicated for the evaluation of cartilaginous structures or the diagnosis of femoral head necrosis. CT in older patients may also be useful for 30 analysis of bony structures, e. g. for planning complex osteotomies.
    Notes: Zusammenfassung Kernspintomogramm (MRI) und Computertomogramm (CT) sind geeignete Methoden zur objektiven Erfassung der Zentrierung nach offener oder geschlossener Reposition einer Hüftgelenkluxation und können in besonderen Situationen die Arthrographie ersetzen. Bis zur ausreichenden Ossifikation der Hüftkopfkerne, d. h. im 1. Lebensjahr, ist dem MRI der Vorzug zu geben. Vom 2. Lebensjahr an ist für die Beurteilung des Repositionsergebnisses das CT gleichwertig. Beim älteren Kind kann das MRI aber auch indiziert sein für die Beurteilung der knorpeligen Hüftstrukturen oder zur Diagnose einer Femurkopfnekrose. In höherem Alter können durch eine aufwendige CT-Untersuchung die knöchernen Verhältnisse auch dreidimensional dargestellt werden, z. B. zur Planung komplexer Korrekturosteotomien.
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  • 151
    ISSN: 1433-044X
    Keywords: Schlüsselwörter Thorakolumbale Wirbelfraktur ; Instabilität ; Bandscheibendegeneration ; Magnetresonanztomographie ; Key words Thoracolumbar fracture ; Instability ; Disc degeneration ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: To analyse the possible injuries of vertebral segments, especially the disc, after unstable thoracolumbar fractures stabilised with AO internal fixator, we performed magnetic resonance imaging (MRI) of the traumatised region after implant removal. There were two aspects of disc degeneration (DD): (1) biochemical changes and (2) structural damage. MRI detects biochemical processes as one aspect of DD that is often small even in the presence of greater structural damage of the nucleus pulposus caused by fracture. None of the patients presented with structural failure of the anulus fibrosus, which is the essential structural component of the vertebral segments with regard to stability. We observed biochemical changes more often in the lower of the two fracture-adjacent discs and alterations of discal shape more often in the upper of the two, whereas loss of height concerned both discs to approximately the same degree. The supporters of upper-disc resection in thoracolumbar fractures justify their procedure among other things with the structural disc damage, such as alteration of shape and loss of height (altogether more frequent in the upper disc). Our observations that a disc with a structurally altered nucleus pulposus can be biochemically intact and can show an intact anulus fibrosus are arguments in favour of disc preservation. With regard to the upper disc, the widespread opinion that complete and regular disc damage requires a resection has to be revised. The question of whether the lower disc should be resected more often because of its greater biochemical changes cannot be answered by the present study alone. Besides the excellent static information in all anatomical structures of the vertebral column available by MRI, a repeat examination in a prone position yields dynamic information on the spinal cord in the case of suspected dorsal adhesions.
    Notes: Zur Analyse möglicher Unfallfolgen an vertebralen Bewegungssegmenten und insbesondere der Bandscheiben nach instabilen, mittels Fixateur interne versorgten thorakolumbalen Wirbelfrakturen führten wir bei 33 Patienten eine Magnetresonanztomographie (MRT) der Verletzungsregion nach der Implantatentfernung durch. Bei der Bandscheibendegeneration nach instabilen thorakolumbalen Wirbelfrakturen sind strukturelle von biochemischen Veränderungen zu unterscheiden. Die mittels MRT bestimmbare biochemische Degeneration findet sich deutlich seltener als ein morphologischer Schaden des Nucleus pulposus. Verletzungen des Anulus fibrosus, der eigentlich stabilisierenden Struktur der vertebralen Bewegungssegmente, wurden bei keinem Patienten beobachtet. Im Vergleich zur frakturbenachbarten oberen Bandscheibe ist der untere Diskus nach Ausheilung der Fraktur zwar weniger von Veränderungen der Form, jedoch häufiger von biochemischer Abnutzung und etwa gleich stark von Höhenverlust betroffen. Die Befürworter einer Resektion der oberen Bandscheibe bei der operativen Behandlung thorakolumbaler Wirbelfrakturen begründen ihr Procedere u. a. mit dem strukturellen Bandscheibenschaden, wie z. B. Höhenverlust und Impaktierung von Bandscheibengewebe in den Wirbelkörper, die in der Summe häufiger bei dem frakturbenachbarten oberen Diskus beobachtet werden. Unsere Beobachtungen, wonach eine Bandscheibe trotz morphologischer Schädigung des Gallertkerns einen dennoch biochemisch intakten Nucleus pulposus und strukturell unversehrten Anulus fibrosus aufweisen kann, sprechen eher für den Erhalt des betreffenden Diskus. Für die frakturbenachbarte obere Zwischenwirbelscheibe (seltener biochemisch degeneriert) bedeutet dies, daß die weitverbreitete Ansicht von der regelmäßigen Zerstörung und demzufolge obligaten Resektion zu überdenken ist. Die Frage, ob die untere Bandscheibe bei nachgewiesenermaßen ausgeprägter biochemischer Degeneration entsprechend häufiger reseziert werden sollte, kann durch die vorliegende Studie allein nicht beantwortet werden. Neben der statischen Beurteilbarkeit sämtlicher anatomischer Strukturen der Wirbelsäule in der MRT liefert die Wiederholung der Untersuchung in Bauchlage eine dynamische Information über das Verhalten des Rückenmarkes bei Verdacht auf dorsale Adhäsion.
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  • 152
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    Der Nervenarzt 68 (1997), S. 792-800 
    ISSN: 1433-0407
    Keywords: Schlüsselwörter Okuläre Myositis ; Orbitale Myositis ; Vergrößerung ; Extraokulärer Augenmuskeln ; Orbitale Kernspintomographie ; Orbitale Computertomographie ; Key words Ocular myositis ; Orbital myositis ; Enlarged extraocular muscles ; Magnetic resonance imaging ; Computed tomography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary We report a young woman presenting with „painful diplopia” caused by inflammation of external eye muscles affecting both eyes sequentially. Orbital MRI disclosed swelling, signal hyperintensity and enhancement of isolated eye muscles. Corticosteroid treatment led to a complete remission within a few days. The compiled data of a literature review enclosing 52 sufficiently documented patients diagnosed as orbital myositis is reported with respect to clinical features, laboratory findings, associated disease, value of imaging procedures (CT, MRI). Therapeutic aspects and differential diagnosis are reviewed.
    Notes: Zusammenfassung Eine junge Patientin mit subakuter schmerzhafter Diplopie als Folge von entzündlichen Veränderungen der äußeren Augenmuskeln, die sequentiell beide Augen betrafen, wird vorgestellt. Das orbitale Kernspintomogramm zeigte eine Schwellung, Signalhyperintensität und Kontrastmittelanreicherung einzelner Augenmuskeln. Die Behandlung mit Kortikosteroiden führte zu einer vollständigen Remission der Symptomatik innerhalb weniger Tage. Aufgrund der Daten von insgesamt 52 gut dokumentierten Patienten mit okulärer Myositis aus der Literatur stellen bewegungsabhängige retrobulbäre Schmerzen (94%) mit Diplopie (85%) die Kernsymptome des Krankheitsbildes dar. Ein weiterer klinischer Hauptbefund ist die konjunktivale Injektion (73%), meistens an der Insertionsstelle des betroffenen Muskels. Die exophthalmische Form mit zusätzlichem Lidödem, Ptose, Chemose und Exophthalmus tritt seltener auf (24%), eine Visusabnahme ist die Ausnahme. Ein beidseitiger Augenmuskelbefall, typischerweise sequentiell, wird in 40% beobachtet. Frauen sind häufiger betroffen (73%), das mittlere Erkrankungsalter liegt bei 34 Jahren. Der M. rectus medialis ist der am häufigsten betroffene Muskel (70%). Die Diagnosesicherung gelingt heute mit der Kernspintomographie auch in leichteren Fällen. Der durch die Entzündung erhöhte Wassergehalt der befallenen Muskeln erklärt die gegenüber der Computertomographie erhöhte Sensitivität der Kernspintomographie. Therapie der Wahl ist die Behandlung mit Kortikosteroiden, hierunter kommt es in 90% innerhalb von Tagen zur Abheilung. Bei zu kurzer Therapiedauer sind Rezidive häufig. Bei Therapieresistenz ist die niedrigdosierte Bestrahlung meist effizient.
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  • 153
    ISSN: 1432-2161
    Keywords: Key words Gorham syndrome ; Massive osteolysis ; Spine ; Thorax ; Magnetic resonance imaging ; Computed tomography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Gorham syndrome is a rare disorder that is characterized by local osseous invasion and surrounding soft tissues by an angiomatous mass, eventually causing lysis of the affected bone. To date, only four cases have reported the MR imaging appearance of this disease and the findings have been variable. We present a case involving the cervical and thoracic spine and part of the osseous hemithorax with attention to the MR findings.
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  • 154
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    Skeletal radiology 26 (1997), S. 60-63 
    ISSN: 1432-2161
    Keywords: Key words Neurilemmoma (schwannoma) ; Bone neoplasms ; Magnetic resonance imaging ; Magnetic resonance contrast enhancement
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  We present a case of intraosseous neurilemmoma of the fibula in a 56-year-old woman. This case showed the typical radiographic appearance except for the presence of spotted calcifications that mimicked a cartilaginous tumor. Enhanced MR images revealed the heterogeneity of the tumor, which consisted of Antoni type A and B tissue.
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  • 155
    ISSN: 1432-2161
    Keywords: Key words Bone marrow ; MR studies ; Bone marrow ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Objective. To correlate the MR appearance of the proximal femur marrow with clinical and blood parameters. Design and patients. The proportion of the femoral neck surface area occupied by red marrow was determined on T1-weighted magnetic resonance (MR) images of the hip in a series of 120 subjects, aged from 15 to 75 years, with ten females and ten males per decade, and correlated with clinical data. This parameter and the bulk T1 values of femoral red marrow were determined in 30 other subjects 25–46 years of age and correlated with their blood parameters. Results. In the series of 120 subjects, the proportion of red marrow surface area decreased with age (P〈10–4) and was higher in female than male subjects (P〈10–4). Within each decade, the proportion of red marrow surface area was higher in females than in males between 25 and 65 years but neither before 25 nor after 65 years. In the series of 30 subjects, the proportion of red marrow surface area and bulk T1 values of femoral red marrow were significantly negatively correlated with hemoglobin blood levels but not with blood cell counts. Conclusion. The MR appearance of proximal femur red marrow is influenced by age and sex. A relationship with hemoglobin blood level is demonstrated.
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  • 156
    ISSN: 1432-2161
    Keywords: Key words Fibrolipomatous hamartoma ; Macrodystrophia lipomatosa ; Magnetic resonance imaging ; Peripheral nerve disease ; Lipofibromatous hamartoma ; Median nerve
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Objective. To analyze the MR imaging features of fibrolipomatous hamartoma (FLH) of nerves. Design and patients. MR imaging studies from six patients (three men and three women) were retrospectively reviewed by three musculoskeletal radiologists. In four patients, a biopsy of the nerve lesion was performed. In two patients, biopsy data were unavailable and the diagnosis was based on the clinical history combined with the MR imaging findings. Results and conclusion. MR imaging demonstrated fusiform nerve enlargement that was caused by fatty proliferation and thickening of nerve bundles. Nerve bundles appeared as serpentine tubular structures, hypointense on both T1- and T2-weighted images. The degree of fatty proliferation varied among patients. In addition, significant variation in the distribution of fat along the course of the nerves was noted. In three patients, FLH followed the branching pattern of the nerves, a characteristic pathologic finding. In two patients, intramuscular fat deposition (biceps and tibialis posterior muscles) was present. MR imaging findings of FLH are typical, allowing a confident diagnosis. The variation of fatty proliferation among patients and involved nerves as well as the tendency of the abnormalities to follow the branching pattern of the nerves is well demonstrated with MR imaging. FLH may present as an isolated nerve lesion, may be associated with intramuscular fat deposition, or may occur as a feature of macrodystrophia lipomatosa (MDL).
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  • 157
    ISSN: 1279-8517
    Keywords: Ocular development ; Orbit ; Fetus ; Eye ; Magnetic resonance imaging ; Anatomy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé Le but de cette étude est de mesurer la croissance oculaire fœtale et de déterminer une courbe à l'aide de mesuresin utero. La croissance oculaire fœtale a été établie par l'analyse des images obtenues en imagerie par résonance magnétique (IRM). L'étude anatomique a permis de définir les meilleures séquences contrastées en IRM pour calculer la surface oculaire. L'analyse biométrique des valeurs de la surface oculaire dans le plan neuro-oculaire de 35 fœtus nous a permis d'établir une modélisation linéaire de la courbe de croissance oculaire in utero. L'évaluation de la croissance oculaire peut permettre de déceler et de confirmer des anomalies malformatives oculaires comme les microphtalmies.
    Notes: Summary The aim of this study was to measure fetal ocular development and to determine a growth curve by means of measurementsin utero. Fetal ocular development was recorded by analysis of the results of magnetic resonance imaging (MRI). An anatomic study allowed definition of the best contrasted MRI sequences for calculation of the ocular surface. Biometric analysis of the values of the ocular surface in the neuro-ocular plane in 35 fetuses allowed establishment of a linear model of ocular growth curvein utero. Evaluation of ocular development may allow the detection and confirmation of malformational ocular anomalies such as microphthalmia.
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  • 158
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    Acta neurochirurgica 139 (1997), S. 478-479 
    ISSN: 0942-0940
    Keywords: Magnetic resonance imaging ; cerebral infarction ; neoplastic angioendotheliosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
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  • 159
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    Acta neurochirurgica 139 (1997), S. 613-618 
    ISSN: 0942-0940
    Keywords: Magnetic resonance imaging ; monoclonal antibody ; pituitary adenoma ; proliferative potential ; regrowth
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The proliferative potential of 45 pituitary adenomas was compared with their biological behaviour as determined by immunohistochemical studies, radiological findings, and clinical manifestations. The PCI (proliferating cell index) as measured using antibody MIB-1 in this study ranged from 0.05 to 4.80%, with an average PCI of 1.49±0.19% (mean±standard error of the mean). There was no significant correlation between proliferation and hormonal state, maximum size, intra-adenomatous haemorrhage, or invasiveness. However, a PCI ≧ 1.5% appeared to correlate with the likelihood of tumour regrowth (regrowth rate: 50%); for PCIs 〈 1.5%, the rate was 16%. Regrowth adenomas had a higher mean MIB-1 PCI than non-regrowth adenomas [2.34±0.58% (SE) versus 1.14±0.16%, p ≦ 0.05]. MIB-1 PCIs may provide information that is useful for planning follow-up studies and treatment after surgical resection.
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  • 160
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    European journal of pediatrics 156 (1997), S. 367-370 
    ISSN: 1432-1076
    Keywords: Key words Childhood leukaemia treatment long-term side-effects  ;  Cerebral haemorrhage  ;  Cavernous angioma  ;  Central nervous capillary telangiectases  ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Modern treatment of childhood acute lymphoblastic leukaemia (ALL) has dramatically improved the prognosis for children with this disease. Therapeutic approaches consist of multimodal chemotherapy and radiotherapy with significant long-term side-effects. We report on 4 children out of a group of 120 newly diagnosed patients with ALL, who survived the disease for more than 2 years and developed a cerebral haemorrhage after chemotherapy and fractionated cranial irradiation. Following a period of 2–12 years the four children presented with acute neurological signs and symptoms, i.e. seizures, ataxia and hemiparesis. CT and MRI revealed intracerebral mass lesions, interpreted as haemorrhage. After neurosurgery the patients neurological state improved. Histological examination confirmed the suspected diagnosis of bleeding cavernous haemangioma or capillary telangiectases. There are two possibilities to explain these rare alterations: they may be pre-existent to the disease and therapy or they may be caused by irradiation. Conclusion Acute neurological symptoms in patients treated for ALL may be caused by spontaneous cerebral haemorrhaging of cavernous haemangiomas or capillary telangiectases induced by chemotherapy and/or radiotherapy.
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  • 161
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    Intensive care medicine 23 (1997), S. 702-703 
    ISSN: 1432-1238
    Keywords: Key words Vena cava ; Systemic venous return ; Congenital heart disease ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We describe a case of left-sided superior vena cava. The diagnosis was suggested by chest radiograph after central venous catheter placement. This was subsequently confirmed by magnetic resonance imaging.
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  • 162
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    European radiology 7 (1997), S. 1028-1030 
    ISSN: 1432-1084
    Keywords: Key words: Spinal cord compression ; Spine ; neoplasms ; Osteochondroma ; Chondrosarcoma ; Computed tomography ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. Various neoplastic, vascular, and developmental causes may lead to spinal neural foraminal widening, the most common causes of spinal dumbbell lesions being schwannomas and neurofibromas. Occasionally, some other slow-growing tumors may cause neural foraminal widening. We report an exceptional case of a low-grade spinal chondrosarcoma which apparently developed from a pre-existing osteochondroma in the neural arcus of C6. The lesion passed through the C5–C6 foramen, producing a dumbbell mass.
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  • 163
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    European radiology 7 (1997), S. S289 
    ISSN: 1432-1084
    Keywords: Key words: Breast neoplasms ; Magnetic resonance imaging ; Gadolinium/diagnostic use ; Contrast media ; Organometallic compounds/diagnostic use
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. Magnetic resonance imaging (MRI) of the breast brings the advantages of high resolution cross-sectional imaging to breast cancer diagnosis, treatment and research: improved cancer detection, staging, selection of therapy, evaluation of therapeutic response in vivo, detection of recurrence, and even the development of new therapies. Until now breast cancer treatment and research has been impeded by the limited means of evaluating the breast cancer in vivo: primarily clinical palpation and mammography of the breast tumor. A review of the initial studies shows that with the use of paramagnetic contrast agents, MRI has a sensitivity of 96 % for detecting breast cancers. MRI detects multicentric disease with a sensitivity of 98 %, superior to any other modality. The ability of MRI to detect recurrent local breast cancer in the conservatively treated breast is nearly 100 %. MRI is capable of monitoring tumor response to chemotherapy and actually guiding therapeutic interventions such as interstitial laser photocoagulation.
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  • 164
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    European radiology 7 (1997), S. 1245-1251 
    ISSN: 1432-1084
    Keywords: Key words: Knee ; Magnetic resonance imaging ; Children ; Trauma
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. The appearances of knee injuries on MR imaging are less well documented in children than adults. Some patterns of injury are shared by both groups of patients, e. g. meniscal damage. The frequency of specific injuries may differ, e. g. anterior cruciate ligament (ACL) tear. Congenital abnormality, coexistent pathology and previous treatment of the knee appear to be associated with meniscal problems. Discoid menisci are seen most frequently in children and have unique features on MR scans. Cruciate ligament tears are difficult to diagnose in the smallest children. The ACL may not be identified due to its small size. Normal bone marrow signal may be confused with marrow infiltration or bone microfracture. Radiographically occult fractures around the knee appear to be strongly associated with ligamentous injury as in adult patients. Osteochondral fractures, osteochondral lesions and articular cartilage damage are revealed on MR scans, but their long-term effects are uncertain. It is possible to diagnose a range of knee injuries on MR scans in children. The biggest diagnostic challenge is in pre-school children.
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  • 165
    ISSN: 1432-1920
    Keywords: Key words Anterior cervical surgery ; Complications ; Infection ; Computed tomography ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report a 44-year-old woman who developed an atypical retro-oesophageal abscess 4 years after anterior cervical surgery with fusion (ACSF). She presented with dysphagia but no fever or definite laboratory signs of inflammation. Delayed or chronic dysphagia following Cloward's operation is usually related to graft displacement. Infection may also, more rarely, be encountered in conjunction with dysphagia, but is typically associated with a classical clinical presentation and laboratory results. We recommend that in cases of delayed dysphagia without evidence of graft migration, the possibility of retropharyngeal infection should be considered, even in the absence of clinical signs or supporting laboratory evidence. MRI in this rare delayed complication is nonspecific but suggestive, and hence represents the imaging modality of choice in such situations.
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  • 166
    ISSN: 1432-1920
    Keywords: Key words Tuberous sclerosis ; Magnetic resonance imaging ; Pulse sequences
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We carried out fluid-attenuated inversion recovery (FLAIR) pulse sequences with long repetition and echo times in seven children with tuberous sclerosis, and compared them with conventional spin-echo (SE) sequences. FLAIR images exhibited higher sensitivity than conventional SE images to cortical and subcortical tubers. The low signal intensity of cerebrospinal fluid on FLAIR images allowed more accurate delineation of the cortical and subcortical tubers. However, T1-weighted imaging was still superior for delineation of subependymal nodules.
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  • 167
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    Neuroradiology 39 (1997), S. 411-413 
    ISSN: 1432-1920
    Keywords: Key words Inferior sagittal sinus ; Cerebral venous thrombosis ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We present a case of isolated inferior sagittal sinus thrombosis shown on CT, MRI and angiography. This condition has not, to our knowledge, been described previously.
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  • 168
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    Neuroradiology 39 (1997), S. 418-422 
    ISSN: 1432-1920
    Keywords: Key words Ventriculography ; Magnetic resonance imaging ; Gadolinium DTPA
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report intrathecal use of gadolinium DTPA for MRI of the cerebrospinal fluid (CSF). In two patients with leptomeningeal carcinomatosis, we injected 0.01 mmol gadolinium DTPA into the lateral ventricle via an Ommaya device. Coronal T1-weighted images of the head were obtained at 0.2 T prior to and after injection. There was pronounced enhancement of CSF close to the injection site, allowing good delineation of CSF and surrounding brain tissue. No side effects occurred. MRI with intrathecal administration of highly diluted gadolinium DTPA may be a promising alternative to conventional investigation of CSF-filled cavities using iodinated X-ray contrast media or radionuclides.
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  • 169
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    Neuroradiology 39 (1997), S. 423-426 
    ISSN: 1432-1920
    Keywords: Key words Leukodystrophy ; adult onset ; autosomal dominant ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report MRI findings in a family with an autosomal-dominant, adult-onset neurological disorder. The clinical picture, the white matter changes detected on MRI and the absence of any laboratory abnormality suggested the diagnosis of leukodystrophy with an unknown biochemical defect. Autosomal-dominant inheritance is extremely rare in this kind of disease, and most reported families have not undergone MRI. We performed MRI and clinical examination of 17 members of our family; 9 affected subjects, at different stages of the disease, were detected. The most characteristic MRI findings were initially symmetrical areas of signal change in the white matter of the trigonal region; demyelination extending thereafter to the frontal and parietal regions, partially involving subcortical white matter; the temporal lobe and optic radiations were less involved; the internal capsule and corpus callosum were involved later, in a dorsoventral direction; patchy demyelination was evident in the late stages in the brain stem; the cerebellum was spared even in the latest stages of the disease. While pathological examination is essential to characterise and classify these kinds of diseases, MRI can make substantial contributions to understanding their natural history, and to detect early signs of the disease.
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  • 170
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    Neuroradiology 39 (1997), S. 453-457 
    ISSN: 1432-1920
    Keywords: Key words Otosclerosis ; otospongiosis ; Computed tomography ; Magnetic resonance imaging ; Tympanocochlear scintigraphy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Our aim was to determine whether MRI reliably shows pathology in patients with active otosclerosis (otospongiosis). We studied five patients with clinical and audiometric signs of this disorder and positive findings on high-resolution CT and tympanocochlear scintigraphy. Contrast enhancement of otospongiotic lesions was found in all affected ears, and could be topographically related to demineralised otospongiotic foci on CT. In lesions in the lateral wall of the labyrinth MRI sometimes showed the pathology better than CT, where partial-volume effects could be troublesome.
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  • 171
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    Neuroradiology 39 (1997), S. 495-498 
    ISSN: 1432-1920
    Keywords: Key words Reye's syndrome ; Computed tomography ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Early MRI in a case of clinically established Reye's syndrome confirmed CT findings of compressed ventricles and additionally demonstrated signal alterations in the thalamus, mesencephalon and pons. On follow-up MRI the pontine lesion had vanished by 1 week later, while the thalamic lesion persisted for more than 2 months. The patient, however, recovered without neurological sequelae.
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  • 172
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    Neuroradiology 39 (1997), S. 483-489 
    ISSN: 1432-1920
    Keywords: Key words Brain ; magnetic resonance imaging ; Brain ; tumours ; Magnetic resonance imaging ; diffusion studies
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We used MRI for in vivo measurement of brain water self-diffusion in patients with intracranial tumours. The study included 28 patients (12 with high-grade and 3 with low-grade gliomas, 7 with metastases, 5 with meningiomas and 1 with a cerebral abscess). Apparent diffusion coefficients (ADC) were calculated in a single axial slice through the tumours; the sequence was sensitive to diffusion along the cephalocaudal axis. Our main finding was that ADC in contrast-enhancing areas within cerebral metastases was statistically significantly higher than ADC in contrast-enhancing areas in high-grade gliomas (P≤ 0.05). Furthermore, the ADC in oedema surrounding metastases were statistically significantly higher the ADC in oedema around high-grade gliomas (P≤ 0.02). The ADC in patients with meningiomas did not differ significantly from those seen with high-grade gliomas or cerebral metastases. The highest ADC were found within cystic or necrotic tumour areas. In one patient with a cerebral abscess, suspected of having a high-grade glioma, the ADC was similar to that in high-grade gliomas. The finding of higher ADC in cerebral metastases than in high-grade gliomas may be helpful in trying to distinguish between these tumours preoperatively; it suggests increased free extracellular and/or intracellular water fraction in cerebral metastases. The method seems to hold potential for further noninvasive characterisation of intracranial tumours.
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  • 173
    ISSN: 1432-1920
    Keywords: Key words Pituitary gland ; infection ; abscess ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Pituitary abscesses, rare lesions, may be divided into primary and secondary types. Primary pituitary abscesses occur within a previously healthy gland, while secondary abscesses arise within an existing lesion, such as an adenoma, craniopharyngioma, or Rathke's cleft cyst. Secondary abscesses share radiologic characteristics with the lesions from which they arise. There has been no review of the MRI characteristics of primary pituitary abscesses. We report two cases and review the literature. The typical primary pituitary abscess gives the same or slightly lower signal than brain on T1-weighted images, and could be mistaken for a solid mass or presumed to represent a pituitary adenoma. Contrast-enhanced images are useful, demonstrating absence of central enhancement, suggesting a fluid or necrotic center. In one of our cases, meningeal enhancement was obvious; this has not been reported previously and may be diagnostic, when associated with a rim-enhancing pituitary mass.
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  • 174
    ISSN: 1432-1920
    Keywords: Key words Temporal lobe epilepsy ; Limbic system ; Hippocampus ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We performed MRI on 27 patients with clinically proven temporal lobe epilepsy (TLE), all with prior EEG lateralisation, and 10 volunteers, studied to evaluate disparity in size arising from biological variation (group 1). Three-dimensional spoiled GRASS (3DSPGR) sequences provided 2-mm contiguous sections of the limbic system, enabling assessment of the hippocampus (HC), fornix (FN) and mamillary body (MB). Measurements of FN and MB width were made from a workstation. Any percentage difference in size was computed. In 19 cases there was unilateral abnormality in the HC (group 2); in 18 and 19 cases respectively there was a smaller FN and MB on the same side as the abnormal HC. This percentage difference in size was significantly greater than that in group 1 in the FN and MB in 17 and 17 cases respectively. Comparison of percentage difference computations for FN and MB between groups 1 and 2 showed high statistical significance (P 〈 0.0002). In 5 patients with clinical TLE the HC was normal on MRI (group 3). Unequal FN and MB sizes were found in 4, significant in 2. Comparison of percentage difference computations for FN and MB showed statistical significance (P 〈 0.0005 and P 〈 0.0003 respectively). There was no case of discordance between the sides of hippocampal abnormality and the smaller FN or MB or between the sides of smaller FN and MB. The strong concordance between the changes in the HC and those in the FN and MB suggests that this combination will play an important role in the assessment of TLE and limbic system abnormality.
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  • 175
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    Neuroradiology 39 (1997), S. 589-592 
    ISSN: 1432-1920
    Keywords: Key words Lumbar spine ; post-operative ; Contrast media ; Fat suppression ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In ten patients who had undergone lumbar laminectomy, visual assessment of epidural scar enhancement and diagnostic confidence was performed after 0.1 mmol/kg gadodiamide intravenously, again after a further 0.2 mmol/kg, and once more using a fat-suppression sequence. The single-dose contrast-enhanced T1-weighted images showed clear enhancement of epidural scar in eight cases, and clearly improved diagnostic confidence as regards scar and/or disc herniation in six. Triple-dose contrast-enhanced images showed further increase in epidural enhancement clearly in only two cases and marginally in six, with no significant increase in diagnostic confidence. Fat-suppression, performed in eight cases, showed a further clear increase in epidural enhancement in seven cases, but again no increase in diagnostic confidence. In one patient with arachnoiditis contrast enhancement and diagnostic confidence increased only slightly after each contrast injection, and again with the fat-suppression sequence. Increasing contrast medium dose was thus not useful following laminectomy when epidural scarring obscures a possible recurrent disc herniation. Use of fat suppression may, however, permit reduction of the dose of contrast medium necessary to provide adequate scar enhancement.
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  • 176
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    Neuroradiology 39 (1997), S. 737-740 
    ISSN: 1432-1920
    Keywords: Key words Epidural haematoma ; Spine ; Magnetic resonance imaging ; Computed tomographic myelography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We present a case of spontaneous spinal epidural haematoma (SSEH) with a rare clinical course of repeated spontaneous recovery and relapse. The patient suffered three episodes of upper-back pain of sudden onset followed by sensory and motor dysfunction after weight lifting. In the first two episodes, the neurological deficits recovered spontaneously and completely. In the last episode, paraplegia persisted even after emergency surgery. Serial studies with computed tomographic (CT) myelography and magnetic resonance imaging (MRI) demonstrated the remitting and relapsing course of the SSEHs. The possible causes of the SSEHs and the mechanisms of spontaneous recovery are discussed.
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  • 177
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    Neuroradiology 39 (1997), S. 747-750 
    ISSN: 1432-1920
    Keywords: Key words Schwannoma ; Nerve sheath tumours ; Face neoplasms ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Neurosarcoma is a rare tumour originating from the sheath of peripheral nerves. Facial lesions have been reported in about 20 patients. We describe the MRI appearances of neurosarcoma with histological correlation in three patients. The lesions lay in the submandibular region, the left parapharyngeal space and the right orbit. MRI showed a well-defined mass with mixed components. The lesions were moderately heterogeneous on T1-weighted images in two cases and on T2-weighted images in all cases. Gadolinium enhancement occurred in all cases to variable degrees. In two cases, small high signal foci were seen on T2-weighted sequences. MRI appearances of neurosarcoma are not specific.
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  • 178
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    Neuroradiology 39 (1997), S. 741-746 
    ISSN: 1432-1920
    Keywords: Key words Computed tomography ; Magnetic resonance imaging ; Nasopharyngeal carcinoma
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Precise assessment of the extent of nasopharyngeal carcinoma (NPC) represents the basic step towards optimal treatment. We compared the capacity of CT and MRI in assessing the extent of NPC in 67 patients. MRI was superior to CT in demonstrating lesions in the retropharyngeal node, skull base, intracranial area, carotid space, longus colli muscle and levator palatini muscle. Of 25 cases in which retropharyngeal adenopathy was recognised only on MRI, seven had been reported as showing oropharyngeal involvement and 18 as primary extension to the carotid space on CT. MRI showed skull-base involvement in 40 patients compared with 27 on CT and intracranial involvement in 38 patients versus 24 on CT. There was not a single case in which skull base invasion was seen on CT but not on MRI. MRI enabled improved recognition of tumour infiltration of longus colli muscles (34 cases compared with 15 on CT). It allowed us to clarify 12 questionable sinonasal opacities on CT. Overall, T-staging was changed in 18 of 67 patients (26.9 %), including upstaging in 15 cases and downstaging in 3 cases, after comparing CT with MRI. The nodel status was changed from negative on CT to positive on MRI in 4 of 67 patients (6 %). We believe that MRI allows more accurate evaluation of the extent of NPC than CT and should be the primary mode of investigation.
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  • 179
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    Neuroradiology 39 (1997), S. 815-817 
    ISSN: 1432-1920
    Keywords: Key words Enucleation ; Optic nerve ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We examined five patients who had enucleation of one eye for inflammatory or neoplastic disease, using MRI at 1.5 Tesla. None had symptoms referable to the enucleated orbit. In addition, age- and-sex matched individuals were imaged as control subjects, and a further 15 subjects, referred for other than orbital disease, were reviewed. Measurements were made retrospectively of the dimensions of the optic chiasm to establish normal values. All five patients showed abnormalities on MRI following enucleation: abnormal signal within the optic nerve remnant on short τ inversion recovery (STIR) images, and atrophy of the nerve remnant and the chiasm. These findings were not apparent in the control or normal subjects. Such findings are to be expected following enucleation and should not be interpreted as indicating active pathology.
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  • 180
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    Neuroradiology 39 (1997), S. 870-872 
    ISSN: 1432-1920
    Keywords: Key words Spinal cord ; compression ; Haematopoiesis ; extramedullary ; Thalassaemia ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Spinal epidural extramedullary haematopoiesis is very rare in thalassaemia. A 27-year-old man with thalassaemia intermedia presented with symptoms and signs of spinal cord compression. MRI showed a thoracic spinal epidural mass, representing extramedullary haematopoietic tissue, compressing the spinal cord. Following radiotherapy, serial MRI revealed regression of the epidural mass and gradual resolution of spinal cord oedema.
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  • 181
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    Neuroradiology 39 (1997), S. 873-876 
    ISSN: 1432-1920
    Keywords: Key words Parry-Romberg Syndrome ; Suppressive therapy ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Parry-Romberg syndrome is a poorly – understood disorder characterized by progressive hemifacial atrophy involving the skin, soft tissue, and bone. Involvement of the central nervous system with impairment in neurologic function occurs infrequently. We describe a child with this syndrome in whom central nervous system involvement, documented on serial MRI, played a prominent role. We have attempted to correlate the clinical course with the radiologic findings, and to determine the impact of prednisone and methotrexate on the intracranial lesions.
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  • 182
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    Neuroradiology 39 (1997), S. 139-141 
    ISSN: 1432-1920
    Keywords: Key words Oculomotor nerve paralysis ; Lyme disease ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Lyme disease is a cause of illness involving multiple organ systems, including, in 10–15 % of cases, the nervous system. Peripheral radiculoneuritis, cranial neuritis, encephalitis and myelitis are among the neurological manifestations found in the second and third stages. We present the MRI findings in isolated oculomotor nerve involvement by Lyme disease and discuss the differential diagnosis.
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  • 183
    ISSN: 1432-1920
    Keywords: Key words Myotonic dystrophy ; Magnetic resonance imaging ; Trinucleotide repeats ; Cognitive impairment
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract MRI was performed in 13 patients with the adult form of myotonic dystrophy (MD) and compared with that of sex- and age-matched normal controls. There was some cerebral atrophy in the patients and marked thickening of the skull in three of them, associated with ossification of the falx cerebri in two. We found high-signal areas on T 2-weighted images in the white matter in 9 (70 %) of the patients; five showed high-signal areas in the subcortical white matter of the temporal lobes. These findings were associated with intellectual impairment in only one patient, who had a history of a difficult birth and temporal lobe epilepsy.
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  • 184
    ISSN: 1432-1920
    Keywords: Key words Wilson's disease ; Magnetic resonance imaging ; Portal-systemic encephalopathy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Most reports of MRI in Wilson's disease have been of abnormal low-signal lesions on T1-weighted images and high signal intensity on T2-weighted images. In contrast, we report three patients who had high-signal lesions in the globus pallidus on T1-weighted images, a finding seen in patients with portal-systemic encephalopathy. The possible causes include the paramagnetic effect of copper or iron and accumulation of Alzheimer type II glial cells.
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  • 185
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    Neuroradiology 39 (1997), S. 180-184 
    ISSN: 1432-1920
    Keywords: Key words Encephalitis ; Japanese B ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We document the MRI features in seven patients with Japanese encephalitis. MRI was carried out on a 1.5 T system within 10–60 days of onset. In all the patients MRI revealed bilateral thalamic lesions, haemorrhagic in five. Signal changes were present in the cerebrum in four patients, the midbrain and cerebellum in three each, the pons in two and the basal ganglia in one. The lesions were haemorrhagic in three of the four patients with lesions in the cortex, two of the three with lesions in the midbrain and cerebellum, but the pontine lesions were haemorrhagic in both patients. Spinal cord involvement was seen in one of the three patients who underwent MRI. In two patients MRI was repeated 3 years after the onset, showing marked reduction in abnormal signal; and all the lesions gave low signal on both T1- and T2-weighted images. Bilateral thalamic involvement, especially haemorrhagic, may be considered characteristic of Japanese encephalitis, especially in endemic areas.
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  • 186
    ISSN: 1432-1920
    Keywords: Key words Brain ; Toxic encephalopathy ; Methanol intoxication ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We present the MRI findings of cerebral and optic pathway damage in the acute and subacute stages of methanol intoxication. In the acute stage, CT and MRI showed bilateral haemorrhagic necrosis of the corpus striatum and infarcts in the anterior and middle cerebral arterial territories. MRI in the subacute stage demonstrated atrophy of the optic chiasm and prechiasmatic optic nerves in addition to the cerebral infarcts. The patient survived, with total blindness.
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  • 187
    ISSN: 1432-1920
    Keywords: Key words Brain metastasis hemorrhagic ; Papillary thyroid cancer ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report a 40-year-old woman, who initially developed cerebellar symptoms, with multiple hemorrhagic brain metastases from a papillary thyroid cancer. Intracranial masses gave heterogeneous high signal on T 1-weighted and T 2-weighted images, hemosiderin rims on the latter. Some of the tumors showed contrast enhancement. Metastatic thyroid cancer is a consideration in a patient with multiple hemorrhagic masses.
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  • 188
    ISSN: 1432-1920
    Keywords: Key words Facial nerve ; Magnetic resonance imaging ; Gadolinium
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We prospectively analysed the normal contrast-enhanced MRI features of the facial nerve and determined criteria for pathological contrast enhancement. We studied 31 patients with clinically normal facial nerves with T1-weighted images before and after contrast medium. The intensity, thickness and right-left symmetry of enhancement were assessed in each segment and correlated with MRI features observed in abnormal facial nerves. Enhancement along at least one segment of the facial nerve was seen in 98 % of cases, but only within the facial canal: labyrinthine segment: 78.2 %; geniculate ganglion: 96.9 %; tympanic: 88.4 %; mastoid: 66.6 %. Marked (++) to intense (+++) enhancement was seen in the labyrinthine segment in 17.4 %, the geniculate ganglion in 36.3 %, and the tympanic (25.6 %) and mastoid (7.1 %) segments, whereas intense enhancement was only seen in the geniculate ganglion (6 %) and the tympanic segment (11.6 %). A right-left asymmetry was noted in 69 % of cases. No correlation was found between enhancement and the thickness of the nerve. No enhancement of the eighth nerve was seen. We suggest three criteria for pathological enhancement: enhancement outside the facial canal; extension of enhancement to the eighth nerve; and intense enhancement in the labyrinthine and/or mastoid segments.
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  • 189
    ISSN: 1432-1920
    Keywords: Key words Sarcoma ; meningeal ; Magnetic resonance imaging ; Tumours ; intracranial ; children
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Meningeal sarcomas are very rare, highly aggressive tumours affecting children more frequently than adults. The clinical course and MRI of meningeal sarcomas in two cases are discussed with special regard to possible misinterpretation. In one case MRI demonstrated a circumscribed mass in contact with the meninges, with central areas of haemorrhage. In the other, a case of primary leptomeningeal sarcomatosis, several MRI examinations over the course of almost a year were unhelpful, despite severe neurological complaints. Then MRI revealed meningeal contrast enhancement all over the brain and spinal canal, together with cerebral infarcts. MRI of meningeal sarcomas has not been discussed in the literature. MRI did not permit specific diagnosis, but enabled visualisation of the extent of the tumour and/or meningeal involvement. Early histological diagnosis is indispensable for adequate treatment.
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  • 190
    ISSN: 1432-1920
    Keywords: Key words Fluid-attenuated inversion recovery sequences ; Normal brain ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Axial fast FLAIR images of the brains of 40 normal volunteers in four age groups between 16 and 55 years were examined and the number and size of areas of increased white-matter signal recorded. Increased signal in the corticospinal tract region was seen at the level of the internal capsule in all subjects, extending up towards the centrum semiovale and down towards the pons for 0.5–5.5 cm (median 2.5 cm). In all cases the IIIrd and IVth ventricles were outlined by a thin line of high signal. Focal areas of high signal (caps) were seen around the frontal and occipital horns in 90 % and 77 % respectively; 54 % of caps were asymmetrical. None of the above features varied with the age or sex of the subject, but the numbers of discrete white matter ’lesions' increased with age. The findings are used to suggest guidelines for the identification of areas of ’normal' high signal to be excluded in quantification of lesions on fast FLAIR images.
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  • 191
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    Neuroradiology 39 (1997), S. 276-277 
    ISSN: 1432-1920
    Keywords: Key words Tumours ; spinal Meningioma ; Sciatica ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report a 27-year-old woman with atypical sciatica due to a giant, rapidly growing, lumbar (T12-S1) meningioma. The unique features of this case are discussed and the importance of early investigation by MRI of patients with atypical low back pain and sciatica is highlighted.
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  • 192
    ISSN: 1432-1920
    Keywords: Key words Corpus callosum ; dysgenesis ; Developmental anomalies ; Probst's bundles ; Anterior commissure ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We analysed the MRI findings in 23 patients with callosal dysgenesis in relation to their associated telencephalic anomalies to investigate the morphological significance of the development of Probst's bundles and the anterior commissure in congenital callosal dysgenesis. We classified callosal dysgenesis into three types: total defect (9 patients), partial defect (7) and hypoplasia (7). Associated anomalies were observed in 15 patients, including migration disorder (8 patients), micrencephaly (5), and lipoma (2). The remaining 8 patients had no associated anomalies. Probst's bundles were not identified in 4 patients with a severe migration disorder. An absent or hypoplastic anterior commissure was observed in 9 of the 16 patients with callosal defect and all 7 of those with callosal hypoplasia. Colpocephaly and keyhole dilatation of the temporal horns were seen in 16 and 21 patients, respectively. Callosal dysgenesis may occur not only through a defect in the callosal anlage, but also from impaired growth of axonal fibres projecting from the cerebral isocortex. Therefore, associated telencephalic anomalies may be responsible for additional features in callosal dysgenesis. Consequently, identification of Probst's bundles and the anterior commissure may be important when assessing cortical development in patients with callosal dysgenesis.
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  • 193
    ISSN: 1432-1920
    Keywords: Key words Arteries ; vertebral ; Arteries ; dissection ; Magnetic resonance imaging ; Magnetic resonance angiography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A review of 4,500 angiograms yielded 11 patients with dissection of the vertebral arteries who had MRI and (in 4 patients) MR angiography (MRA) in the acute phase of stroke. One patient with incidental discovery at arteriography of asymptomatic vertebral artery dissection and two patients with acute strokes with MRI and MRA findings consistent with vertebral artery dissection were included. Dissection occurred after neck trauma or chiropractic manipulation in 4 patients and was spontaneous in 10. Dissection involved the extracranial vertebral artery in 9 patients, the extra-intracranial junction in 1, and the intracranial artery in 4. MRI demonstrated infarcts in the brain stem, cerebellum, thalamus or temporo-occipital regions in 7 patients with extra- or extra-intracranial dissections and a solitary lateral medullary infarct in 4 patients (3 with intracranial and 1 with extra-intracranial dissection). In 2 patients no brain abnormality related to vertebral artery dissection was found and in one MRI did not show subarachnoid haemorrhage revealed by CT. Intramural dissecting haematoma appeared as crescentic or rounded high signal on T1-weighted images in 10 patients examined 3–20 days after the onset of symptoms. The abnormal vessel stood out in the low signal cerebrospinal fluid in intracranial dissections, whereas it was more difficult to detect in extracranial dissections because of the intermediate-to-high signal of the normal perivascular structures and slow flow proximal and distal to the dissection. In two patients examined within 36 h of the onset, mural thickening was of intermediate signal intensity on T1-weighted images and high signal on spin-density and T2-weighted images. MRA showed abrupt stenosis in 2 patients and disappearance of flow signal at and distal to the dissection in 5. Follow-up arteriography, MRI or MRA showed findings consistent with occlusion of the dissected vessel in 6 of 8 patients.
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  • 194
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    Neuroradiology 39 (1997), S. 354-356 
    ISSN: 1432-1920
    Keywords: Key words Spine ; Atlas ; Axis ; Osteoarthritis ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We present the MRI appearances of advanced degenerative changes at the atlanto-odontoid (AO) joint. Changes including obliteration of the joint space, subchondral sclerosis and osteophytosis were clearly depicted on fast gradient-echo T1-weighted MRI images. Recognition of these changes may be helpful in the diagnosis in patients with suboccipital pain.
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  • 195
    ISSN: 1432-1920
    Keywords: Key words Morquio's disease ; Craniocervical junction ; Brain ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We reviewed MRI of the brain and cervical spine in 11 patients with Morquio's disease. No abnormality was seen in the brain. The odontoid peg was abnormal in all patients, with varying degrees of cord compression due to an anterior soft tissue mass and indentation by the posterior arch of the atlas. The degree of cord compression was more marked than suggested by the symptoms and signs. We recommend MRI of the cervical spine in children with Morquio's disease before the development of neurological symptoms, to optimise the timing and type of surgical intervention.
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  • 196
    ISSN: 1432-1920
    Keywords: Key words Chordoma ; clivus ; Magnetic resonance imaging ; Differential diagnosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We present six proven cases of chordoma of the clivus studied by CT and MRI, with special attention to the extent of the tumour and to the signal intensity after intravenous gadolinium. MRI is the best technique for assessing the extent of the tumour but CT is important for showing osteolysis. Our aim was to determine differential diagnostic neuroradiological criteria. Reliable signs of chordoma of the skull base are: posterior extension to the pontine cistern; a lobulated, “honeycomb” appearance after gadolinium; the swollen appearance of the bone in the early stages; bone erosion on CT and frequent extension to critical structures such as the circle of Willis, cavernous sinuses and brain stem.
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  • 197
    ISSN: 1432-1920
    Keywords: Key words Aneurysm ; giant ; Magnetic resonance imaging ; Dural tail sign
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The “dural tail” sign on gadolinium (Gd-DTPA)-enhanced MRI has been described in association with meningiomas. Various series with histopathological correlation have shown that in some cases there is tumour invasion into the dura mater, but in the majority of cases it represents a hypervascular, non-neoplastic reaction. While this sign was originally thought to be specific for meningioma, subsequent case reports have described the presence of a dural tail in other intra- and extra-axial lesions. We present a patient with a giant aneurysm arising from the P2 segment of the right posterior cerebral artery, adjacent to the tentorium, with a prominent dural tail on Gd-DTPA-enhanced MRI. In this location, differentiation of an aneurysm from a meningioma was critical.
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  • 198
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    Neuroradiology 39 (1997), S. 811-814 
    ISSN: 1432-1920
    Keywords: Key words Meningeal melanocytoma ; Magnetic resonance imaging ; Computed tomography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report the MRI and CT findings of an intracranial meningeal melanocytoma (IMM) arising from Meckel's cave and review the imaging characteristics of IMM. On CT, IMM constantly appear as well-circumscribed, isodense to slightly dense, extra-axial tumours with homogeneous contrast enhancement. This appearance is nonspecific and similar to that of meningiomas or small neuromas. On MRI, the signal of IMM is strongly related to the amount of melanin pigment: the more melanin, the more shortening of T1 and T2 relaxation times. Only when it shows as a homogeneous mass, bright on T1 and dark on T2 weighting, can a specific diagnosis of a melanin-containing tumour be made. However, this still cannot provide a distinction between IMM and malignant meningeal melanoma.
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  • 199
    ISSN: 1432-1920
    Keywords: Key words Spine ; Spinal cord ; compression ; Arachnoid cyst ; extradural ; Myelography ; Computed tomography ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Extradural arachnoid cysts are uncommon expanding lesions in the spinal canal which may communicate with the subarachnoid space. Usually in the lower thoracic spine, they may cause symptoms by compressing the spinal cord or nerve roots. We report cases of thoracic and lumbar arachnoid cysts studied by cystography, myelography, CT and MRI. These techniques showed extradural cystic lesions containing cerebrospinal fluid, with variable communication with the subarachnoid space, causing anterior displacement and flattening of the spinal cord.
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  • 200
    ISSN: 1432-1920
    Keywords: Key words Sturge-Weber syndrome ; Single-photon emission computed tomography ; Magnetic resonance imaging ; Computed tomography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Demonstration of the full extent of abnormality in patients with the Sturge-Weber syndrome (SWS) is important for prognosis and in planning surgery to remove the seizure focus. We compared single-photon emission computed tomography (SPECT), MRI and CT in nine children under the age of 4 years with seizures as part of SWS, in an attempt to determine the optimal method of imaging in different clinical settings. Seven unilateral and two bilateral cases were studied by interictal 99mtechnetium hexamethylpropyleneamineoxime (HMPAO) SPECT, and contrast-enhanced CT and MRI, giving information on 11 abnormal hemispheres. All imaging modalities showed abnormalities in every child. Perfusion imaging showed focal regions of decreased uptake in 9 of 11 (82 %) abnormal hemispheres and demonstrated a widespread decrease but no focal defect in 2; it also revealed crossed cerebellar diaschisis in 2 cases. CT demonstrated typical gyriform calcification in 9 of 11 (82 %) affected hemispheres. Contrast-enhanced MRI showed more extensive involvement than contrast-enhanced CT in 5 of 11 (45 %) cases. The area of hypoperfusion shown by SPECT was smaller than the area of contrast enhancement on MRI in 6 of 11 cases (55 %), comparable in 3 (27 %) and larger in 2 cases (18 %). CT is sufficient to confirm the clinical diagnosis of SWS, but MRI frequently shows more extensive abnormal areas. 99mTc HMPAO imaging is a useful addition when it is important to know the full extent of the disease, for example prior to surgery. It is likely to detect areas of hypoperfusion, representing ischaemic regions, which may act as an epileptogenic focus and may not be shown by CT or MRI.
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