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  • 1995-1999  (268)
  • 1920-1924
  • 1999  (268)
  • Rat  (115)
  • MRI  (93)
  • CT  (77)
Material
Years
  • 1995-1999  (268)
  • 1920-1924
Year
  • 1
    ISSN: 1432-2161
    Keywords: Key words Lipoma arborescens ; Synovial membrane ; MRI ; Shoulder ; Bursitis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  A 44-year-old man presented with lipoma arborescens of the right shoulder, associated with a rotator cuff tear. MRI revealed villous proliferations with signal intensity of fat on all pulse sequences. At surgery, this bursa was found to contain moderately yellow cloudy fluid without fat globules. Histological examination of the lesion showed subsynovial accumulation of mature fat cells.
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  • 2
    ISSN: 1432-2161
    Keywords: Key words Chronic expanding hematoma ; Ancient hematoma ; CT ; MRI ; Soft tissue mass
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Objective. To identify the characteristic MRI findings of chronic expanding hematoma correlated with the pathology. Design and patients. Three patients who had a chronic expanding hematoma involving the musculoskeletal system were reviewed retrospectively. Results and conclusion. Huge soft tissue masses suggestive of malignancy with destruction of the bony structure were revealed on radiography and computed tomography. MRI showed the masses to exhibit heterogeneous signal intensity on both T1- and T2-weighted images with a peripheral rim of low signal intensity, reflecting the central zones of fluid collection due to fresh and altered blood with a wall of collagenous fibrous tissue. These MRI findings were seen in all three patients and are considered to be characteristic; they assist in differentiation from neoplasm in consideration of the history of trauma or surgery.
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    Skeletal radiology 28 (1999), S. 402-406 
    ISSN: 1432-2161
    Keywords: Key words Erosions ; Femoral neck ; Synovial desmoplastic fibroblastoma (collagenous fibroma) ; MRI
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  A 78-year-old woman presented with pain at the left hip. Initial radiographs showed minimal age-related changes. Over the next 2 years she developed large erosions in the left femoral neck and proceeded to hip replacement. Histological examination showed bland spindle cells in a loose and hyalinised collagenous stroma considered to represent a desmoplastic fibroblastoma (collagenous fibroma). This is the first reported case of synovial desmoplastic fibroblastoma.
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    Skeletal radiology 28 (1999), S. 411-414 
    ISSN: 1432-2161
    Keywords: Key words Leiomyoma ; soft tissue ; Leiomyoma ; thigh ; Leiomyoma ; ossified ; MRI ; Radiography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  A case of ossified leiomyoma of the deep soft tissues of the left thigh is presented. The radiographic appearance suggested a low-grade chondrosarcoma. MRI of the lesion showed signal characteristics similar to muscle on both T1- and T2-weighted spin echo sequences with linear areas of high signal intensity on T1-weighted images consistent with medullary fat in metaplastic bone. Histopathological examination of the resected specimen revealed a benign ossified soft tissue leiomyoma.
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  • 5
    Electronic Resource
    Electronic Resource
    Springer
    Skeletal radiology 28 (1999), S. 465-469 
    ISSN: 1432-2161
    Keywords: Key words Lower leg ; Muscle hernia ; Fascial defect ; MRI ; Dynamic imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Muscle hernias of the lower leg involving the tibialis anterior, peroneus brevis, and lateral head of the gastrocnemius were found in three different patients. MRI findings allowed recognition of herniated muscle in all cases and identification of fascial defect in two of them. MR imaging findings and the value of dynamic MR imaging is emphasized.
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  • 6
    Electronic Resource
    Electronic Resource
    Springer
    Skeletal radiology 28 (1999), S. 470-472 
    ISSN: 1432-2161
    Keywords: Key words Telangiectatic osteosarcoma ; CT ; Paget’s disease ; skull
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Sarcomatous transformation is the most dreaded complication of Paget’s disease. We report on a case of post-Paget telangiectatic osteosarcoma of the skull, a variant of osteogenic osteosarcoma, in a 79-year-old woman. We discuss the radiological pattern in relationship to the differential diagnosis.
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  • 7
    Electronic Resource
    Electronic Resource
    Springer
    Skeletal radiology 28 (1999), S. 477-480 
    ISSN: 1432-2161
    Keywords: Key words Spindle cell hemangioendothelioma ; skeletal muscle ; MRI ; forearm
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Spindle cell hemangioendothelioma occurring in skeletal muscle is extremely rare. No reported studies have performed an imaging evaluation of intramuscular spindle cell hemangioendothelioma. We report on such a tumor arising in an unusual site, the right extensor digiti minimi, in a 46-year-old woman. An en bloc resection was performed and the patient has been disease free for 8 years. Radiologic imaging in the present case showed similar findings to those described in intramuscular hemangioma.
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  • 8
    ISSN: 1432-2161
    Keywords: Key words Chondrosarcoma ; Osteochondroma ; Bursa ; CT ; MRI
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Multiple hereditary osteochondromatosis is an uncommon autosomal dominant condition in which patients are predisposed to the development of chondrosarcoma. We report a case of a patient who developed a secondary low-grade chondrosarcoma in this setting. The tumor was associated with an unusual multinodular invasive growth pattern into a pre-existing bursa that was present overlying the osteochondroma.
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  • 9
    Electronic Resource
    Electronic Resource
    Springer
    Skeletal radiology 28 (1999), S. 545-560 
    ISSN: 1432-2161
    Keywords: Key words Trauma ; Joints ; injuries ; Joints ; radiography ; Joints ; MRI ; Cartilage ; Bones ; fractures
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Fractures involving the articulating surfaces of bone are a common cause of chronic disability after joint injury. Acute fractures of the articular surface typically run parallel to the surface and are confined to the cartilage and/or the immediate subchondral cancellous bone. They should be distinguished from vertical or oblique bone fractures with intra-articular extension. This article reviews the mechanism of acute articular surface injuries, as well as their incidence, clinical presentation, radiologic appearance and treatment. A classification is presented based on direct inspection (arthroscopy) and imaging (especially MRI), emphasizing the distinction between lesions with intact (subchondral impaction and subchondral bone bruises) and disrupted (chondral, osteochondral lesions) cartilage. Hyaline cartilage, subchondral bone plate and subchondral cancellous bone are to be considered an anatomic unit. Subchondral articular surface lesions, osteochondral fractures and solely chondral fractures are different manifestations of impaction injuries that affect the articulating surface. Of the noninvasive imaging modalities, conventional radiography and MRI provide the most relevant information. The appropriate use of short tau inversion recovery, T1-weighted and T2-weighted (turbo) spin-echo as well as gradient-echo sequences, enables MRI to classify the various acute articular surface lesions with great accuracy and provides therapeutic guidance.
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  • 10
    Electronic Resource
    Electronic Resource
    Springer
    Skeletal radiology 28 (1999), S. 584-589 
    ISSN: 1432-2161
    Keywords: Key words Myxopapillary ependymoma ; Sacrum ; Osteolysis ; X ray ; CT ; MRI
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  The authors report an unusual case of sacral osteolytic myxopapillary ependymoma treated with curettage and radiotherapy. There is no evidence of recurrence 8 years after treatment. A review of the literature is presented on sacral ependymomas presenting with an osteolytic radiographic appearance (24 cases in 18 reports). The differential diagnosis with other sacral neoplasms is discussed.
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  • 11
    ISSN: 1432-2161
    Keywords: Key words CT ; MRI ; Temporomandibular joint ; Temporal bone
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Objective. During routine MR imaging of temporomandibular joints we have observed that an area of low signal is sometimes identified within the temporal bone overlying the glenoid fossa on proton-density sequences. This finding at times simulates a mass. CT in this situation has demonstrated marked pneumatization of the mastoid air cell extending to that portion of the temporal bone overlying the glenoid fossa. We undertook a clinical study to determine the frequency and appearance of such a finding. Design and patients. We reviewed the images of 12 patients who underwent both MR and CT examinations of their temporomandibular joints. The authors, by consensus, graded all 24 joints using a four-point scale for the presence and appearance of a low-signal area overlying the glenoid fossa on the MR images prior to seeing the corresponding CT images. We then compared our grading with the findings on CT to assess for the presence and extent of pneumatization of the temporal bone overlying the glenoid fossa. Results. Of the 24 joints reviewed there was identical extent of low signal on MR imaging and extent of pneumatization on CT in 22 of 24 joints. In two of the 24 joints assessed there was overestimation of pneumatization due to extensive sclerosis secondary to surgery. Conclusion. The findings of an area of low signal overlying the glenoid fossa on a T2-weighted scan of a nonoperative temporomandibular joint is often due to extensive temporal bone pneumatization of the mastoid air cells. Recognition of the nature of this finding will avoid mistaking it for a fibrous or osseous lesion. Patients with previous operative history may, however, require further investigation with CT.
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  • 12
    ISSN: 1432-2161
    Keywords: Key words Osteochondroma ; Chondroma ; Extraskeletal tumor ; Soft tissue tumor ; Foot ; CT ; MRI
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  A case of pathologically proven extraskeletal osteochondroma is presented with magnetic resonance imaging (MRI), computed tomography (CT), bone scan and radiographic findings. The diagnosis of extraskeletal osteochondroma should be considered when a discrete, ossified mass is localized in the soft tissues of the distal extremities. Nomenclature surrounding this entity is controversial and is discussed.
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  • 13
    Electronic Resource
    Electronic Resource
    Springer
    Skeletal radiology 28 (1999), S. 616-620 
    ISSN: 1432-2161
    Keywords: Key words Joint ; MRI ; Infectious arthritis ; Septic joint ; Inflammation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Objective. To differentiate the MR features of septic versus nonseptic inflamed joints. Design and patients. Thirty patients were referred for MRI with inflamed joints (19 were subsequently found to be septic and 11 nonseptic). At 1.5 T enhanced MRI five groups of signs related to joint space, synovium, cartilage, bone and peri-articular soft tissue respectively were assessed and compared between the septic and nonseptic groups. Results. The prevalence of MRI findings in septic versus nonseptic joints (respectively) was as follows: effusion (79% vs 82%), fluid outpouching (79% vs 73%), fluid heterogeneity (21% vs 27%), synovial thickening (68% vs 55%), synovial periedema (63% vs 55%), synovial enhancement (94% vs 88%), cartilage loss (53% vs 30%), bone erosions (79% vs 38%), bone erosions enhancement (77% vs 43%), bone marrow edema (74% vs 38%), bone marrow enhancement (67% vs 50%), soft tissue edema (63% vs 78%), soft tissue enhancement (67% vs 71%), periosteal edema (11% vs. 10%). The presence of bone erosions appeared to be an indicator for an infected joint (P=0.072); coexistence of bone marrow edema slightly improves the significance (0.068). A similar trend was obtained when combining bone erosions with either synovial thickening, synovial periedema, bone marrow enhancement or soft tissue edema (P=0.075). Conclusions. The combination of bone erosions with marrow edema is highly suggestive for a septic articulation; the additional coexistence of synovial thickening, synovial edema, soft tissue edema or bone marrow enhancement increases the above level of confidence. Similar to conventional radiography, the single sign that appeared to show a significant trend was the presence of bone erosions. However, no single sign or combination could either be considered pathognomonic or exclude the presence of a joint infection.
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  • 14
    Electronic Resource
    Electronic Resource
    Springer
    Skeletal radiology 28 (1999), S. 703-709 
    ISSN: 1432-2161
    Keywords: Key words Proliferative myositis ; Childhood ; Lumbar muscles ; Ossification ; X-ray ; CT ; MRI ; PET
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  A case of proliferative myositis in the lumbar paraspinal muscles in a 14-year-old boy is presented. Imaging investigations including plain radiograph, ultrasound, computed tomography (CT), magnetic resonance imaging (MRI), bone scan and positron emission tomography (PET) were suggestive of an inflammatory process such as myositis ossificans. The diagnosis was made by incisional biopsy. More pronounced edema, more muscle fiber necrosis and a higher cellularity were found compared to adult cases. The karyotype of the lesion was normal. Clinically, the mass disappeared spontaneously. After 24 months, asymptomatic bridging ossification between the third and fourth lumbar vertebrae was noted.
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  • 15
    ISSN: 1432-2161
    Keywords: Key words Osteosarcoma ; conventional ; Metastasis ; Soft tissues ; Retroperitoneum ; CT ; X-ray
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Osteosarcoma (osteogenic sarcoma) metastasizes primarily to the lung. With the introduction of neoadjuvant chemotherapy as part of the treatment, the overall and disease-free survival rates have dramatically improved. In this case report, a young man with multiple soft tissue and bone metastases, including a rare large bone-forming retroperitoneal metastasis, is described. Despite the extensive extrapulmonary metastases, the patient did not develop pulmonary metastases in the 4 years following initial presentation of the primary tumour.
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  • 16
    Electronic Resource
    Electronic Resource
    Springer
    Skeletal radiology 28 (1999), S. 61-74 
    ISSN: 1432-2161
    Keywords: Key words Ligament ; Ligament injury ; MRI ; Soft tissue injury ; Soft tissue trauma
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Magnetic resonance imaging has had a dramatic effect on the means by which we diagnose ligament injuries. Tears resulting from either acute trauma or overuse can be detected noninvasively, directing appropriate therapy be it conservative or surgical. For the elite athlete, earlier diagnosis leads to earlier intervention, or alternatively, a normal MRI examination can result in an earlier return to play. While MRI is accepted for the diagnosis of certain injuries such as complete tears of the cruciate ligaments of the knee, other injuries, such as partial cruciate ligament tears or tears of the intercarpal ligaments of the wrist, remain controversial.
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  • 17
    Electronic Resource
    Electronic Resource
    Springer
    Skeletal radiology 28 (1999), S. 717-722 
    ISSN: 1432-2161
    Keywords: Key words Sarcoid ; vertebrae ; Sarcoid ; rib ; Sarcoid ; calvarium ; Osteolytic ; CT ; MRI ; Surgical fusion
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Skeletal sarcoidosis is rare. This report describes a 31-year-old African American man who presented with a destructive osteolytic lesion of C2 and another lesion in a rib. The lesion at C2 was treated with corpectomy and bone graft. Four months later the lesion recurred and a new lesion was discovered in the cervical vertebral column. The patient declined surgery for instability for another 3 months, choosing to remain in a halo. Seven months following the initial operation, a technetium bone scan showed spread of the disease to the calvarium and thoracic and lumbar vertebrae. The patient had no symptoms referable to these sites. The patient agreed to have his neck fused at this point. For the next 10 months, the patient was on steroids and a further new lesion appeared at L5 without localizing signs or symptoms. The patient declined further evaluation over the next 12 months and is now considered lost to follow-up.
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  • 18
    ISSN: 1432-2161
    Keywords: Key words Stress fractures ; CT ; MR imaging ; Radionuclide study ; Femur ; stress fractures
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  We present five cases of a distinctive type of longitudinal stress fracture of the upper femoral shaft in which the fracture line is parallel to the outer surface of the bone, in contrast to the perpendicular orientation to the cortical surface in previously reported cases of diaphyseal stress fractures. In two cases the fracture recurred after 15 and 18 months, respectively.
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  • 19
    ISSN: 1432-2161
    Keywords: Key words Bone tumor ; Chondrosarcoma ; CT ; Magnetic resonance imaging ; Tumor of the ankle ; Tumor of the foot
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  The foot is an uncommon location for chondrosarcoma. The presentation, diagnosis, pathological findings, surgical treatment and follow-up of three patients with chondrosarcoma in this rare location are presented. Though nonspecific, MR imaging findings were of aid in the diagnosis and treatment planning of these patients. If the diagnosis of this tumor is rapidly made, a tumor excision instead of limb amputation may be sufficient treatment at surgery.
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  • 20
    Electronic Resource
    Electronic Resource
    Springer
    Skeletal radiology 28 (1999), S. 159-162 
    ISSN: 1432-2161
    Keywords: Key words SAPHO syndrome ; CT ; Parosteal osteosarcoma ; Sternoclavicular joints
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Considerable attention has been paid in the past 10 years to the radiological spectrum of disease entities belonging to the SAPHO syndrome. We report an unusual case presenting with an extra-axial (femoral) lesion, prior to description of this syndrome, which was radiologically and histologically mistaken for a parosteal osteosarcoma. Nineteen years later, a further lesion developed in the scapula together with the typical sternoclavicular manifestations, at which stage the correct diagnosis of SAPHO syndrome was established.
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  • 21
    ISSN: 1432-2161
    Keywords: Key words Shoulder ; Biceps tendon ; Anomaly ; Arthroscopy ; MRI
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  A developmental anomaly of the long head of the biceps tendon was found in a cadaveric shoulder. Findings on arthroscopy, routine MR imaging, and MR arthrography were compared and correlated with results of anatomic dissection. MR arthrography appears to be a very good diagnostic imaging method for depicting this anomaly prior to arthroscopy.
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  • 22
    Electronic Resource
    Electronic Resource
    Springer
    Skeletal radiology 28 (1999), S. 111-115 
    ISSN: 1432-2161
    Keywords: Key words Bone neoplasms ; Osteosarcoma ; Parosteal osteosarcoma ; Metatarsal ; MRI
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  A 70-year-old man presented with increasing swelling of 2 years’ duration, on the dorsal aspect of the forefoot. Imaging studies revealed a heavily calcified surface lesion of bone with early invasion of the underlying second metatarsal. Both imaging findings and the subsequent resection histology were consistent with a parosteal osteosarcoma, which is particularly rare at this site and at this age. The differential diagnosis of a mineralizing surface lesion of bone arising in the foot is discussed.
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  • 23
    Electronic Resource
    Electronic Resource
    Springer
    Skeletal radiology 28 (1999), S. 145-152 
    ISSN: 1432-2161
    Keywords: Key words Intramuscular lipoma ; Liposarcoma ; Malignant soft tissue tumors ; MRI
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Objective. To investigate the spectrum of magnetic resonance (MR) findings of intramuscular lipoma. Design and patients. A retrospective review of 17 consecutive cases of intramuscular lipoma examined with MR imaging was undertaken. Features assessed included the size and margin of the mass; the homogeneity of the contents, including the presence or absence of intermingled muscle fibers; whether the mass was uninodular or multinodular; and the presence of linear structures between and within the tumor nodules. Three well-differentiated liposarcomas and one dedifferentiated liposarcoma associated with lipoma-like components were also studied to allow a comparison of the benign and malignant lesions. Results. The diameter of the intramuscular lipomas varied from less than 3 cm to more than 10 cm. Ten of the intramuscular lipomas were homogeneous but the remaining seven were inhomogeneous with intermingled muscle fibers within the mass. The intramuscular lipomas were well defined in 12 cases, and infiltrative in five. In one case the margin of the lesion showed prominent infiltration of the surrounding muscle tissue. Of the 17 cases of intramuscular lipoma, 15 were composed of a single nodule, whereas three of four cases of liposarcoma were composed of multinodular masses. Conclusion. The MR findings of intramuscular lipoma varied from a small, single and homogeneous mass identical to ordinary (superficial) lipoma, to a large, inhomogeneous lesion with an infiltrative margin. The presence of infiltrative margins and intermingled muscle fibers in intramuscular lipoma indicates a benign lesion rather than malignancy. In addition, uninodularity of the mass is helpful in differentiating intramuscular lipoma from well-differentiated liposarcoma.
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  • 24
    Electronic Resource
    Electronic Resource
    Springer
    Skeletal radiology 28 (1999), S. 163-168 
    ISSN: 1432-2161
    Keywords: Key words SAPHO syndrome ; Spine ; MRI ; Spondyloarthropathy ; Pustulosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  We report on the MRI findings in the vertebrae and surrounding soft tissues in two patients with the SAPHO syndrome (Synovitis, Acne, Pustulosis, Hyperostosis, Osteitis). The MRI findings include abnormal bone marrow signal, either focal or diffuse, of the vertebral bodies and posterior elements; hyperintense paravertebral soft tissue swelling and abnormal signal of the intervertebral discs. These changes are consistent with discitis and osteitis.
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  • 25
    ISSN: 1432-2161
    Keywords: Key words Malignant peripheral nerve sheath tumor ; Schwannoma ; Neurofibroma ; CT ; MRI
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Objective. To distinguish between benign and malignant tumors in the peripheral nerves. Design and patients. The clinical, imaging and histologic findings of 99 benign and 16 malignant tumors in the peripheral nerves were reviewed retrospectively. Results. Preoperative motor weakness was observed in only six of 99 benign tumors and was mild, while slight to severe motor weakness was present in 15 of 16 malignant lesions. Pain at rest was present in five of 99 benign tumors and in 15 of 16 malignant tumors. All benign lesions showed a smooth tumoral margin, while half the malignant lesions showed an invasive margin on CT or MRI. Thirteen of 28 benign lesions on CT and nine of 23 on MRI showed round to geographic central enhancement, but this pattern was not seen in malignant lesions. Conclusion. Absence of severe motor weakness and a central enhancement pattern strongly suggest a benign nature, while severe rest pain and invasive tumor margin suggest malignant lesions in peripheral nerve tumors.
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  • 26
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    Electronic Resource
    Springer
    Skeletal radiology 28 (1999), S. 220-223 
    ISSN: 1432-2161
    Keywords: Key words Patellar tendinosis ; Jumper’s knee ; Patellar tracking ; MRI ; knee
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Objective. To assess whether an association exists between patellar tendinosis and abnormal patellar tracking. Design and patients. The MRI examinations of 630 patients (i.e. 860 knees) referred with anterior knee pain over a 4-year period were assessed in retrospect for the presence of patellar tendinosis and abnormal patellar tracking. The images of the patients with patellar tendinosis were reviewed and the location within the patellar tendon was recorded. Results. There were 44 knees with proximal patellar tendinosis. Twenty-four of these were considered to have normal patellar tracking and 20 to have abnormal patellar tracking. In the group of 816 knees without proximal patellar tendinosis, 581 were considered to have normal patellar tracking and 235 knees to have abnormal patellar tracking. When the two groups were compared there was a statistically significant difference in the ratio of patients with and without abnormal tracking. Conclusion. In patients referred with anterior knee pain or suspected abnormal patellar tracking there is a significant association between proximal patellar tendinosis and abnormal patellar tracking.
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  • 27
    ISSN: 1432-2161
    Keywords: Key words Calf muscles ; Hypertrophy ; Pseudohypertrophy ; Neuropathy ; Radiculopathy ; MRI
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Enlargement of the ipsilateral muscle compartment is an exceptional finding in patients with chronic radiculopathy, peripheral nerve injury, anterior horn cell diseases, or acquired peripheral neuropathy. We report radiographic, ultrasonographic, CT and MRI findings in a patient with chronic S1 radiculopathy and another with chronic neuropathy of the common fibular nerve (L4-S2), both presenting with painless enlargement of the calf muscles.
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  • 28
    ISSN: 1432-2161
    Keywords: Key words Hip joint ; Osteonecrosis ; MRI ; Bone scintigraphy ; Femoral head ; Transtrochanteric rotational osteotomy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Objective. To assess the ability of bone scintigraphy and magnetic resonance imaging (MRI) to predict the outcome of transtrochanteric rotational osteotomy (TRO) for osteonecrosis of the femoral head (ONFH). Design. This study was a prospective evaluation of imaging techniques. Patients and methods. MRI and bone scintigraphy were performed on 20 hips in 18 patients at 3 months after TRO. The radiographic findings at 3 months after TRO, and the MRI and bone scintigraphic findings, were compared with the radiographic findings at final follow-up (mean 39 months). Results and conclusions. On MRI a low-intensity area or a low-intensity band in the new weight-bearing area extending over the acetabular edge on T1-weighted images was related to the presence of collapse on the radiographs at final follow-up. In hips with an area of absent activity in the new weight-bearing surface on bone scintigraphy, collapse was seen more frequently on radiographs at final follow-up than in hips without this feature. Bone scintigraphy was no more specific than radiography in predicting the outcome after TRO. We consider MRI to be superior to bone scintigraphy in predicting the occurrence of collapse, which is one of the major short-term problems after TRO.
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  • 29
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    Skeletal radiology 28 (1999), S. 298-304 
    ISSN: 1432-2161
    Keywords: Key words Osteosarcoma ; MRI ; Metastases ; skeletal muscle ; Soft tissue neoplasm
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Two cases of osteogenic sarcoma with skeletal muscle metastases are described. A 40-year-old woman presented with progressive swelling of both calves and a soft tissue back lump. She had been diagnosed with mandibular chondroblastic osteogenic sarcoma 6 years earlier. Radiographs showed calcified masses. MRI scans and bone scintigraphy revealed multiple soft tissue masses in both calves. Bone scintigraphy also showed uptake in the back lump, right thigh and left lung base. Biopsy confirmed metastatic chondroblastic osteogenic sarcoma, which initially responded well to chemotherapy. However, the metastatic disease subsequently progressed rapidly and she died 21 months after presentation. The second case concerns a 20-year-old man who presented with a pathologic fracture of the humerus, which was found to be due to osteoblastic osteogenic sarcoma. He developed cerebral metastases 17 months later, followed by metastases at other sites. Calcified masses were subsequently seen on radiographs of the abdomen and chest. CT scans confirmed the presence of densely calcified muscle metastases in the abdominal wall, erector spinae and gluteal muscles. The patient’s disease progressed rapidly and he died 30 months after presentation.
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  • 30
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    Skeletal radiology 28 (1999), S. 342-346 
    ISSN: 1432-2161
    Keywords: Key words Chordoma ; Notochordal rest ; MRI ; Vertebra
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Chordomas of the lumbar vertebral bodies are rare. We report an unusual case of an entirely intra-osseous chordoma of the fifth lumbar vertebra treated by vertebrectomy. Conventional radiographs and scintigraphy were normal. The lesion was well visualised by MR imaging, but showed only slight sclerosis on CT. We give our reasons for making a diagnosis of chordoma rather than giant notochordal rest and discuss the problems of management resulting from this diagnostic dilemma.
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  • 31
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    Skeletal radiology 28 (1999), S. 347-349 
    ISSN: 1432-2161
    Keywords: Key words Plasmacytoma ; Plasmacytoma ; amyloid ; Plasmacytoma ; calcified ; Plasmacytoma ; extraosseous ; Plasmacytoma ; thorax ; Plasmacytoma ; MRI
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  We report on a rare, calcified, plasma cell tumor of the spine causing progressive myelopathy. Other unusual features were the lack of an osseous lesion at the site of the mass, considerable calcified amyloid within the mass but no identifiable amyloid elsewhere, and normal serum immunoelectrophoresis.
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  • 32
    ISSN: 1432-2161
    Keywords: Key words Classification ; Fractures ; MRI ; Thoracolumbar spine
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Objective. To define the state of different structures of the fractured thoracolumbar spine which may play a role in the immediate and long-term mechanical stability on MR images and to investigate the relationship of these findings with the AO classification of spinal injuries. Design. The state of the anterior longitudinal ligament, posterior longitudinal ligament, posterior ligamentous complex, cranial and caudal endplates, cranial and caudal discs and the vertebral body were defined using clinical, experimental and radiological data. The state of these structures was reported for each fracture on the MRI examinations and the different MRI features appropriate for different fracture classes were defined. Patients. MRI examinations of 70 patients with 100 fractures of the thoracolumbar spine were used for this study. Results. Wide variations were seen in the state of the structures studied. We could not find a definite pattern to relate these findings with the AO classification scheme. Conclusions. MR findings should be integrated into future classification schemes of thoracolumbar spine fractures. This would enable specific data about the structures involved in the stability of the spine to be acquired. Prospective studies using the criteria developed in this study may help resolve some of the controversies concerning the diagnosis and prognosis of these injuries as well as the development of new classification systems.
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  • 33
    ISSN: 1432-2161
    Keywords: Key words Musculotendinous tuberculosis ; ultrasonography ; Musculotendinous tuberculosis ; MRI
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Musculoskeletal tuberculosis usually involves the spine. Tuberculous infection of muscles and tendons is rare. A patient with tuberculous infection of the gracilis muscle and tendon is reported. Lower extremity Doppler ultrasound was initially performed, as the physical examination mimicked deep vein thrombosis. Sonography identified the abnormal muscle and tendon and was then used to guide aspiration. The sonographic appearance of the gracilis muscle and tendon is described and compared with correlative MR images.
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  • 34
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    Skeletal radiology 28 (1999), S. 527-531 
    ISSN: 1432-2161
    Keywords: Key words Parosteal osteosarcoma ; dedifferentiation ; rhabdomyosarcoma ; Parosteal osteosarcoma ; femur ; MRI
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Dedifferentiated parosteal osteosarcomas are characterized histologically by the combination of low-grade fibroblastic osteosarcoma admixed with a high-grade component that typically has the appearance of malignant fibrous histiocytoma or osteosarcoma. Herein we report a case of dedifferentiated parosteal osteosarcoma of the distal femur, in which the high-grade component consisted of rhabdomyosarcoma. To our knowledge, a rhabdomyosarcomatous component has not been described previously in a dedifferentiated parosteal osteosarcoma. The clinical, radiologic, and pathologic features of this rare type of surface osteosarcoma are described.
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  • 35
    ISSN: 1432-2161
    Keywords: Key words Soft tissue sarcoma ; Aneurysm ; Vascular malformation ; MRI ; Digital subtraction angiography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Differentiation of vascular abnormalities from soft tissue sarcomas may be difficult on clinical grounds, but is usually possible on imaging criteria. We report the MRI and digital subtraction angiography (DSA) findings in a patient presenting with a mass behind the knee. We discuss differentiating features and review the literature of similar cases.
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  • 36
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    Skeletal radiology 28 (1999), S. 33-40 
    ISSN: 1432-2161
    Keywords: Key words Osteoblastoma ; Spine ; Radiography ; CT ; MRI ; Pathology
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Objectives. To illustrate the CT and MRI features of spinal osteoblastomas and correlate the imaging with histological findings. Design. In a retrospective review the CT and MRI features of spinal osteoblastomas with respect to mineralisation, signal intensity (SI), adjacent reactive changes, enhancement following gadolinium-DTPA (5 cases) and adjacent soft tissue masses were compared and correlated with the histological findings including the degree of osteoid formation and matrix mineralisation, vascularity and surrounding reactive changes in bone and soft tissue. Patients. Eleven patients (7 males and 4 females; age range 8–43 years, mean age 19.5 years) with 12 osteoblastomas (1 patient suffered a recurrence) were studied. Results. All lesions showed classical features on CT with varying degrees of matrix mineralisation, whereas MRI identified mineralisation in only eight of 12 cases. MRI showed low signal intensity of the lesion on both T1- and T2-weighted sequences in several cases in the absence of heavy mineralisation. In these cases, histological examination revealed diffuse osteoid production by the tumour. All patients given gadolinium showed enhancement within the tumour on MRI. Reactive bone marrow changes were identified on MRI in 10 cases, and in five of these the changes were at multiple levels. An adjacent soft tissue mass was demonstrated in five cases, but extraosseous tumour was present histologically in only two of these. Conclusions. The MRI appearances of spinal osteoblastomas are varied and show no characteristic features. MRI may also overestimate the extent of the lesion due to extensive reactive changes and adjacent soft tissue masses. CT should continue to be the investigation of choice for the characterisation and local staging of suspected spinal osteoblastomas.
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  • 37
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    Skeletal radiology 28 (1999), S. 49-51 
    ISSN: 1432-2161
    Keywords: Key words Cryptococcoma ; sacrum ; Cryptococcoma ; immunocompromised ; MRI ; sacrum ; CT ; sacrum
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Cryptococcoma of the sacrum was the initial presentation of systemic cryptococcosis in a patient on chronic steroid therapy for autoimmune hepatitis. The bone lesion was the only overt manifestation of systemic cryptococcal disease, which preceded other clinical manifestations and led to the subsequent diagnosis of systemic infection.
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  • 38
    ISSN: 1432-2161
    Keywords: Key words Intraneural ganglion ; Peroneal nerve palsy ; Drop foot ; MRI
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  A case of peroneal nerve palsy caused by an intraneural ganglion is presented. The cystic mass was located posterolateral to the lateral femoral condyle and extended along the common peroneal nerve distal to the origin of the peroneus longus muscle. The nerve was compressed in the narrow fibro-osseous tunnel against the fibula neck and the tight origin of the peroneus longus muscle. The nerve was decompressed by complete tumor excision and transection of the origin of the peroneus longus muscle. Full recovery of nerve function was obtained in 6 months.
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  • 39
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    Skeletal radiology 28 (1999), S. 655-657 
    ISSN: 1432-2161
    Keywords: Key words Acromegaly ; Locking ; Metacarpophalangeal joint ; Osteophyte ; Volar plate hypertrophy ; Radiography ; MRI
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  A 39-year-old man with acromegaly exhibited locking of metacarpophalangeal (MCP) joints of both index fingers. Large osteophytes were found at the metacarpal heads by radiography and computerized tomography (CT). Magnetic resonance (MR) images revealed hypertrophy of volar plates. We suggest that these characteristic acromegalic features caused locking of MCP joints. Surgery was required on one of the joints to release the locking.
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  • 40
    ISSN: 1432-2161
    Keywords: Key words Chondroblastoma ; malignant ; recurrent ; p53 mutation ; Aneuploidy ; Pelvis ; Femur ; Xray ; CT
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  We report a rare case of malignant chondroblastoma, which presented in a 47-year-old man as a recurrent tumor, 18 years following wide excision of a typical pelvic chondroblastoma. Radiologic studies of the recurrent tumor showed a large, lytic, destructive lesion of the right pelvic bones and femur, with a pathologic fracture of the latter, a large pelvic soft tissue mass, and multiple pulmonary metastases. Biopsy tissue showed typical features of chondroblastoma, but also increased nuclear atypia, hyperchromasia, and pleomorphism, compared to the original tumor, and, most significantly, abnormal mitotic figures. Immunohistochemical studies of the recurrent tumor revealed p53 mutation and extensive proliferative activity, and flow cytometric studies showed DNA aneuploidy, none of which was present in the original tumor. The patient received chemotherapy and radiation, but died of disease eight months after presentation. We also review chondroblastoma in general, to assign this unusual lesion to a tumor subtype.
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  • 41
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    Skeletal radiology 28 (1999), S. 658-660 
    ISSN: 1432-2161
    Keywords: Key words Medial collateral ligament ; tear ; interposition ; Knee ; MRI ; Posterolateral dislocation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Displacement of the medial collateral ligament (MCL) into the medial knee joint is an extremely rare finding associated with MCL tears, and is easily diagnosed on magnetic resonance imaging. A case of intra-articular interposition of the MCL during a severe knee injury is presented. A radiolucent ”fat stripe” sign and adjacent skin dimpling on radiographs may be relatively specific indicators of this injury.
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  • 42
    ISSN: 1432-2161
    Keywords: Key words Shoulder ; arthrography ; Shoulder ; comparative studies ; Shoulder ; injury ; Shoulder ; MRI
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Purpose. In a patient with internal derangement of the shoulder, the diagnostic method of choice is controversial. Conventional arthrography can diagnose most rotator cuff tears accurately; however, in many institutions MR arthrography is usually necessary to diagnose labral tears. We utilized decision tree methodology to compare the cost- effectiveness of conventional arthrography and conventional MRI with a hypothetical algorithm in which a patient underwent arthrography, performed with admixed gadolinium, which if negative, was followed by MRI. Design. The use of double-contrast arthrography alone, conventional MRI alone, and gadolinium-enhanced MRI used as an adjunct to conventional arthrography were modeled for the diagnosis of full-thickness rotator cuff tears (RCT), partial RCTs, labral tears, and the absence of cuff/labral tears using decision analysis methodology. English language medical publications were searched to determine the base probabilities for the accuracy of the diagnostic tests. The outcome utilities ranged from –1 to +1 to reflect the value of correct diagnostic evaluation. Charges for diagnostic tests and appropriate surgical treatments were based on 1997 Medicare reimbursement rates for professional fees and hospital charges in an outpatient setting. Sensitivity analyses were performed to evaluate the effects of uncertainty regarding the prevalence of each disease state and the accuracy of several diagnostic tests. Results. In the base-case analysis, the average effectiveness of double-contrast arthrography alone, MRI alone and arthrography selectively followed by MRI were 0.6610, 0.6715, and 0.7204, respectively. The average costs for each of these strategies were $1090, $2033, and $2339, respectively. Conclusion. Arthrography performed with admixed diluted gadolinium, which if negative is immediately followed by MRI, was somewhat more expensive than conventional MRI. However, because of much greater effectiveness, cost-effectiveness was significantly higher for our proposed algorithm. Conventional arthrography without gadolinium, although less expensive, had severely limited effectiveness.
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  • 43
    ISSN: 1432-2307
    Keywords: Key words Pyruvate kinase isoenzymes ; N-Nitrosomorpholine ; Rat
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  The expression of the pyruvate kinase (PK) isoenzymes L and M2 was analysed in the livers of rats treated with the hepatocarcinogenic agent N-nitrosomorpholine (NNM) in the drinking water. In control animals L-PK expression was restricted to liver parenchymal cells, whereas M2-PK was detected in bile duct epithelial, blood vessel wall, endothelial and Kupffer cells. In rats treated with NNM proliferating oval cells were consistently L-PK negative and M2-PK positive, while the ductal cells of cholangiofibroses were clearly L-PK positive and coexpressed M2-PK. However, no morphological differentiation of ductal cells into hepatocyte-like cells was observed. In the clear and acidophilic cell foci storing glycogen in excess strong staining for L-PK was observed. In glycogen-poor foci induced by NNM a shift from L-PK to M2-PK expression takes place.
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  • 44
    ISSN: 1432-5233
    Keywords: Key words Cadmium ; Diabetes ; VEP ; TBARS ; Rat
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Fifty-two healthy male Swiss albino rats, aged three months, were used in this study. They were divided into four groups: control (c), diabetic (D), cadmium (Cd), and diabetic + Cd (D+Cd). A diabetic condition was induced in D and D + Cd groups by administration of alloxane (5 mg/100 g). After this treatment, Cd and D + Cd groups were injected intraperitoneally with CdCl2 (2 mg/kg week). At the end of the 2-month experimental period, flash visual evoked potentials (FVEPs) of the four groups were recorded with disk electrodes attached with electrode paste 0.5 cm in front of and behind the bregma. The mean latencies off the P1, N1, P2, N2 and P3 components were significantly prolonged in the diabetic group compared with the control group. The mean latencies of P3 in the D + Cd group and of P1 and P3 in the Cd group were longer than those of the control group. P2N2 amplitude of Cd and D + Cd groups were significantly increased compared with the control group. On the other hand, thiobarbituric acid-reactive substances (TBARS) were determined as an indicator of lipid peroxidation. Our data showed that Cd treatment and diabetic condition caused a significant increase of lipid peroxidation in kidney, brain, retina and lens.
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  • 45
    ISSN: 1432-2102
    Keywords: Schlüsselwörter PACS ; Filmlos ; MR ; Key words PACS ; Filmless ; MRI
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary At our hospital, an average MRI examination comprises 170 images. These examinations were evaluated exclusively on digital reporting systems with two high-resolution monitors for a period of 1 year. A retrospective analysis of this reporting method in comparison with films on a conventional viewing wall was performed with subjective and objective data. Radiologists and technicians were requested to evaluate the system on a subjective scale from 1 to 5 for seven topics (image analysis, inspection, time for reporting, handling, comparison with previous reports, quality of PC laser prints, training period). Moreover, personal interviews were conducted and protocols taken. Patient and image frequency, film costs, data transfer time and amount of system failures were evaluated as objective data. The most important results were: Two thirds of the film checking radiologists prefer the conventional viewing walls over the computer monitors. However, 70% of the residents prefer using the computer monitor for reporting. Seventy percent of the interviewed radiologists considered comparison with former examinations on film very difficult. Digitizing of former MRI examinations was not a convincing method; printing on a standard PC laser printer was considered to yield insufficient quality. The different acceptance between radiologists and residents seems to be related to different experiences. The reduction in film costs (48.6%) will improve further with complete PACS installation in the whole hospital. Data transfer rates are still poor; further improvement of network performance is necessary for convenient work. One whole MRI examination and report could be stored on CD-ROM for a cost of less than 2 euros. This could be a future means of cheap archiving and documentation suitable for viewing on any PC with DICOM III viewer. Images and reports could stay with the patient as in the past.
    Notes: Zusammenfassung Im Durchschnitt werden pro Tag 14,05 Patienten mit durchschnittlich 170 Schichtbildern pro Patient an unserer MRT-Anlage untersucht. Die Befundung dieser Bilder erfolgte über ein Jahr ausschließlich auf digitalen Befundungsstationen, bestehend aus zwei hochauflösenden Monitoren und einer Graphikworkstation. Ein Bildausdruck erfolgte zusätzlich auf einem hochauflösenden Laserpapierdrucker. Auf Grund von subjektiv und objektiv erhobenen Daten wurde ein retrospektiver Vergleich zwischen digitaler Bildschirmbefundung und Filmbefundung am Leuchtkasten durchgeführt. Material und Methode: Befragt wurde aufgrund einer subjektiven Bewertungsskala von 1 bis 5 nach 7 Kriterien. Weiters wurden in Interviews die subjektiven Erfahrungen protokolliert. Objektiv wurde überdies Anzahl und Zeit der Systemausfälle, Filmverbrauch, Untersuchungsfrequenzen, Bildmenge pro Tag sowie Zeitmessungen für Datentransfers gemessen. Ergebnisse: Zwei Drittel der Oberärzte bevorzugten die Leuchtkastenbefundung, 70% der Ärzte in Ausbildung zogen die Befundung auf Bildschirmen vor. 70% der befragten Ärzte sahen als eindeutiger Schwachpunkt des digitalen Befundungssystems den Vorbildvergleich an. Alle befragten Ärzte (n=13) bewerteten die Arbeit mit (auswärtigen) konventionellen MRT-Untersuchungen auf Film und der gleichzeitigen Bildschirmbefundung als besonders mühsam. Das Einscannen von Voruntersuchungen mit Betrachtung am Bildschirm erwies sich als nicht Praxis tauglich, die Dokumentation auf Papierbildern durch PC-Laserausdruck erwies sich als unbrauchbar. Diskussion: Der deutliche Akzeptanzunterschied zwischen Fachärzten und in Ausbildung befindlichen Ärzten ist vermutlich auf die unterschiedliche Vorerfahrung (Vorprägung) zurückzuführen. Die nur 48,6% Reduktion Filmverbrauch werden vermutlich nach einer stärkeren Verbreitung von digitalen Bilddaten verbessert werden. Die tatsächlich erzielten Bildtransferraten liegen derzeit zeitlich weit über den technisch möglichen. Die Optimierungen von Netzwerken und beteiligten Rechnern sind daher dringend erforderlich. Als alternatives Dokumentations- und Ausgabemedium könnte auch die äußerst preiswerte CD-ROM dienen. Sie sind auf jedem gängigen PC-System verwendbar. Das Prinzip, daß Befund und Bilder beim Patienten verbleiben, wäre damit leicht aufrecht zu erhalten.
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  • 46
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    Der Radiologe 39 (1999), S. 16-24 
    ISSN: 1432-2102
    Keywords: Schlüsselwörter Sprunggelenk ; Sprunggelenksverletzung ; Bandverletzung ; Streßradiographie ; MRT ; Key words Ankle ; Ankle injuries ; Ligament injuries ; Stress X-ray ; MRI
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary The diagnosis of lateral collateral ankle ligament trauma is based on patient history, clinical examination, and clinical stress tests. If the clinical stress test is positive, stress radiography could be performed. There is no consensus about the usefulness of stress radiography in acute ankle sprain, particularly about the cut-off talar tilt angle beyond which a two-ligament rupture would be certain, ranging from 5° to 30°. Today MRI is not used for this indication, although it allows, with controlled positioning of the foot and with defined sections, visualization of injured lateral collateral ankle ligaments. In ankle injuries, plain radiographs form the established basis of diagnostic imaging and can provide definitive answers in most cases. CT is used in complex fractures for complete visualization. MRI is the method of choice for several diagnostic problem cases, including occult fractures and post-traumatic avascular necrosis. In tendon injuries, MRI is important if ultrasound is not diagnostic. Generally, for the evaluation of acute ankle injuries, MRI is the most important second-step procedure when radiographs are nondiagnostic.
    Notes: Zusammenfassung Die Diagnose einer lateralen Bandverletzung beim frischen Sprunggelenkstrauma fußt auf der Anamnese, der klinischen Untersuchung und klinischen Streßtests. Bei positiven klinischen Streßtests kann eine Streßradiographie durchgeführt werden. Es gibt keine Übereinstimmung für den Wert der Streßradiographie beim frischen Supinationstrauma des Sprunggelenks, insbesonders für den Winkel der Aufklappbarkeit bei einer Zweibandverletzung, der von 5°–30° reicht. Die MRT wird zur Zeit bei dieser Indikation nur in Einzelfällen benutzt, obwohl sie mit definierter Fußpositionierung und Ausrichtung der Untersuchungsebene eine ausgezeichnete Beurteilung der Sprunggelenksbänder erlaubt. Bei knöchernen Sprunggelenksverletzungen ist die Verwendung des konventionellen Röntgen die etablierte Methode und meist diagnostisch. Die CT kommt bei komplexen Frakturen zum Einsatz, um das gesamte Frakturausmaß darzustellen. Die MRT ist die Methode der Wahl bei verschiedenen Problemfällen wie okkulter Fraktur oder posttraumatischer Osteonekrose. Bei Sehnenverletzungen ist die MRT wichtig, falls eine Ultraschalluntersuchung nicht zur Diagnose führt. Allgemein entwickelt sich bei der Untersuchung der frischen Sprunggelenksverletzung die MRT zur zweitwichtigsten bildgebenden Methode, falls das konventionelle Röntgen zu keiner ausreichenden Diagnose kommt.
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  • 47
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    Der Radiologe 39 (1999), S. 958-964 
    ISSN: 1432-2102
    Keywords: Schlüsselwörter Spiral-CT ; Mehrzeilen-Spiral-CT ; Pankreaskarzinom ; Tumorstaging ; 2D-/3D-Bildgebung ; Key words Computed tomography ; Computed tomography ; helical ; Computed tomography ; technology ; Computed tomography ; thin-section ; Pancreatic neoplasms ; CT
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Purpose. Investigation of the capabilities of MSCT and its value for the staging of pancreatic carcinomas. Methods. 50 Patients with suspected pancreatic carcinoma were examined with a biphasic multislice-spiral-CT protocol: slice collimation 4×1 mm, Pitch 3.5–4 mm. After administation of 120 ml contrast medium and 50 ml NaCl with a flow rate of 3.0 ml/s the examination was started with a delay of 40 s (pancreatic phase) and 80 s (portalvenous phase). Results. Multislice spiral CT allows the examination of the whole upper abdomen with nearly isotropic data sets. This is the premise for the optimal assessment of the tumor extent in all planes, excellent demarcation of the tumor against the adjacent vessels and organs and the demarcation of small peripancreatic lymph nodes. Conclusions. Multislice spiral CT and the use of interactive multiplanar reconstructions improve the staging of pancreatic cancer.
    Notes: Zusammenfassung Ziel unserer Untersuchungen war es, die Möglichkeiten der Mehrzeilen-Detektor-Spiral-CT und ihre Bedeutung für das Staging von Pankreastumoren zu evaluieren. Bei insgesamt 50 Patienten, bei denen der Verdacht auf ein Pankreaskarzinom bestand, wurde im Rahmen der Tumorstagings ein biphasisches hochaufgelöstes Mehrzeilen-Spiral-CT mit einer Schichtkollimation von 4×1 mm, einem Pitch von 3,5–4, 120 ml Kontrastmittel, 50 ml 0,9%NaCl-Bolus, 3,0 ml/s Fluß und einem Startdelay von durchschnittlich 40 s (Pankreasparenchymphase) und 80 s (portalvenöse Phase) durchgeführt. Die Mehrzeilen-Spiral-CT ist in der Lage die gesamte Pankreasloge und auch die angrenzenden Organe mit hoher Ortsauflösung in allen Raumebenen abzubilden. Die nahezu isotrope multiplanare Bildgebung erlaubt die vollständige Erfassung der Tumorausdehnung in allen Raumebenen und eine bessere Abgrenzung der Tumoren gegenüber dem angrenzenden Fettgewebe, den benachbarten Organen (Gefäße, Duodenum, Magen) und einen sichereren Nachweis von peripankreatischen Lymphknoten. Die Mehrzeilen-Spiral-CT und der Einsatz von interaktiven multiplanaren Rekonstruktionen verbessern nachhaltig die Bestimmung der Ausdehnung von Pankreaskarzinomen.
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  • 48
    ISSN: 1432-2102
    Keywords: Schlüsselwörter Fokale Leberläsionen ; Spiral-CT ; MRT ; Kontrastmittel ; SPIO ; Key words Focal liver lesions ; Spiral CT ; MRI ; Ferumoxides
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Purpose: Evaluation of the diagnostic efficacy of contrast-enhanced, dual-phase spiral CT and MRI before and after administration of SPIO particles in focal hepatic disease with previously uncertain diagnosis. Material and methods: In 46 patients in whom primary or secondary hepatic malignancy was suspected, dual-phase spiral CECT and breath-held T1-weighted gradient-echo and T2-weighted fast spin-echo MRI (1.5 T, body-phased-array coil) before and after SPIO administration were compared. The indications for the subsequent MRI studies were based on ambiguous findings on CECT. The number of hepatic lesions, the overall lesion detection and characterization was evaluated by consensus and compared to the gold standard (histological proof in 30/46 of the cases, long-term follow-up in 16/46 of the cases). Results: In 34 of 46 cases the correct diagnoses were established by CECT (sensitivity 96%, specificity 48%) revealing significantly less lesions than MRI. Unenhanced MRI had sensitivity of 93% and specificity of 71%, whereas SPIO-enhanced MRI had sensitivity of 97% and specificity of 88%. The differences between the modalities were even more pronounced in the detection of lesions smaller than 10 mm with SPIO-MRI as the most sensitive method. Conclusions: In this problem-oriented scenario, SPIO-enhanced MRI was superior to spiral CT and unenhanced MRI regarding the diagnostic efficacy in the pre-operative work-up of focal liver lesions. SPIO-enhanced MRI can be recommended as a problem-solving tool for the clinical routine.
    Notes: Zusammenfassung Fragestellung: Analyse der diagnostischen Wertigkeit der kontrastmittelverstärkten, biphasischen Spiral-CT im Vergleich zu nativer und SPIO-verstärkter MRT bei Patienten mit V.a. fokale Leberläsionen vor eventueller Leber-OP. Material und Methode: 46 Patienten mit V.a. sekundäre oder primäre Lebertumoren wurden nach i.v.-Kontrastmittelgabe an einem Spiral-CT und an einem 1,5 Tesla-Magneten (Atemstillstand-Sequenzen, Körper-Array-Spule) vor und nach i.v.-Infusion von superparamagnetischen Eisenoxydpartikeln untersucht. Die CT- und MRT-Untersuchungen wurden hinsichtlich Läsionsanzahl, -detektion und -charakterisierung qualitativ beurteilt und mit dem Goldstandard (Histologie in 30/46, follow-up in 16/46 der Fälle) verglichen. Ergebnisse: Die Spiral-CT erbrachte in 34/46 Fällen eine korrekte Diagnose, wobei sie signifikant weniger Läsionen in der Leber zeigte als die MRT. Die native MRT war der Spiral-CT hinsichtlich Läsionsdetektion und diagnostischer Effizienz überlegen und wurde noch von der SPIO-verstärkten MRT übertroffen. Der Unterschied zwischen den Modalitäten war bei Läsionen kleiner 10 mm noch deutlicher, von denen die Spiral-CT lediglich 6/13 Läsionen detektierte. Schlußfolgerungen: Die SPIO-MRT ist der biphasischen Spiral-CT und der nativen MRT im Nachweis und bei der Charakterisierung fokaler Leberläsionen überlegen und kann in problematischen Fällen allgemein empfohlen werden.
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  • 49
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    Der Radiologe 39 (1999), S. 610-618 
    ISSN: 1432-2102
    Keywords: Schlüsselwörter Staging ; Gynäkologische Karzinome ; Schnittbildverfahren ; Computertomographie (CT) ; Magnetresonanztomographie (MRT) ; Sonographie (US) ; Key words Staging ; Gynecologic neoplasm ; Cross-sectional imaging modalities ; CT ; MRI ; Sonography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary The prognosis in patients with gynecologic cancers depends not only on the stage but also on a wide spectrum of other findings. Cross-sectional imaging modalities, including sonography, CT and MRI, have increasingly been used for optimal treatment planning in gynecologic cancers. Their staging criteria are based on the well-established FIGO staging system. CT and MRI compete with sonography, which plays a pivotal role in the evaluation of the female pelvis. This paper reviews the role of sonography, CT and MRI in the staging of gynecologic malignancies. It puts the emphasis on MRI, which has been established as imaging modality of choice in the preoperative evaluation of cervical and endometrial cancer, and which seems slightly superior to CT in the staging of ovarian cancer.
    Notes: Zusammenfassung Die Prognose gynäkologischer Karzinome hängt nicht nur vom Stadium, sondern von einem breiten Spektrum anerkannter Kriterien ab. Zur optimierten Therapieplanung werden heute zunehmend die Schnittbildverfahren Sonographie, CT und MRT für die morphologische Charakterisierung der Veränderungen eingesetzt. Die Stagingkriterien der bildgebenden Verfahren orientieren sich an der anerkannten FIGO-Klasssifikation. CT und MRT konkurrieren mit der Sonographie, die als anerkannte und weitverbreitete Modalität in der Gynäkologie etabliert ist. In dieser Übersichtsarbeit werden die Schnittbildverfahren Sonographie, CT und MRT im Staging gynäkologischer Karzinome einander gegenübergestellt. Der Schwerpunkt der Ausführungen liegt dabei auf der MRT, die als Methode der Wahl zum Staging des Zervix- und Endometriumkarzinoms gilt, beim Ovarialkarzinom der CT ebenbürtig und in manchen Fragestellung tendentiell überlegen ist.
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  • 50
    ISSN: 1432-2307
    Keywords: Key words Medullary thyroid carcinoma ; Basement membrane ; Laminin ; Rat
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Medullary thyroid carcinoma (MTC) originates from C cells, which secrete calcitonin (CT), their specific marker. C cells are located in contact with the basement membrane (BM) of the thyroid follicles, which is partly made up of the laminin-2 isoform synthesized by thyrocytes. During oncogenesis, proliferation of the C cells, invading the centre of the follicles, leads to a break in their normal contact with the BM. As specific interactions of cells with BM components, especially laminins, are important for proliferation and differentiation, we investigated the relationships of normal and neoplastic C cells with laminin in the Wag/Rij rat model of human MTC. Immunocytochemical studies showed a progressive loss of the laminin layer underlying the hyperplastic C cell nodules around the large dedifferentiated tumours. The α2, β1 and γ1 chains of the laminin-2 isoform were synthesized and secreted by rat MTC 6–23 cell cultures and the tumours induced by subcutaneous injection of these cells. In situ hybridization combined with anti-CT immunocytochemistry showed a low expression of α2 mRNA on differentiated C cells and thyrocytes, but an overexpression on immunonegative spontaneous MTC and induced intrathyroid tumours. The high level of α2 gene expression, together with tumour dedifferentiation, suggests a relationship with malignancy.
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  • 51
    ISSN: 1432-2277
    Keywords: Key words Xenotransplantation ; 15-deoxyspergualin ; Guinea pig ; Rat
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract This study aimed to investigate the effects of 15-deoxyspergualin (DSG), tacrolimus (FK 506) and cyclosporin A (CyA), alone or in combination, on delayed xenograft rejection (DXR). We used the guinea-pig-to-C6-deficient (C6–)-PVG-rat heart transplantation model, since in this strain combination, hyperacute rejection is avoided. In C6- control rats, the guinea pig xenografts survived for 39.2 ± 6.3 h (mean ± SD). Splenectomy alone resulted in a xenograft survival of 71.8 ± 7.8 h, but the addition of CyA or FK 506 did not further improve graft survival (73.6 ± 3.0 h and 72.0 ± 17.6 h, respectively). In contrast, DSG treatment increased graft survival to a mean of 99.8 ± 9.2 h. When CyA or FK 506 was combined with DSG, no additional effects were observed (105 ± 24.3 h and 95.1 ± 5.6 h, respectively). DSG alone or in combination with FK 506 or CyA resulted in a significant reduction in the serum IgM levels and reduced the deposits of IgM and IgG in rejected grafts. However, all xenografts were still heavily infiltrated by ED1 + macrophages, regardless of the treatment used. Thus, DSG treatment resulted in moderate prolongation of xenograft survival in C6– rats. The effect seems to be related to suppression of xenoreactive antibody production. To prolong xenograft survival further, strategies that inhibit macrophage infiltration seem required.
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  • 52
    ISSN: 1432-1912
    Keywords: Key words Blood pressure ; Endothelium ; Human ; Mesenteric artery ; Rat ; Smooth muscle
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The majority of the findings concerning arterial physiology and pathophysiology originate from studies with experimental animals, while only limited information exists about the functional characteristics of human arteries. Therefore, the aim of the present work was to compare the control of vascular tone in vitro in mesenteric arterial rings of corresponding size (outer diameter 0.75–1 mm) from humans and Wistar-Kyoto rats. The relaxations to acetylcholine (ACh) were clearly less marked in the mesenteric arteries of humans when compared with rats. How-ever, when calcium ionophore A23187 was used as the vasodilator, the endothelium-mediated relaxations did not significantly differ between these species. The NO synthase inhibitor N G-nitro-l-arginine methyl ester (l-NAME) attenuated the relaxations to ACh and A23187 in both groups. The endothelium-independent relaxations to the β-adrenoceptor agonist isoprenaline and the nitric oxide (NO)-donor nitroprusside were somewhat lower in human arteries, while vasodilation induced by the K+ channel opener cromakalim was similar between humans and rats. Arterial contractile sensitivity to noradrenaline and serotonin was slightly lower in human vessels, whereas contractile sensitivity to KCl was similar between these species. The contractions induced by cumulative addition of Ca2+ with noradrenaline as the agonist were effectively inhibited in both groups by the calcium channel blocker nifedipine, the effect of which was clearly more pronounced in human arteries. In conclusion, the control of vascular tone of isolated arteries of corresponding size from humans and rats appeared to be rather similar. The most marked differences between these species were the impaired endothelium-mediated dilation to ACh and the more pronounced effect of nifedipine on the Ca2+-induced contractions in human arteries.
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  • 53
    ISSN: 1432-198X
    Keywords: Key words Hypercalciuria ; Idiopathic hypercalciuria ; Bone mineral content ; 1 ; 25-Dihydroxyvitamin D ; Furosemide ; Ammonium chloride ; Rat
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  The relationship between bone mineral status and hypercalciuria is controversial. The effect on bone composition of different forms of hypercalciuria was studied in female rats made hypercalciuric by 7-week administration of oral furosemide (F, n=12), intraperitoneal 1,25-dihydroxy vitamin D (VD, n=11), or oral ammonium chloride (AC, n=12). Seven untreated rats served as controls (C). Hypercalciuria (mg/100 g per 24 h, mean ±SEM) of F (4.3±0.2), VD (4.1±0.4), and AC (3.9±0.3) groups was of similar intensity (C rats 1.3±0.1, P〈0.01). Weight and length gains and serum CO2, sodium, potassium, calcium, and phosphate were no different among the four groups. Bone was studied by dual-energy X-ray absorptiometry of left tibiae. AC rats had significantly less bone area (1.505±0.018 cm2) than VD and C (1.602±0.020 and 1.587±0.019 cm2). Bone mineral content was decreased in F (0.357±0.007 g) and AC (0.362±0.006 g) compared with VD (0.407±0.008 g) and C (0.389±0.009 g) groups. Bone mineral density was different between F (0.231±0.002 g/cm2) and VD and C rats (0.254±0.004 and 0.245±0.003 g/cm2), and also between AC (0.240±0.003 cm2) and VD rats. In these rat models, hypercalciuria of renal origin (F) and hypercalciuria caused by acid load (AC) adversely impaired bone mass.
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  • 54
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    Pediatric nephrology 13 (1999), S. 800-805 
    ISSN: 1432-198X
    Keywords: Key words In situ hybridization ; Kidney development ; Nephrogenesis ; Phosphatase activity ; Serine/threonine protein phosphatase 2A ; Protein phosphorylation ; Rat
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Several lines of evidence suggest that the serine/threonine protein phosphatase (PP)2A is of vital importance for cell cycle regulation, cell differentiation, and signal transduction. This prompted us to study the expression of the mRNA for PP2A catalytic isoforms α and β in the developing rat kidney using in situ hybridization histochemistry. The expression patterns of the two isoforms were strikingly similar. Both were ubiquitously expressed in early metanephric kidneys. Later in gestation they were expressed in the nephrogenic zone. Strong expression was observed on postnatal day (PN) 10. This was followed by a downregulation at PN20, i.e., when nephrogenesis is completed. The expression in the adult kidney was very weak and mainly confined to the medulla. In a phosphatase activity assay, PP2A accounted for 78% of the total serine/threonine phosphatase activity in embryonic day 15 rat kidneys. PP1 was the main contributor to the remaining activity. In conclusion, PP2A is the major serine/threonine phosphatase in fetal kidneys. The age-dependent expression pattern supports the concept that this enzyme is of particular importance during renal morphogenesis and development.
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  • 55
    ISSN: 1432-198X
    Keywords: Key words Cystinosis ; Cysteamine ; Renal function ; Rat ; Prenatal
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  The safety of cysteamine after renal transplantation and during pregnancy is an important issue, since girls with cystinosis are in better health on cysteamine therapy and thus more likely to become pregnant. In the first study, cysteamine was given to pregnant rats on days 6.5–18.5 post conception in oral doses of 0, 37.5, 75, 100, and 150 mg/kg per day. The dams were sacrificed on day 20.5, the fetal kidneys removed and prepared for histological examination. In the second study, cysteamine was given to dams on days 6.5–19.5 post conception in oral doses of 0, 37.5, 50, and 75 mg/kg per day. Dams were allowed to give birth naturally and pups were given cysteamine on days 4–21 to yield the same oral doses of cysteamine given to the dam. Renal function was evaluated on day 35. Histological examination of fetal kidneys revealed no changes even in kidneys from fetuses with growth retardation and malformations. Furthermore, there were no alterations in renal function in offspring on day 35. These findings demonstrate that cysteamine therapy does not affect renal development in the rat. Further investigations will be required to prove whether cysteamine therapy has the potential to affect renal development in the human.
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  • 56
    ISSN: 1432-1831
    Keywords: Key wordsToxoplasma gondii ; Toxoplasmosis ; Rat ; Animal model
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract There is evidence that not only the immune status, but also the genetic predisposition of certain hosts influence the clinical outcome of Toxoplasma gondii infection. By far the majority of our knowledge on genetic and immunological mechanisms involved in control of T. gondii infection has been obtained by studying mouse models, which in terms of clinical outcome of infection differ considerably from humans. Rats which show a rather similar course of infection in comparison to humans have not so far been investigated for effects of genetic differences on course of the infection. In this study we show that, like mice, different strains of rats exhibit a remarkable variation in the number of brain cysts arising from chronic infection. LEW rats seem to be highly resistant to cyst formation, in contrast to F344 rats that are susceptible. In addition, F344 rats express high numbers of γδ T cells during the acute phase of infection, whereas LEW rats express elevated but comparably low numbers of γδ T cells. The RT1 (rat MHC) haplotypes of both strains are identical in the RT1A and RT1B/D regions, which encode the restriction elements for conventional peptide antigens. Consequently, rat strain-specific differences may be useful to define MHC-independent mechanisms of resistance against T. gondii, which may also act in humans.
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  • 57
    ISSN: 1432-0738
    Keywords: Key words Benzene ; Benzene metabolites ; Diabetes ; Cytochrome P-450 ; Rat
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Benzene is a ubiquitous environmental pollutant primarily metabolized by a cytochrome P-450 (CYP-450) isoenzyme, CYP-450 IIE1. A consistent induction of CYP450 IIE1 has been observed in both rat and human affected by diabetes mellitus. The aim of this study was to evaluate whether streptozotocin (STZ)-induced diabetes determines modifications in the metabolic pathways of benzene in rat. Benzene (100 mg/kg per day, dissolved in corn oil) was administered i.p. once a day for 5 days. Urine samples were collected every day in STZ-treated and normoglycaemic animals, treated and untreated with benzene (n = 10). Urinary levels of trans,trans-muconic acid and of phenol, catechol and hydroquinone (free and conjugated with sulphuryl and glucuronic group) were measured by high-performance liquid chromatography (HPLC). In normoglycaemic rats during the 5 days of treatment with benzene we observed a progressive and significant decrement in the urinary excretion of phenol, phenyl sulphate and glucuronide, catechol, catechol glucuronide, hydroquinone, hydroquinone glucuronide and t,t-muconic acid (P 〈 0.05). In the diabetic animals, conversely, the same metabolites showed progressively increasing urinary levels (P 〈 0.05). Catechol sulphate and hydroquinone sulphate levels were below the instrument's detection limit. In the comparison between diabetic and normoglycaemic benzene treated rats, the inter-group difference was significant (P 〈 0.05) from day 3 of treatment for t,t-muconic acid, and from day 1 for free and conjugated phenol, free and glucuronide catechol and free hydroquinone. In the normoglycaemic rat exposed to benzene the decreasing trend observed in urinary excretion of free and conjugated metabolites may be due to their capability to reduce cytochromial activity. Conversely, in the diabetic rat, urinary levels of benzene metabolites tended to increase progressively, probably due to the consistent induction of CYP-450 IIE1 observed in diabetes, which would overwhelm the inhibition of this isoenzyme caused by phenolic metabolites. Furthermore, the metabolic switch towards detoxification metabolites observed after administration of high doses of benzene is not allowed in the diabetic because of reduced glutathione-S-transferase activity. As a consequence, higher levels of hydroquinone, phenol and catechol, considered the actual metabolites responsibles for benzene toxicity, will accumulate in the diabetic rat. Extrapolating these data to human, we may thus suggest that occupational exposure to benzene of a diabetic subject poses a higher risk level, as his metabolism tends to produce and accumulate higher levels of reactive benzene catabolites.
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  • 58
    ISSN: 1432-0533
    Keywords: Key words Clomethiazole ; Rat ; Spinal cord-injury ; Neuroprotection
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Clomethiazole (CMZ) has a neuroprotective effect in experimental focal and global forebrain ischemia. This neuroprotective effect may depend on its ability to enhance GABA receptor activity. We have studied the effect of pretreatment with CMZ on motor function recovery and nerve cell damage after spinal cord injury (SCI). Rats were randomized and 30 min before SCI they received a single intraperitoneal dose of CMZ (150 mg/kg) or saline. The spinal cord was injured with a 50 g (4.5 g/mm2) load, applied over the exposed dura, through a curved rectangular plate (2.2 × 5.0 mm) for 5 min at T8–9. The animals became paraplegic 1 day after injury. The rats were evaluated for recovery of hind limb motor function. All animals recovered to some extent over the observation period of 12 weeks. However, hind limb motor function was significantly better in the animals pretreated with CMZ. At 12 weeks the rats were killed and perfused/fixed for morphological investigations. Microtubule-associated protein 2 (MAP2) immunostaining was used to stain neurons and dendrites and Luxol-fast blue to stain myelinated tracts of the white matter. The injured segment of the spinal cord showed severe atrophy, distortion, cavitation and necrosis of grey and white matter. Compared to uninjured controls the transverse sectional area was reduced to 32.7 ± 4% in untreated animals but only to 38.5% ± 4.1 in CMZ-treated animals. MAP2 staining showed that, compared to uninjured controls, grey matter was reduced to 7.4 ± 2.7% in saline-treated injured animals and to 22.7 ± 5.4% in CMZ-treated rats. Our results thus show that in this model CMZ improves hind limb motor function and attenuates the morphological damage to the spinal cord.
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  • 59
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    Anatomy and embryology 200 (1999), S. 413-417 
    ISSN: 1432-0568
    Keywords: Key words Receptor cell ; Axon ; Vomeronasal organ ; Regeneration ; Rat ; HRP-WGA
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Chemosensory neurons in the vomeronasal epithelium (vomeronasal neurons) regenerate following experimentally induced degeneration. Transection of the vomeronasal nerves leads to retrograde degeneration of vomeronasal neurons followed by replacement of the cell population. The projection of the axons of regenerated vomeronasal neurons was examined by horseradish peroxidase(HRP) histochemistry and electron microscopy. HRP-wheat germ agglutinin (WGA) was placed on the surface of the vomeronasal organ of the rat. Dense distribution of HRP-labeled fibers was observed in the vomeronasal nerve and glomerular layers in the accessory olfactory bulb (AOB) of the intact rat. At one week after transection, HRP-labeled fibers were not found in the AOB, and no labeled fibers could be observed on the medial surface of the olfactory bulb where the vomeronasal nerve traversed. Three weeks after transection, labeled fiber bundles were observed on the medial surface of the olfactory bulb in all animals. No labeled fibers were detected in the AOB. From 12 to 32 weeks after transection, projection of HRP-labeled fibers was identified in the AOB in 8 out of 26 rats (the incidence of projection was 30%). But the number of projection fibers on the operated side was much smaller than on the control side. Electron microscopy confirmed that the HRP-labeled terminals make synaptic contacts with neurons in the AOB.
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  • 60
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    Anatomy and embryology 200 (1999), S. 521-531 
    ISSN: 1432-0568
    Keywords: Key words Development ; Internal capsule ; Nucleus basalis ; Rat ; Thalamus
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  This study defines several features of the early connections of the developmentally transient perireticular thalamic nucleus of rats. The neocortex of developing rats was injected with either DiI, biotinylated dextran, WGA-HRP (wheatgerm agglutinin conjugated-horseradish peroxidase), fluorescent latex beads or cholera toxin subunit B (CTB) and their brains were processed for tracer detection with standard methods. In general, tracer injections into various regions of the developing neocortex revealed no labelled neurones within the perireticular nucleus, although some of these tracers (WGA-HRP, dextran) labelled many of the amoeboid microglial cells that are found within this nucleus. There were, however, many retrogradely labelled neurones in a region adjacent to the perireticular nucleus, within the nucleus basalis of the basal forebrain (medial edge of globus pallidus). Their identity was confirmed as neurones of the nucleus basalis since they were all were similar in morphology and somal size to neurones that were immunoreactive to NGFr (nerve growth factor receptor), an antigen found only among neurones of the nucleus basalis and basal forebrain. Moreover, double labelling experiments revealed that most, if not all, of the cortically labelled neurones were NGFr-immunoreactive also. Thus, in conclusion, our results suggest that the perireticular nucleus does not project to the neocortex; the only neurones in the general vicinity of the perireticular nucleus that have a cortical projection form part of the nucleus basalis.
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  • 61
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    Anatomy and embryology 200 (1999), S. 533-540 
    ISSN: 1432-0568
    Keywords: Key words Coronary vasculogenesis ; Angiogenesis ; Coronary artery ; Development ; Rat ; Embryonic heart
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  The aim of this work was to address spatiotemporal and morphologic patterns of coronary artery development in rats, based on immunohistochemical and ultrastructural studies of hearts at different stages of prenatal development. Griffonia simplicifolia I lectin and α-smooth muscle antibody were used to demonstrate endothelial cells and/or their precursors and smooth muscle cells, respectively. Ultrastructural examination was performed on ED14–16 hearts to study the morphology of the developing coronary arteries in different regions of the truncus arteriosus and adjacent myocardium. On ED14 endothelial-like cells present within the mesenchyme surrounding the outflow tract penetrated the aortic wall and the truncoconal proximal myocardium. On ED15 these penetrating cells formed vascular clusters, which were the first signs of presumptive vascular channels. Development of the coronary artery proceeded by coalescence of discontinous vascular clusters, formation of the lumen (vascular channels) and establishing a connection of the proximal part with the aorta. The second layer of cells around vascular channels (embryonic media) consisted of mesenchymal cells that were attracted to the immature vessel and were first seen on ED15. At this time no lumenized connection of the coronary artery with the aorta has been seen. After the lumenized connection of the coronary artery with the aorta had been established perivascular cells of the media started to differentiate into vascular smooth muscle, as was shown by α-smooth muscle actin-staining. Further development and differentiation of the media and adventitia proceeded distally (towards the apex).
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  • 62
    ISSN: 1432-0568
    Keywords: Key words Morphogenesis ; Histochemistry ; Lectins ; Carbohydrates ; Salivary glands ; Rat
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  The developmental expression of salivary glycoconjugates was investigated in the rat submandibular and sublingual glands by conventional and lectin histochemistry. By the time of the first differentiation of secretory structures, in spite of similar morphological features, a different histochemical reactivity was detected, accounting for a relevant content of neutral glycoconjugates in the submandibular gland and the occurrence of both neutral and acidic glycoconjugates in the sublingual one. The use of lectins allowed the main changes of secretory components to be noted around gestational day 18. DBA and WGA lectins seemed to act as pre- and post-natal development markers while Con A lectin was indicative of post-natal differentiation. Taken together, data from lectin histochemistry indicated the transitional occurrence of glycoconjugates, probably involved in temporally restricted functions, as well as the co-existence of different secretory components that might also reflect maturational changes of single products.
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  • 63
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    Anatomy and embryology 199 (1999), S. 265-280 
    ISSN: 1432-0568
    Keywords: Key words Cat ; Rat ; Immunocytochemistry ; NADPH-diaphorase ; Thalamus
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  To gain insight into the cellular organisation of the zona incerta, we have examined the chemoarchitectonic properties of this ”uncertain zone”. The brains of Sprague-Dawley rats and common cats were processed for immunocytochemistry or NADPH-diaphorase histochemistry using standard methods. For the immunocytochemistry, antibodies to γ-aminobutyric acid (GABA), glutamic acid decarboxylase (GAD), parvalbumin, calbindin, tyrosine hydroxylase, somatostatin, serotonin and glutamate were used. Two general patterns of distribution in the zona incerta were seen. First, labelled cells were restricted largely to one of the cytoarchitectonically defined sectors of the zona incerta. For instance, GABA, GAD and parvalbumin-immunoreactive cells were found principally within the ventral sector, NADPH-diaphorase and glutamate-immunoreactive cells within the dorsal sector and tyrosine hydroxylase- and somatostatin-immunoreactive cells within the rostral sector. Second, labelled cells were scattered somewhat across all incertal sectors, with no clear region of concentration. This pattern included the calbindin- and serotonin-immunoreactive cell groups. These results indicate that the zona incerta is made up of many neurochemically distinct cell groups, some of which respect the well-defined cytoarchitectonic boundaries of the nucleus, whilst others do not. This rich neurochemical diversity in the zona incerta suggests that this nucleus may have differential effects on the different structures that it projects to.
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  • 64
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    Zeitschrift für Lebensmittel-Untersuchung und -Forschung 208 (1999), S. 183-188 
    ISSN: 1431-4630
    Keywords: Key words Sulphadimidine ; Fermented sausage ; Carbon-14-labelling ; Rat ; Bound residues
    Source: Springer Online Journal Archives 1860-2000
    Topics: Process Engineering, Biotechnology, Nutrition Technology
    Notes: Abstract  Sulphadimidine (SDM), a drug frequently administered to pigs, is partially converted into other compounds by processing meat to produce raw, fermented sausage. With the aid of 14C-labelled SDM, evidence was obtained that part of the radioactive matter was covalently bound to the matrix. Part of these bound residues could be released in vitro by 4 M HCl at 21  °C or by 0.024 M HCl at 37  °C. Female rats were also able to release bound SDM residues and to excrete these in their urine, in amounts approaching those obtained by treatment with 4 M HCl. Both the parent compound and its main metabolite, N 4-acetyl-SDM, were observed in the urine of rats.
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  • 65
    ISSN: 1432-0851
    Keywords: Key words Transgenic ; Rat ; EGP-2 ; GA733-2 ; Immunotherapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The human pancarcinoma-associated epithelial glycoprotein-2 (EGP-2), also known as 17-1A or Ep-CAM, is a 38-kDa transmembrane antigen, commonly used for targeted immunotherapy of carcinomas. Although strongly expressed by most carcinomas, EGP-2 is also expressed in most simple epithelia. To evaluate treatment-associated effects and side-effects on tumor and normal tissue respectively, we generated an EGP-2-expressing transgenic Wistar rat. To express the cDNA of the EGP-2 in an epithelium-specific manner, the 5′ and 3′ distal flanking regions of the human keratin 18 (K18) gene were used. EGP-2 protein expression was observed in the liver and pancreas, whereas EGP-2 mRNA could also be detected in lung, intestine, stomach and kidney tissues. In this rat, EGP-2-positive tumors can be induced by injecting a rat-derived carcinoma cell line transfected with the GA733-2 cDNA encoding EGP-2. Transgenic rats were used to study specific in vivo localization of an i.v. anti-EGP-2 monoclonal antibody, MOC31, applied i.v. Immunohistochemical analyses showed the specific localization of MOC31 in s.c. induced EGP-2-positive tumors, as well as in the liver. In contrast, in EGP-2-transgenic rats, MOC31 did not bind to EGP-2-negative tumors, the pancreas, or other normal tissues in vivo. In conclusion, an EGP-2-transgenic rat model has been generated that serves as a model to evaluate the efficacy and safety of a variety of anti-EGP-2-based immunotherapeutic modalities.
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  • 66
    ISSN: 1432-0932
    Keywords: Key words Cervical disc disease ; MRI
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The aim of this study is to assess the accuracy of MRI alone in the differentiation of soft cervical disc protrusion from osteophytic compression in cervical disc disease. In a retrospective study, the MRI scans of 41 patients with cervical disc disease, who had previously undergone surgery, were presented to three independent observers, randomly on two different occasions, to identify the accuracy of the diagnosis of the presence of hard or soft disc or both as a cause of compression. The observers (two neurosurgeons and one neuroradiologist) were not involved with the treatment of the cases at any stage and were unaware of the surgical findings. Their observations were compared with those of the surgeon recorded at operation. The intra-observer agreement was poor for diagnosis into three categories as hard or soft disc or both. In distinguishing between the presence or absence of hard disc, there was moderate to good (Kappa = 0.6) intra observer and fair to moderate (Kappa = 0.4) interobserver agreement. The sensitivity of diagnosis of a hard disc was high (87%) but specificity was low (44%), due to the overestimation of the presence of hard disc. There was a significantly higher incidence of hard disc in the elderly age group (76% over the fifth decade, P = 0.0073). It is concluded that MRI alone is not a very efficient diagnostic tool in distinguishing between hard and soft disc in the cervical disc disease.
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  • 67
    ISSN: 1432-0932
    Keywords: Key words Synovial cyst ; CT ; MRI ; Surgical treatment
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The authors describe the case of a 58-year-old man with a 6-month history of severe myelopathy. CT scan and MRI of the spine revealed a cystic formation, measuring about 1 cm in diameter, at C7-T1 at a right posterolateral site at the level of the articular facet. At operation the mass appeared to originate from the ligamentum flavum at the level of the articular facet and was in contact with the dura mater. Once the mass had been removed, there was a significant amelioration of the patient’s symptoms. As previously suspected, histological aspect was synovial cyst. Cervical synovial cysts are extremely rare and, as far as we know, only 22 cases have so far been described in the literature. Diagnostic radiological investigations used were CT scan and MRI. At CT scan the most important diagnostic findings are a posterolateral juxtafacet location of the mass, egg-shell calcifications on the wall of the cyst, and air inside the cyst. At MRI the contents of the cyst are iso/hypointense on T1- and hyperintense on T2-weighted images. There may also be a hypointense rim on T2-weighted images, which enhances after i.v. administration of gadolinium. Surgical treatment consists of removal of the mass. Fixation of the vertebral segments involved is not always necessary.
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  • 68
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    European spine journal 8 (1999), S. 261-265 
    ISSN: 1432-0932
    Keywords: Key words Vertebral rotation ; Idiopathic scoliosis ; CT ; Method
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract CT measurement methods have good reliability for idiopathic scoliosis transverse plane deformity evaluation. However, because of application difficulties and variations in how these methods are applied, more sensitive methods are needed. This paper presents a new method for measurement of vertebral rotation from tomographic scans. First, the method was subject to clinical, intra-observer and inter-observer analysis. Twenty-three patients with adolescent idiopathic scoliosis were studied to test the clinical reliability of this method. There were no statistical differences between the results of the new method and Ho’s method (P = 0.3380) in the clinical study. Intra-observer and inter-observer analysis showed that this method was reliable. An experimental study was then conducted to show the confidence limits of our new method, which were found to be ± 1.6°, and there was no significant difference between the mean rotation value obtained from CT scans using our new method and that obtained using the mechanical method. These results suggest that our new method is a simple, practical and reliable method for measurement of vertebral rotation from CT scans.
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  • 69
    ISSN: 1432-0932
    Keywords: Key words Bone scan ; Growth ; Intervertebral disk ; MRI ; Spondylolysis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We investigated the prognosis of low-back pain and the association of clinical symptoms and anatomic findings among young athletes. Consecutive patients, aged between 12 and 18 years, who had low-back pain that had interfered with their training for at least 4 weeks were included in the case series. All the patients participated in a standardized interview and clinical examination, and plain radiographs and magnetic resonance images were also obtained. Most patients also participated in technetium bone scan examination. In 15 out of 19 subjects there were anatomic abnormalities that corresponded with the location and type of clinical symptoms. Twelve subjects had changes in the disk-vertebral end plate complex and eight had a positive bone scan indicative of posterior vertebral arch stress reaction. Six out of eight boys and two out of 11 girls had stress reaction (P = 0.043). Restriction of painful activities was recommended to all subjects, restriction of activities and the use of a dynamic low-back brace for the first 3 months was recommended to patients with posterior vertebral arch stress reaction. The self-reported intensity of low-back pain (scale 0–100) among all the patients was 69 ± 16 (mean ± SD) at baseline and 18 ± 21 at the 1-year follow-up (P 〈 0.0001). In conclusion, the reasons for prolonged back pain among young athletes are usually established by imaging studies. A knowledge of anatomic abnormalities may help in tailoring training programmes and avoiding the progression of changes during growth. Simple restriction of painful activities usually leads to good recovery.
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  • 70
    ISSN: 1432-0932
    Keywords: Key words Lumbar discectomy ; MRI ; Peridural scar ; Failed back ; syndrome ; Diagnostic injections
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The association between peridural scarring and recurrent pain after lumbar discectomy is much debated. A recently published study found that patients with extensive peridural fibrosis were 3.2 times more likely to experience recurrent radicular pain than those with less extensive scarring. This finding may lead to an overestimation of peridural fibrosis in clinical practice. In a retrospective study we analyzed the records of 53 patients who underwent a lumbar MRI because of recurrent pain after first unilateral microdiscectomy. Patients were classified as those with radicular or non-radicular pain according to history and clinical findings. The diagnosis was confirmed by spinal anesthetic block. The extension of scarring was compared between the two groups of patients. The amount of epidural fibrosis was examined on contrast-enhanced MRI in axial slices subdivided into four quadrants. The amount of fibrosis was divided into four stages in each affected quadrant. We found no differences regarding the amount of peridural fibrosis between patients with radicular pain and patients with non-radicular pain. We conclude that the extent of peridural scarring as defined by MRI is of minor value in the differential diagnosis of recurrent back and leg pain after lumbar microdiscectomy.
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  • 71
    ISSN: 1432-0932
    Keywords: Key words Spine fractures ; Trauma ; MRI ; Intervertebral disc ; Cadaver study
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract This cadaver study evaluated the value of MR images for detection of acute intervertebral disc damage associated with fractures of the thoracolumbar spine. Damage to the intervertebral disc may be a major contributor to chronic instability in non-operative treatment or failure of fixation and recurrence of deformity in posterior fixation methods. MR imaging can help us to understand the injury patterns and their prognostic significance. However, before we can justify the use of MRI in clinical cases, determination of MRI’s ability to detect acute injury to the disc is necessary. Ten fresh cadaver specimens were used for this study. After obtaining radiograms and MR images, injuries were created with a weight-dropping apparatus using a variety of weights and compression angles. Post-injury radiograms and MR images were taken and the specimens were frozen at –20 °C. Slides of these specimens obtained with cryosection techniques were compared with MR images for evaluation of the damage to different parts of the discs. A total of 20 fractures were observed on cryosections. In 12 of the discs adjacent to fractured vertebral bodies, macroscopic damage was seen on the sections. These were all detected on the corresponding MR images. The study showed that MRI is able to detect acute, macroscopic injury to the intervertebral disc. It is therefore justified to use MR for the study of acute disc damage associated with thoracolumbar fractures.
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  • 72
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    European spine journal 8 (1999), S. 218-222 
    ISSN: 1432-0932
    Keywords: Key words Lumbosacral extradural arachnoid cyst ; Low back pain ; MRI ; Cerebrospinal fluid flow
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract No critical discussion of the indication for the surgical treatment of lumbosacral extradural arachnoid cysts is found in the literature. Therefore, we want to compare the results in patients with operative and conservative treatment to define standards for a good surgical result. Over a period of 9 years, we operated on eight patients with a lumbosacral extradural arachnoid cyst and treated eight others conservatively. Only three of the operated patients experienced a postoperative relief of pain, but none was symptom free. The only one with continuing success had a preoperative history of 1 year only. MRI scans without contrast agent were misinterpreted in one included and one excluded case. The results of conservative treatment were nearly the same as those of operative treatment. MRI is the best diagnostic tool, but a variety of sequences must be used. Patients with a short pain history and a clear neurological deficit profited most from surgery. Patients with slight and not clearly related uncharacteristic symptoms should be excluded from surgery.
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  • 73
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    European spine journal 8 (1999), S. 426-428 
    ISSN: 1432-0932
    Keywords: Key words Low back pain ; Growth phase ; Discal degeneration ; Epidemiology ; MRI ; Histology
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract An international congress about “the back of children and teenagers and the prevention of backache” was held in March 1999 in Grenoble (France). Beside specific low back pain following progressive and growth diseases, special attention was paid to non-specific low back pain (LBP). Some epidemiological data show a high incidence of LBP during and after the rapid growth phase, with the concomitant possibility of continued or recurrent evolution. MRI studies reveal frequent signs of disc degeneration: they start after the growth phase, spread during adolescence and are often correlated with backache. An immunohistological study seems to confirm the presence of degenerative-type alterations and changes in collagen in the vertebral plates and nucleus of juvenile spine. These data must be confirmed, and their relation to natural history and prognosis of juvenile LBP have to be clarified by longitudinal studies.
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  • 74
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    European radiology 9 (1999), S. 208-210 
    ISSN: 1432-1084
    Keywords: Key words: Muscles ; diseases ; Neoplasms ; CT
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. Skeletal muscle is one of the most unusual sites of metastasis from any malignancy. We report a patient with rapidly progressive contractures due to metastatic infiltration of a carcinoma of unknown origin into the skeletal muscle. This 61-year-old man presented with a 1-month history of rapidly evolving, painful restriction of mobility of his right arm and his legs. Computed tomography showed diffuse metastatic nodules in all muscles, particularly in the hip abductors. Muscle biopsy revealed extensive infiltration of the muscle with carcinoma cells.
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  • 75
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    European radiology 9 (1999), S. 336-343 
    ISSN: 1432-1084
    Keywords: Key words: Cryptorchidism ; Scrotum ; US ; CT ; MRI ; Testis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. Imaging evaluation of the patient with a non-palpable testis has evolved over recent decades. The rational explanation of imaging in these patients requires a clear understanding of the various causes of a non-palpable testis, and an appreciation of the utility and limitations of the available imaging modalities. This review describes the classification of non-palpable testis and discusses the role of modern imaging in evaluation. In particular, the relative accuracies of ultrasound, CT and MRI is reviewed.
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  • 76
    ISSN: 1432-1084
    Keywords: Key words: Lymphangioleiomyomatosis ; Lymphangiomyomatosis ; CT ; Lung ; CT ; comparative studies
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. Lymphangioleiomyomatosis (LAM) of the lung is a very rare disease. There are obvious discrepancies in the literature concerning the appearance of LAM on CT scans of the lung. This study adds the imaging findings of 11 patients and demonstrates how the imaging findings changed over time in four patients. Twenty-two CT examinations, and radiographs that had been obtained close to the CT examinations, of 11 patients with LAM confirmed by open lung biopsy were retrospectively evaluated with particular attention to the size of cystic lesions and wall thickness. Furthermore the CT scans were analysed for the type of pulmonary infiltration process and its distribution, presence or absence of pleural effusion, pneumothorax and lymph node enlargement. Clinical and CT follow-up studies were available in four patients. The CT scans revealed an increase in the interstitial pattern in all patients. Architectural distortion was seen in two patients and cystic lesions were present in all. The size of the cysts varied from small lesions to bullous emphysema. The cystic lesions revealed a wall thickness up to 2 mm but a wall was not perceptible in all. Pneumothorax was seen in only two patients; pleural effusion was seen in two patients. CT examination of patients with LAM reveals neither a uniform nor a pathognomonic appearance. In the early stages of LAM or in cases with interstitial changes the differential diagnosis of centrilobular emphysema or idiopathic pulmonary fibrosis seems to be more difficult than most authors believe.
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  • 77
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    European radiology 9 (1999), S. 68-72 
    ISSN: 1432-1084
    Keywords: Key words: Gastrointestinal tract ; Neoplasms ; Stomach ; Neoplasms ; CT
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. The purpose of this study was to evaluate the capabilities of subsecond spiral CT in detecting and staging of gastric cancer. Our study included 40 patients with endoscopically detected gastric carcinomas. Two-phase spiral CT was performed within one breathhold each. Distension of the stomach was achieved by intravenous application of scopolamine and drinking of 500 ml water. After bolus injection of contrast medium, scanning was performed in the arterial and venous phase. Gastric tumour extention and lymph node involvement was assessed. Gastric cancer was detected in 39 of 40 cases (sensitivity 97.5 %). Location of the tumour was correctly assessed in all cases. In 31 of the 39 cases (79.4 %) CT staging was accordant with pathological staging. One hundred two (70 %) of 145 nodes infiltrated by tumour tissue were detected and 144 (42.8 %) of 336 nodes free of metastatic involvement were found. The predictive values of positive and negative results for the detection of lymph node metastases were 67.1 and 75 %, respectively. Spiral CT is recommended for staging of gastric cancer.
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  • 78
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    European radiology 9 (1999), S. 205-207 
    ISSN: 1432-1084
    Keywords: Key words: Extramedullary hematopoiesis ; Paget's disease ; Thorax ; Neoplasm ; CT ; MR imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. Extramedullary hematopoiesis usually occurs in hematological diseases but may also be found as an uncommon complication of Paget's disease, probably due to bone effraction mechanism. We present a case of intrathoracic extramedullary hematopoiesis related to Paget's disease. To our knowledge, this is the seventh case reported in the literature. We describe and correlate the conventional X-ray, CT, MR imaging, and cytological findings.
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  • 79
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    European radiology 9 (1999), S. 287-291 
    ISSN: 1432-1084
    Keywords: Key words: Lung ; CT ; Pneumonia ; Aspiration
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. The aim of this study was to assess high-resolution computed tomography (HRCT) findings of exogenous lipoid pneumonia. High-resolution computed tomography was obtained in 25 patients with proven exogenous lipoid pneumonia resulting from aspiration of squalene (derived from shark liver oil). Diagnosis was based on biopsy (n = 9), bronchoalveolar lavage (n = 8), or sputum cytology and clinical findings (n = 8). The clinical history of taking squalene was confirmed in all patients. The CT findings were classified into three patterns: diffuse ground-glass opacity, consolidation, and interstitial abnormalities. Distribution of the abnormalities, duration of taking squalene, predisposing factors for aspiration, and route of administration were analyzed. Ten patients showed diffuse ground-glass opacity pattern. Seven of 10 patients had predisposing conditions such as unconsciousness, pharyngeal dysmotility, or motor disturbances, and 6 patients had a recent history of taking large amount of squalene through nasal route. Seven patients who had consolidation pattern had a history of taking squalene for several months and did not have any predisposing factor. All of the 5 patients who had a pattern of interstitial abnormalities had a history of taking squalene longer than 1 year and showed segmental distribution of interstitial thickening with interposing ground-glass opacities. Three patients simultaneously had two different patterns at different lobes of the lung. The HRCT findings of lipoid pneumonia are ground-glass opacities, consolidation, and interstitial abnormalities. These HRCT findings with appropriate inquiries could be useful for diagnosis of exogeneous lipoid pneumonia.
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  • 80
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    European radiology 9 (1999), S. 525-528 
    ISSN: 1432-1084
    Keywords: Key words: Hypereosinophilic syndrome ; Polymyositis ; MRI
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. A 40-year-old white man presented with fever, muscle pain, skin nodules and persistent hypereosinophilia over a period of 1 year. In addition, he had ventricular arrhythmias with episodes of tachycardia. Besides a lack of response to antiparasitic therapy, laboratory and pathological data excluded the diagnosis of trichinosis or any other parasitic infection. The patient's course of the disease over the previous 11/2 years was compatible with hypereosinophilic syndrome. In a muscle biopsy several eosinophilic perivascular and leucocytic intravascular infiltrates were found, indicative of muscle involvement by the disease. This is a report on the MRI findings of muscle involvement in idiopathic hypereosinophilic syndrome.
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  • 81
    ISSN: 1432-1084
    Keywords: Key words: Ankle ; Ankle sprain ; Lateral collateral ligaments ; MRI
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. The aim of this study was to evaluate the ability of MRI to display injuries of the lateral collateral ligamentous complex in patients with an acute ankle distorsion trauma. The MR examinations of 36 patients with ankle pain after ankle distorsion were evaluated retrospectively without knowledge of clinical history, outcome and/or operative findings. The examinations were performed on a 1.5-T whole-body imager using a flexible surface coil. The signs for ligamentous abnormality were as follows: complete or partial discontinuity, increased signal within, and irregularity and waviness of the ligament. The results were compared with operative findings in 18 patients with subsequent surgical repair. Eighteen patients with conservative therapy had a follow-up MR examination after 3 months. There was 1 sprain, 3 partial and 32 complete tears of the anterior talofibular ligament, and 5 sprains, 5 partial, and 7 complete tears of the calcaneofibular ligament. There were no lesions of the posterior talofibular ligament. Compared with surgery, MRI demonstrated in 18 of 18 cases the exact extent of anterior talofibular ligament injuries and underestimated the extent in 2 of 8 cases of calcaneofibular ligament injury. In patients with follow-up MRI after conservative therapy, a thickened band-like structure was found along the course of the injured ligament in 17 of 18 cases. The absence of ligament repair after conservative treatment was confirmed during operative revision in one case. The MRI technique allows for grading of the extent of injury of the lateral collateral ligamentous complex after acute ankle strain. It seems to be suitable for monitoring the healing process after conservative-functional treatment of ligament tears.
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  • 82
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    European radiology 9 (1999), S. 552-554 
    ISSN: 1432-1084
    Keywords: Key words: Adenomatoid tumor ; Adrenal gland ; MRI
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. The aim of this case report is to describe the appearance on magnetic resonance imaging (MRI) of an incidentally found adenomatoid tumor of the adrenal gland, and to evaluate the utility of MRI in characterizing this type of tumor. The appearance of the tumor was nonspecific on T1-weighted in-phase, opposed-phase, and T2-weighted images, as well as its behavior after paramagnetic contrast administration, outlining the differential diagnosis among carcinoma, metastatic tumors, and pheochromocytoma. After surgery, the pathologic diagnosis was adenomatoid benign tumor of mesothelial origin. Although MRI enables the characterization of most benign lesions of the adrenal gland, the appearance of other lesions is nonspecific. In our case, MRI did not assist in preoperative diagnosis, guiding us towards a diagnosis of malignancy.
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  • 83
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    European radiology 9 (1999), S. 643-647 
    ISSN: 1432-1084
    Keywords: Key words: MRI ; CT ; Lumbar vertebrae ; Osteoporosis ; Trabeculae
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. The aim of the study was to assess the relative number of bone trabeculae in different orientations by using magnetic inhomogeneity measurements by MR imaging. Twelve defatted human vertebrae (L2–L4) were studied by MR imaging and CT. In the MR measurements the reversible transaxial decay rate, R2', was determined using the GESFIDE sequence. The relative contribution to R2' of bone trabeculae oriented along the x (R2'x), y (R2'y) and z (R2'y) axes was assessed, by rotation of the specimen in the magnetic field. The results were validated by CT measurements of trabecular structure at a resolution of 0.2 × 0.2 × 1 mm, using custom-made software. R2' ranged from 4.9 to 32 s–1. After separation, theoretical R2'x ranged from 2.3 to 10.7 s–1, R2'y ranged from 2.6 to 14.0 s–1 and R2'z ranged from 4.7 to 17.9 s–1. The number of bone trabeculae per millimeter identified in axial CT images ranged from 0.15 to 0.38 and from 0.039 to 0.22 per millimeter in sagittal images. The difference between axial and sagittal CT images was statistically significant and due to anisotropic voxels. The correlation between R2' and the number of bone trabeculae per millimeter was statistically significant (r = 0.83, p 〈 0.001 for x orientation; r = 0.63 for y orientation, and r = 0.59 for z orientation, p 〈 0.05 for both). The relative amount of bone trabeculae in different orientations can be assessed in vitro using R2' measurements.
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  • 84
    ISSN: 1432-1084
    Keywords: Key words: Appendicitis ; Diverticulitis ; US ; CT ; Pitfalls
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. We describe four patients in whom ultrasound (US) and/or computed tomography (CT) demonstrated a thickened appendix, secondarily enlarged due to perforated sigmoid diverticulitis (n = 2) or carcinoma (n = 2). The underlying pathology was correctly recognized in all cases. Secondary thickening of the appendix due to perforated sigmoid disease provides a potential pitfall mainly on US and may lead to an incorrect diagnosis and thus to unnecessary surgery or a wrong surgical intervention. Although US alone is enough to diagnose periappendicitis and sigmoid disease, combined use of US and CT may improve assessment of its origin and extension.
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  • 85
    ISSN: 1432-1084
    Keywords: Key words: Kidney ; Ureteropelvic junction obstruction ; CT ; Trauma
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. The aim of this study was to present CT findings of occult ureteropelvic junction obstruction in patients with renal trauma and to describe the clinical signs and singular CT features that are characteristically observed with trauma and are relevant to management of these patients. We retrospectively reviewed 82 helical CT studies in patients with renal trauma referred to our institution. We found 13 cases of occult preexisting renal pathology, six of which were occult ureteropelvic junction obstructions. The clinical presentation, radiologic findings of trauma according to the Federle classification, and CT findings of obstructed ureteropelvic junction are presented. We found three category-I lesions (one in a horseshoe kidney), two of them treated with nephrostomy because of increased ureteropelvic junction obstruction due to pelvic clots; two category-II lesions (parenchymal and renal pelvis lacerations) that had presented only with microhematuria; and one category-IV lesion (pelvic laceration alone). Pelvic extension was demonstrated in all the cases with perirenal collections. The CT studies in all the cases with suspected ureteropelvic junction obstruction showed decreased parenchymal thickness and enhancement, and dilatation of the renal pelvis and calyx, with a normal ureter. Computed tomography can provide information to confidently diagnose underlying ureteropelvic junction obstruction in renal trauma, categorize the traumatic injury (at times clinically silent) and facilitate proper management according to the singularities observed, such us rupture of the renal pelvis alone (Federle category IV) and increasing ureteropelvic obstruction due to clots which can be decompressed by nephrostomy.
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  • 86
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    European radiology 9 (1999), S. 841-852 
    ISSN: 1432-1084
    Keywords: Key words: Liver transplantation ; Hepatocellular carcinoma ; Cholangiocarcinoma ; MR Imaging ; CT ; Ultrasound
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. Hepatic transplantation has emerged as a potentially curative treatment of certain malignant hepatic neoplasms such as hepatocellular carcinoma, bile duct carcinoma, fibrolamellar hepatocellular carcinoma, metastases from neuroendocrine tumors, and epithelioid hemangioendothelioma. In the early years of hepatic transplantation, there was great enthusiasm to cure patients with unresectable hepatobiliary malignancy. This early enthusiasm was tempered by the unfavorable outcome of transplantation in advanced cases of malignancy and the organ-donor shortage. Presently, patients have to be selected with predictable likelihood for long-term survival. Pre-transplantation imaging is indispensable for detection, characterization, staging, and surgical road-mapping before the procedure. The present article focuses on the role of imaging modalities in these different aspects of preoperative assessment.
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  • 87
    ISSN: 1432-1084
    Keywords: Key words: Abdomen ; Neoplasms ; CT ; Lymphatic system ; Anatomy ; Metastases ; Omentum
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. The aim of this study was to enhance our understanding of the pathways of lymphatic spread of primary carcinomas in the upper abdomen by recognizing the development, configuration, and frequency of nodal enlargement in discrete anatomic regions. The study included 417 patients with histologically confirmed carcinomas (CC) of the stomach (n = 267), liver (n = 98), gallbladder (n = 25), and bile ducts (n = 27). All patients were studied by high-resolution CT and tumor extension to the lymph nodes of the subperitoneal space was clearly identified in 59 patients [33 with CC of the stomach, 8 with CC of the gallbladder, 3 with CC of the bile ducts, and 15 with hepatocellular carcinoma (HCC)]. In 47 of 59 patients this extension was confirmed by surgery or aspiration biopsy. Three discrete anatomic groups of lymph nodes were recognized producing a relatively distinct CT configuration when involved: (a) the hepatoduodenal seen in 49 patients; (b) the peripancreatic demonstrated in 33 patients; and (c) the aortocaval recognized in 16 patients. These groups of lymph nodes can be seen individually involved or in combination. Recognition of involvement of these nodes is important for correct diagnosis and staging of upper abdominal malignancies. The development of this involvement follows the natural flow of lymph via the lesser omentum to the retroperitoneal space.
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  • 88
    ISSN: 1432-1084
    Keywords: Key words: Osteomyelitis ; Radiography ; Bone scintigraphy ; CT ; Ultrasound ; MR imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. Conventional radiographs remain the initial imaging modality involved in the diagnosis of osteomyelitis. Bone scintigraphy and its specific agents did not only eliminate the problems of inherent low sensitivity of conventional radiographs, but also increased the specificity to higher degrees. Spiral CT, on the other hand, has solved several diagnostic problems, such as osteomyelitis of the sterno-clavicular junction and hidden areas in the pelvic bones. Magnetic resonance imaging with its multiplanar capability, greater anatomic details and excellent soft tissue bone marrow contrast resolution has a significant role in surgical planning and limb preservation. Ultrasound and US-guided aspiration has recently been involved in the diagnosis and management of osteomyelitis with several advantages particularly in children. Our goal in this review is to outline the ability of various imaging techniques by comparing their strengths and weaknesses in the diagnosis of osteomyelitis. Finally, we suggest various imaging algorithms for specific clinical scenarios. Spondylitis and septic arthritis are not discussed in this review.
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  • 89
    ISSN: 1432-1084
    Keywords: Key words: Lumbar spine ; MRI ; MR myelography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. The purpose of our study was to evaluate the accuracy of MR myelography in depicting disc herniation in the lumbar spine when compared with conventional MRI in patients presenting with clinical evidence of disc herniation. One hundred patients referred for conventional MR imaging of the lumbar spine also had coronal MR (TR 9000 ms, TE 272 ms eff, NEX 3, echo train length 32) myelography performed. Three experienced observers compared magnetic resonance myelography (MRM) with conventional lumbar spine MR using the following variables: visibility of thecal sac and nerve roots, and the presence, location and severity of disc herniation. Disc protrusions were seen at 110 disc space levels on conventional MR images as opposed to 93 on MRM. However, only 72 % of lesions seen on conventional MR were diagnosed by MRM. Similarly, only 63.8 % of nerve root compression abnormalities seen at conventional MR were visualized when compared with conventional MRM. The sensitivity, specificity and accuracy of MRM when compared with conventional MR was 72, 93 and 85 %, respectively. The MRM technique yields images that resemble conventional myelography and may be used to help confirm abnormalities seen on conventional MR in selected cases; however, the large number of false-positive and false-negative examinations indicates that caution should be used in interpreting MRM images.
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  • 90
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    Keywords: Key words: Vena cava ; Stenosis ; Obstruction ; Interventional procedure ; Neoplasm ; Grafts and prosthesis ; Thrombolysis ; CT
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. The aim of this study was to report our experience on the management of superior vena cava obstruction (SVCO) secondary to malignant disease, using endovascular procedures. Twenty-six patients with SVCO due to primary or secondary tumors of the lung or the mediastinum, or catheter inserted for treatment of an extra-thoracic neoplasm, had an endovascular therapy which consisted of stenting, angioplasty, thrombo-aspiration or local fibrinolysis. Immediately after the procedure, rapid relief of symptoms occurred in 24 (90 %) of the patients. The mean Kishi's score decreased from 5.5 to 0.96. Immediate complications included one death related to pericarditis bleeding following fibrinolysis. Three patients relapsed after 20 days, 4 months and 6 months, and needed a second stenting. At 6 months the primary patency rate was 83 % and the secondary patency rate was 89 %. Endovascular treatment of SVCOs is a simple and safe procedure to restore the patency of the superior vena cava in malignant SVCO. It should be indicated in most cases as first-line treatment and performed as early as possible.
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  • 91
    ISSN: 1432-1084
    Keywords: Key words: Diaphragm ; Hepatic hernia ; Blunt trauma ; CT
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. We report a case of blunt traumatic right diaphragm rupture with hepatic hernia. The diagnosis was first suggested by an abnormal hepatic location depicted on axial CT. This finding can be considered as a potentially new indirect sign of right diaphragm rupture in patients with blunt trauma. The diagnosis was then confirmed by reformatted CT and MR images.
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  • 92
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    European radiology 9 (1999), S. 1098-1100 
    ISSN: 1432-1084
    Keywords: Key words: Osteoid osteoma ; Carpal bones ; Capitate ; MRI
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. A case of osteoid osteoma of the capitate in a 29-year-old male is reported. The patient suffered from unspecific clinical findings and a 3-year history of uncharacteristic wrist pain. Conventional radiographs of the wrist revealed a circumscribed sclerosis in the proximal part of the capitate bone beside a diffuse demineralisation of the carpal bones. Magnetic resonance imaging demonstrated a circumscribed, tumorous lesion with marked enhancement after IV administration of contrast agent and a highly calcified nidus, which was sharply demarcated by a small rim of granulation tissue from the surrounding spongious bone. Based on MRI findings, the diagnosis of an osteoid osteoma was established and confirmed after operation and histologic analysis.
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  • 93
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    Springer
    European radiology 9 (1999), S. 1101-1103 
    ISSN: 1432-1084
    Keywords: Key words: Echinococcosis ; Soft tissues ; MRI ; Hydatid disease
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. Hydatid disease of the soft tissues forms a rare mass lesion of the extremities. Two cases of primary hydatid disease in soft tissues are presented with MR imaging findings. A cystic mass with multiloculated or multicystic appearance was identified on MR images in both cases. The lesions were surrounded by a rim with two layers representing a collageneous and a vascularized pericyst. The contrast-enhanced images demonstrated the vascularized component of the wall clearly in the first case. In diagnosis of hydatid disease and in its differentiation from other cystic lesions of the extremities, we think that the described MR appearances can be used confidently.
    Type of Medium: Electronic Resource
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  • 94
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    Springer
    European radiology 9 (1999), S. 1104-1106 
    ISSN: 1432-1084
    Keywords: Key words: Tendinitis ; CT ; Tendons ; Calcification
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. Two cases of calcific tendinitis of gluteus maximus muscle are presented. The CT findings, including amorphous calcification without soft tissue mass and possible cortical erosion at the femoral enthesis of the gluteus maximus muscle, are highly suggestive of calcific tendinitis at this unusual but classical location. Ossifying entheses with well-defined cortical defect are frequent at the femoral insertion of the gluteus maximus muscle in asymptomatic subjects and must be differentiated from a real cortical erosion sometimes associated with these calcific tendinitis.
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  • 95
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    Electronic Resource
    Springer
    European radiology 9 (1999), S. 1113-1116 
    ISSN: 1432-1084
    Keywords: Key words: Breast ; Rhabdomyosarcoma ; Mammography ; Ultrasound ; MRI
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. The authors report a case of blood-borne bilateral metastatic breast disease of alveolar rhabdomyosarcoma (RMS) in a 21-year-old patient. The possibilities of mammography, ultrasound, and MRI in the early detection of breast metastases and their appearance on these modalities are discussed. Whereas mammography rendered no additional information due to dense breast parenchyma and ultrasound showed only a solitary tumor without definite criteria of malignancy, multifocal bilateral spread was verified with MRI and early ring-like enhancement suggested malignancy. Therefore, we conclude that MRI may provide useful information in evaluating patients with sarcomas, even when there is no clinical evidence for metastatic disease of the breast.
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  • 96
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    European radiology 9 (1999), S. 1117-1119 
    ISSN: 1432-1084
    Keywords: Key words: Tuberculosis ; Skeletal ; CT ; MR imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. Chest wall involvement is an uncommon manifestation of musculoskeletal tuberculosis. We present computed tomography and magnetic resonance imaging findings in a case with multifocal musculoskeletal tuberculosis presenting as a breast mass. These radiological modalities are not diagnostic without histopathological confirmation, but they are valuable guides to surgery in defining the extent of disease involvement.
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  • 97
    ISSN: 1432-1084
    Keywords: Key words: Lipoid pneumonia ; Diagnosis ; Lung ; Disease ; CT ; MRI
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. The objective of this study was to describe high-resolution CT (HRCT) and MR findings of exogenous lipoid pneumonia and to correlate them with pathologic findings. A retrospective review of the medical records of our institution revealed seven patients with a diagnosis of lipoid pneumonia based on clinical data, chest films, bronchoalveolar lavage, and follow-up. Both HRCT and MR imaging were reviewed by two readers. Pathologic examination of the resected specimen or surgical biopsies were also reviewed in the four available cases. The HRCT findings were pulmonary consolidations (n = 6) with fatty (n = 3) or unspecific but low attenuation values (n = 3), areas of ground-glass opacities (n = 5), septal lines, and centrilobular interstitial thickening (n = 5). In five of the seven cases, a crazy-paving pattern of various spread was also present, either isolated (n = 1) or surrounding a pulmonary consolidation. In two cases traction bronchiectasis and cystic changes consistent with fibrosis were seen. At MR imaging (n = 2) a pulmonary consolidation of high signal intensity on T1-weighted image consistent with lipid content was present in one case. Pathologic examination (n = 4) showed the coexistence of lobules with lesions of various ages, sometimes in contiguous lobules, within the same patient. Recent lesions were those with alveolar fill-in by spumous macrophages and almost normal alveolar walls and septae. In more advanced lesions, lobules were filled in with larger vacuoles often surrounded by inflammatory infiltrates of alveolar walls, bronchiolar walls, and septa. The oldest lesions were characterized by fibrosis and parenchymal distortion around large lipid-containing vacuoles. The HRCT findings reflect pathologic findings in exogenous lipoid pneumonia. Although non-specific, consolidation areas of low attenuation values and crazy-paving pattern are frequently associated in exogenous lipoid pneumonia and are indicative of the diagnosis.
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  • 98
    ISSN: 1432-1084
    Keywords: Key words: Lung nodule ; CT ; Inflammatory pseudotumor
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. Lung inflammatory myofibroblastic tumor is an uncommon cause of solitary lung nodule (0.7 % of lung tumors). The principal site of inflammatory pseudotumor is the lung, but it can also occur elsewhere in various organs. Although benign, they may be locally very aggressive. Recurrent and multifocal forms have been described. Since they are likely to mimic malignant neoplasms, accurate histopathologic diagnosis is necessary in order to guide appropriate surgical excision and avoid aggressive treatments. We report a case of lung involvement in a young adult with radiologic and pathologic correlations.
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  • 99
    ISSN: 1432-1084
    Keywords: Key words: Castleman disease ; CT ; MR imaging ; Paraneoplastic pemphigus ; Abdomen ; Neoplasms
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. We describe the CT and MRI features of a case of Castleman disease which was unusual by both its retroperitoneal location and its association with paraneoplastic pemphigus.
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  • 100
    ISSN: 1432-1084
    Keywords: Key words: Lung neoplasms ; Staging ; Pleura ; CT
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. The aim of this investigation was to evaluate whether thin-sectional CT with different reconstruction algorithms can improve the diagnostic accuracy with regard to chest wall invasion in patients with peripheral bronchogenic carcinoma. Forty-one patients with intrapulmonary lesions and tumor contact to the thoracic wall as seen on CT staging underwent additional 1-mm CT slices with reconstruction in a high-resolution (HR) and an edge blurring, soft detail (SD) algorithm. Five criteria were applied and validated by histological findings. Using the criteria of the intact fat layer, HRCT had a sensitivity of 81 % and a specificity of 79 %, SD CT had a sensitivity of 96 % and a specificity of 78 %, and standard CT technique had a sensitivity of 50 % and a specificity of 71 %, respectively. Regarding changes of intercostal soft tissue, HRCT achieved a sensitivity of 71 % and a specificity of 96 %, SD CT had a sensitivity of 94 % and a specificity of 96 % (standard CT technique: sensitivity 50 % and specificity 96 %) . For the other criteria, such as pleural contact area, angle, and osseous destruction, no significant differences were found. Diagnostic accuracy of chest wall infiltration can be improved by using thin sectional CT. Especially the application of an edge-blurring (SD) algorithm increases sensitivity and specificity without additional costs.
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