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  • 1995-1999  (4,097)
  • Chemical Engineering  (1,635)
  • Theoretical, Physical and Computational Chemistry  (1,576)
  • Magnetic resonance imaging  (885)
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  • 101
    ISSN: 1432-1920
    Keywords: Key words Spinal subdural haematoma ; Magnetic resonance imaging ; Computed tomography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Chronic spinal subdural haematoma is a uncommon. We describe the CT and MRI appearances of chronic spinal and intracranial subdural haematomas following minor trauma. The aetiology, pathogenesis and differential diagnosis are discussed.
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  • 102
    Electronic Resource
    Electronic Resource
    Springer
    Neuroradiology 41 (1999), S. 129-133 
    ISSN: 1432-1920
    Keywords: Key words Cryptococcosi ; Acquired immunodeficiency syndrome ; Computed tomography ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract CT and MRI in one case of Cryptococcus neoformans infection showed contrast-enhancing parenchymal lesions resembling granulomata or abscesses. After an initial phase without contrast enhancement, the full extent of the lesions was visible within 2 weeks of presentation. The enhancing masses were assumed to represent intracerebral cryptococcomas. Despite evidence of massive meningeal infection on cerebrospinal fluid (CSF) examination, no radiological signs of meningitis, invasion of the Virchow-Robin spaces or ventriculitis could be demonstrated. With antimycotic treatment the contrast enhancement disappeared and cystic, partly calcified lesions remained. Recurrence of meningeal infection without radiological correlates was apparent in this stage. In a second case of proven cryptococcus meningitis, dilation of Virchow-Robin spaces or cysts in the adjacent parenchyma were the main abnormalities on MRI. Enhancing masses were not detected. These cases may represent two different reactions of the immunocompromised hosts to infection with C. neoformans: widening of the perivascular spaces as a correlate of the more typical meningeal infection and enhancing parenchymal lesions as a sign of further invasion from the CSF spaces. Enhancement of cryptococcomas, indicating an inflammatory response in the surrounding brain, is not typical in patients with impairment of immune function.
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  • 103
    Electronic Resource
    Electronic Resource
    Springer
    Neuroradiology 41 (1999), S. 158-162 
    ISSN: 1432-1920
    Keywords: Key words Midbrain ; tumours ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We diagnosed 60 cases of midbrain tumours by MRI between 1993 to 1997. There were 39 males and 21 females, aged 2–64 years, mean 25.6 years. We found 38 patients with true intramedullary midbrain tumours, 11 predominantly in the tectum, 20 in the tegmentum and 7 with a downward extension to the pons; there were 7 within the cerebral aqueduct. There were 22 patients with infiltrating midbrain tumours extending from adjacent structures, 11 cases each from the thalamus and pineal region. All patients received surgical treatment. Gross total resection was achieved in 42 cases, subtotal (〉 75 %) resection in 18. Pathological diagnoses included 16 low-grade and 15 high-grade astrocytomas; 5 oligodendroastrocytomas; 2 ependymomas; 11 glioblastomas; and 11 pineal parenchymal or germ-cell tumours. Midbrain tumours are a heterogeneous group of neoplasms, with wide variation in clinical and MRI features, related to the site and type of tumour. MRI not only allows precise analysis of their growth pattern, but also can lead to a correct preoperative diagnosis in the majority of cases.
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  • 104
    Electronic Resource
    Electronic Resource
    Springer
    Neuroradiology 41 (1999), S. 175-178 
    ISSN: 1432-1920
    Keywords: Key words Infarct ; cerebral ; Computed tomography ; Magnetic resonance imaging ; diffusion-weighted
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We compared CT and MRI obtained within the first 3 h of onset of a cerebral infarct. Echo-planar diffusion-weighted MRI delineated the infarcted areas most clearly, and subtle low-density areas on CT were consistent with those shown to be abnormal by diffusion-weighted MR. The signal changes of affected areas on fast spin-echo proton-density, T2-weighted and fast FLAIR images were subtler than the low density on CT.
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  • 105
    ISSN: 1432-1920
    Keywords: Key words Shunt ; portosystemic ; Globus pallidus ; Manganese ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report two toddlers with portosystemic shunts who had symmetrical high-signal globus pallidus lesions on T1- but not T2-weighted MRI, and measurement of whole blood manganese at 2 years of age. These cases suggest that portosystemic shunts can cause elevation of blood manganese and result in manganese accumulation in the globus pallidus, causing high signal on T1-weighted images even in asymptomatic toddlers.
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  • 106
    ISSN: 1432-1920
    Keywords: Key words Cerebral infarcts ; Magnetic resonance imaging ; Contrast enhancement
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We compared contrast enhancement on T1-weighted MRI of acute cerebral infarcts after conventional bolus administration and continuous infusion of gadolinium. We examined 12 patients with a history of acute stroke with contrast-enhanced MRI once a week for a 1 month. Only ischaemic lesions were investigated after cerebral haemorrhage had been excluded by CT. Each MRI study included T2- and proton density-weighted sequences for determination of the size and site of the infarct, immediate postinjection T1-weighted imaging after bolus administration of 0.1 mmol/kg gadolinium-DPTA and delayed T1-weighted imaging after additional continuous infusion of 0.1 mmol/kg over 2 h. A total of 42 MRI studies was performed. In the first week after the onset of stroke, most infarcts (8 of 10) did not enhance after bolus administration, whereas all showed distinct contrast enhancement after the infusion. In the following weeks all but two infarcts showed contrast enhancement after bolus administration; after continuous infusion contrast enhancement could be seen in all cases. While contrast enhancement after bolus administration showed the typical gyriform pattern, enhanced areas were more extensive after the infusion and usually covered the entire infarcted area shown on T2- and proton density-weighted images. We presume that the disturbed blood-brain barrier in ischaemic areas favours delivery of contrast medium to the infarcted tissue if it is offered continuously so that a steady state can develop.
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  • 107
    Electronic Resource
    Electronic Resource
    Springer
    Neuroradiology 41 (1999), S. 428-432 
    ISSN: 1432-1920
    Keywords: Key words Tuberous sclerosis ; Magnetic resonance imaging ; Focal cortical dysplasia ; Cortical dysgenesis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract There is immense variability in the clinical presentation of tuberous sclerosis and many incomplete forms (formes frustes) exist. To investigate the imaging characteristics of cortical tubers seen in tuberous sclerosis unaccompanied by other stigmata, we reviewed MRI and CT of six patients who met the criteria for a definitive diagnosis of TS, established solely by the presence of a histologically confirmed cortical tuber. Five of the patients had a solitary cortical tuber and the last had three lesions, one of which was resected and confirmed histologically. The other two lesions were included in our study. CT showed five tubers as low density, but three were not identified. No calcified or dense lesions were observed. MRI revealed peripheral components and inner cores of seven cortical tubers in five patients, with differing signal characteristics. The subcortical cores, with T1 and T2 prolongation, were separated from the overlying cortex. Abnormal inhomogeneous high signal was observed in both the cortex and subcortical white matter on proton-density weighted or FLAIR images. A radially orientated white-matter band was observed in one patient, and central depression of the expanded gyri in another. In one patient, a cortical tuber was atypical, with a thick cortex on T1-weighted images and a blurred grey/white matter junction with diffusely increased signal on T2-weighted images. Cortical tubers without other stigmata of tuberous sclerosis are shown to be distinct from focal cortical dysplasia.
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  • 108
    Electronic Resource
    Electronic Resource
    Springer
    Neuroradiology 41 (1999), S. 443-446 
    ISSN: 1432-1920
    Keywords: Key words Langerhans cell histiocytosis ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Langerhans cell histiocytosis (LCH) is a disease of unknown cause characterised by proliferation of histiocytic granulomas in tissues; the primary cerebral manifestation is diabetes insipidus caused by hypothalamic infiltration. We present a patient in whom, except for the absence of high signal on T 1 weighting in the posterior pituitary, consistent with central diabetes insipidus, MRI showed no evidence of hypothalamic involvement by histiocytosis, despite the long duration of the disease. However, there was bilateral, symmetrical involvement of the cerebellum and globus pallidus in addition to a calvarial lesion. High signal in the cerebellar white matter on T 2-weighted images may represent demyelination, gliosis and cell loss, as previously reported on pathologic examination.
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  • 109
    ISSN: 1432-1920
    Keywords: Key words Dural arteriovenous fistula ; Craniocervical junction ; Magnetic resonance imaging ; Venous hypertension
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report a 62-year-old woman who presented with a myelopathy at the lower thoracic level. Left vertebral angiography revealed a dural arteriovenous fistula (DAVF) at the craniocervical junction, draining into an anterior spinal vein. Below the T 7 level, the spinal cord gave high signal on T 2-weighted images and enhanced with Gd-DTPA. The patient was successfully treated by simple clipping of vein draining the DAVF. The abnormal signal intensity and contrast enhancement rapidly regressed, except in the conus medullaris. Regression of the parenchymal abnormality on serial MRI following treatment corresponded closely with postoperative improvement of neurological function.
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  • 110
    Electronic Resource
    Electronic Resource
    Springer
    Der Radiologe 39 (1999), S. 828-837 
    ISSN: 1432-2102
    Keywords: Schlüsselwörter Zerebrovaskuläre Erkrankungen ; Intrazerebrale Blutung ; Magnetresonanztomographie ; Computertomographie ; Key Words Cerebrovascular diseases ; Intracerebral hemorrhage ; Magnetic resonance imaging ; Computed tomography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Intracerebral hemorrhage is a common cause of acute neurological deterioration and a frequent indication for emergency neuroimaging. Stroke symptoms are caused in 10 to 15% by intracerebral hemorrhage. It is often not possible to differentiate intracerebral hemorrhage from cerebral ischemia by clinical examination. The therapeutic decision between thrombolysis or conservative therapy is comprised by the etiology. To exclude intracerebral hemorrhage as the cause of clinical symptoms, a CT is usually performed. Localisation and extension of the acute intracerebral hemorrhage are easy to detect. Subacute and chronic intracerebral hemorrhage are better delineated with magnetic resonance imaging. The different signal of the hemorrhage can be used for the age of the intracerebral hemorrhage. The cause of a non-traumatic intracerebral hemorrhage is in over 60% hypertony, less frequent alcoholism, malformation, or amyloid angiopathy. Uncommon causes of hemorrhage are head trauma, blood dyscrasia, tumor or venous thrombosis. Non-traumatic intracerebral hemorrhage are most common in patients between 50 and 70 years. In younger patients a malformation should be excluded with a cerebral angiography. Intracerebral hemorrhages are usually conservatively treated, in some cases an operative decompression is performed.
    Notes: Zusammenfassung Die intrazerebrale Blutung ist eine häufige Ursache akut auftretender neurologischer Symptome und führt oft zu einer notfallmäßigen neuroradiologischen Untersuchung. Etwa 15% der „Schlaganfälle” sind auf eine intrazerebrale Blutung zurückzuführen. Intrazerebrale Blutungen sind klinisch oft nicht von ischämischen Infarkten zu unterscheiden. Eine Computertomographie ist zur Zeit für die Diagnosesicherung – und damit auch zur weiterführenden Therapie – unerläßlich. Ausdehnung und Lokalisation der akuten intrazerebralen Blutung können damit schnell und sicher erfaßt werden. Subakute und chronische Blutungen sind dagegen verläßlicher mit der Magnetresonanztomographie nachweisbar. Aus der unterschiedlichen Signalgebung in den verschiedenen MR-Sequenzen kann auf das Alter der Blutung geschlossen werden. Die Ursache einer nicht-traumatischen intrazerebralen Blutung ist in über 60% der Fälle eine Hypertonie, weniger häufig die Folgen des Alkoholismus, Gefäßfehlbildungen oder die Amyloidangiopathie. Seltener sind Blutgerinnungsstörungen, Traumen, Tumoren, Venenthrombosen oder Intoxikationen die Ursachen einer intrazerebralen Blutung. Nicht-traumatische intrazerebrale Blutungen treten am häufigsten zwischen dem 5.–7. Lebensjahrzehnt auf. Bei jüngeren Patienten sind vor allem Gefäßfehlbildungen als Ursache zu berücksichtigen. Insbesondere bei jüngeren Patienten sollte zur ätiopathogentischen Klärung eine zerebrale Angiographie durchgeführt werden. Spontane intrazerebrale Blutungen werden in der Regel konservativ behandelt, außer man verspricht sich von der operativen Dekompression eine Verbesserung des klinischen Zustandes.
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  • 111
    Electronic Resource
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    Springer
    Der Radiologe 39 (1999), S. 889-893 
    ISSN: 1432-2102
    Keywords: Schlüsselwörter Sarkoidose ; Neurosarkoidose ; Magnetresonanztomographie ; Key words Sarcoidosis ; Neurosarcoidosis ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Neurological involvement is a significant cause of morbidity and mortality in patients with sarcoidosis. The aim of this study was to evaluate the role of magnetic resonance imaging (MRI) in the diagnosis of patients with neurosarcoidosis. The MRI brain scans of 22 patients with sarcoidosis were retrospectively reviewed, along with the clinical information provided in the request form. All patients had signs and symptoms referable to the head and were examined with gadolinium enhancement. Cranial (facial) nerve paralysis was the most common clinical manifestation identified in 10 patients. A wide spectrum of MR findings was noted: periventricular and white matter lesions on T2 W spin echo images, mimicking multiple sclerosis (46%); multiple supratentorial and infratentorial brain lesions, mimicking metastases (36%); solitary intraaxial mass, mimicking high-grade astrocytoma (9%); solitary extraaxial mass, mimicking meningioma (5%); leptomeningeal enhancement (36%). The diagnosis of neurosarcoidosis is often difficult, particularly so in patients who lack either pulmonary or systemic manifestations of sarcoidosis. MRI shows a wide spectrum of brain abnormalities associated with neurosarcoidosis. These findings, however, are not specific for sarcoidosis and one must consider appropriate clinical circumstances in arriving at the correct diagnosis. In selected cases with isolated brain involvement, meningeal or cerebral biopsy may be required.
    Notes: Zusammenfassung Klinische Untersuchungen an Patienten mit systemischer Sarkoidose sprechen in 5%, Autopsieberichte in 25% für eine Beteiligung des Zentralnervensystems. Ziel der Studie ist eine Beurteilung der Beitrags der Magnetresonanztomographie (MRT) in der Diagnostik der Neurosarkoidose. Die MR-Tomogramme von 22 Patienten mit gesicherter Sarkoidose und neurologischer Symptomatik wurden retrospektiv ausgewertet. Häufigstes klinisches Symptom der Neurosarkoidose war eine Fazialisparese (10 Patienten). MR-tomographisch konnte eine Vielzahl verschiedener Befunde erhoben werden: periventrikuläre und Marklagerläsionen in T2-gewichteten Bildern in 46%, multiple bzw. miliare supratentorielle und infratentorielle Läsionen in 36%, solitäre intraaxiale Raumforderungen in 9%, solitäre extraaxiale Raumforderungen in 5% und meningeale Kontrastmittelanreicherung (nodulär oder diffus) in 36%. Schlußfolgerung: Die MR-tomographischen Befunde bei Neurosarkoidose sind oft wenig spezifisch. Die Diagnose wird meist bei gleichzeitigem Nachweis sarkoidosetypischer Granulome in anderen Organen gestellt, eine isolierte zerebrale Manifestation kann erhebliche diagnostische Schwierigkeiten bereiten. Die Neurosarkoidose sollte bei unklaren zerebralen Symptomen und Befunden stets in die Differentialdiagnose einbezogen werden, weil sie behandelbar ist.
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  • 112
    ISSN: 1432-2102
    Keywords: Schlüsselwörter Kalkaneus ; Talus ; Gelenkinstabilität ; Radiologische Diagnostik ; Ultraschall ; Magnetresonanztomographie ; Sprunggelenk ; Synovialmembran ; Arthritis ; Diagnose ; Bildgebende Diagnostik ; Key words Calcaneus ; Joint instability ; Plain film radiography ; Ultrasonography ; Magnetic resonance imaging ; Subtalar joint ; Ankle joint ; Arthritis ; Synovial membrane ; Synovitis ; Diagnosis ; Differential ; Diagnostic imaging ; Rheumatic disease
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Diseases of the hindfoot are associated with considerable functional impairment and therefore may hamper patients’ movements during gait considerably. Because of biomechanical overload, articular structures, tendons and ligaments are prone to early degenerative changes during the course of rheumatic diseases as visible with plain film radiography, sonography (US), or magnetic resonance imaging (MRI). Findings may occur as arthritis of major joints or in the form of fibroostitis and bursitis of the os calcis. Despite the progressive course of rheumatic diseases and characteristic imaging findings, high variability of X-ray signs may occur. Plain film radiograms and high-resolution ultrasonography play a key role in imaging rheumatic diseases of the hindfoot. MRI supports imaging diagnosis in selected cases. The principal goals of diagnostic imaging are precise and reproducible documentation of morphologic abnormalities and differentiated analysis for planning proper conservative or surgical treatment.
    Notes: Zusammenfassung Erkrankungen des Sprunggelenks und der Fußwurzel sind, da mit einer deutlichen Einschränkung der Beweglichkeit dieser Region einhergehend, für den Patienten meist sehr belastend. Bei rheumatischen Krankheitsbildern steht neben der Funktionseinschränkung vor allem in späteren Stadien die Destruktion biomechanisch stark beanspruchter Strukturen (hyaliner Knorpel, subchondraler Knochen, Bänder und Sehnen) im Vordergrund des klinischen wie auch des radiologischen Bildes. Grundsätzlich sind Arthritiden der großen Gelenke und die Calcaneopathia rheumatica zu beobachten. Trotz des meist stadienhaften Verlaufes mit charakteristischem Befallsmuster ist die bildgebende Diagnostik wegen der großen Formvariabilität der unterschiedlich ausgeprägten Veränderungen oft schwierig. Zusätzlich zu nativröntgenologischen Aufnahmen gehören die hochauflösende Sonographie, ergänzt durch die MRT, mit denen Gelenke und Sehnen direkt darstellbar sind, heute zur Standarddiagnostik. Ziel der Diagnostik ist einerseits die präzise reproduzierbare Dokumentation morphologischer Veränderungen zur Verlaufskontrolle, andererseits ihre möglichst differenzierte Analyse zur Einleitung adäquater konservativer oder operativer Therapiemaßnahmen, um Patienten zu einer aktiveren Lebensweise verhelfen zu können.
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  • 113
    ISSN: 1432-2102
    Keywords: Schlüsselwörter Intrazerebrale Blutung ; Kernspintomographie ; MR-Angiographie ; Key words Intracerebral hematoma ; Magnetic resonance imaging ; Magnetic resonance angiography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary We review the signal characteristics of intracerebral hematomas (ICH) on magnetic resonance imaging (MRI), with special emphasis on the diagnosis of intracerebral hemorrhage within the first hours after stroke. The detection of peracute ICH was evaluated in 42 patients of a prospective, MR randomized stroke trial. These patients underwent a protocol of T1 and T2 weighted sequences, diffusion weigthed sequences and MR – angiography within 6 hours after onset of acute hemiparesis. The signal behaviour of ICH in any stage after bleeding was additionally reviewed in a retrospective series of 63 patients, who were submitted for MRI over a 12 months period because of known ICH. MRI correctly identified 4 hyperacute ICH in the prospective group and 4 hyperacute ICH in the retrospective group. These ICHs had high signal on T2 weighted images, were isointense in T1 weighted images and had signal voids on the diffusion weighted sequences. The signal intensities of acute, subacute and chronic ICHs correlated to previous experiences as reported in the literature. In conclusion, MRI reliably identified all hematomas even in the hyperacute stage. Diffusion weighted images were most sensitive to the presence of deoxyhemoglobine and helpful for the differentiation and characterization of acute ischemia. Therefore, MRI at 1.5 T can be employed as an alternative to CT for the emergency diagnosis of acute stroke.
    Notes: Zusammenfassung In dieser Übersicht wird das kernspintomographische (KST) Erscheinungsbild der intrazerebralen Blutung (IZB) anhand eigener Erfahrungen und der Literatur diskutiert. Besonderes Gewicht wurde auf den KST Nachweis der hyperakuten IZB innerhalb der ersten Stunden gelegt. Es wurden einerseits die Befunde von 42 Patienten einer prospektiven, KST randomisierten Schlaganfallstudie ausgewertet, bei denen die KST als Erstuntersuchung innerhalb von 6 Stunden durchgeführt worden war. Andererseits werteten wir retrospektiv jene KST Untersuchungen aus, die im Jahr 1998 unter der Fragestellung einer IZB (n=63) erfolgten. Die KST erwies sich als sensitiv im Nachweis auch der hyperakuten IZB. Es wurden weder falsch-negative noch falsch-positive Befunde erhoben. Die hyperakute IZB kommt in der T2-Gewichtung hyperintens und in der T1-Gewichtung isointens zur Darstellung. Auf den diffusionsgewichteten Sequenzen führen minimale Deoxyhämoglobinkonzentrationen bereits in dieser Phase zu Signalauslöschungen. Das Erscheinungsbild der akuten, subakuten und chronischen IZB entsprach dem, in der Literatur mitgeteilten, Signalverhalten. Zusammenfassend waren alle IZB, unabhängig vom Stadium in der KST nachweisbar. Die Diffusionsgewichtung war in der hyperakuten Blutungsdiagnose und deren Abgrenzung von der akuten Ischämie hilfreich. Zumindest bei 1,5T erscheint die KST somit für die Diagnostik des akuten Schlaganfalls geeignet und sollte, da Ischämien besser als mit der Computertomographie charakterisiert werden können, für die Akutdiagnostik verfügbar gemacht werden.
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  • 114
    ISSN: 1432-2102
    Keywords: Schlüsselwörter Schlaganfall ; Intrazerebrale Blutung ; Magnetresonanztomographie ; Computertomographie ; Ratten ; Key words Cerebrovascular diseases ; Intracerebral hemorrhage ; Magnetic resonance imaging ; Rats
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Background and Purpose: Stroke symptoms are caused in 10 to 15% by intracerebral hemorrhage. From the clinical examination it is often impossible to differentiate intracerebral hemorrhage from cerebral ischemia. To exclude intracerebral hemorrhage as the cause of clinical symptoms a CT is usually performed. The aim of our study was a direct comparison of the sensitivity of Computed Tomography and MRI using different MR sequences for the detection of acute intracerebral hemorrhage. Methods: In 8 male Wistar rats intracerebral hemorrhage was induced by infusion of collagenase into the caudate nucleus. After 1hour the brains were subsequently imaged with CT and MRI using T2- and T1-weighted Spin Echo sequences, diffusion-weighted sequences, T2*-weighted gradient echo sequences and FLAIR-sequences. Visibility of the intracerebral hemorrhage was examined using a scoring system from 1=not visible to 5=excellent visible. Finally, the intracerebral hemorrhage was verified by histological staining. Results: In all animals, intracerebral hemorrhage was visible in T2*-weighted gradient echo and diffusion weighted MR images 1 h after infusion of collagenase. T2- and PD-weighted SE images were positive in 7/8 rats. T1-weighted images revealed signal changes in 5/8 rats, and FLAIR sequence was positive in 8/8 rats. In CT intracerebral hemorrhage was only visible in 3/8 rats. When measuring the increase of Hounsfield units within the suspected hemisphere we saw a mean increase of 7% compared to the normal hemisphere in 3/8 rats. Conclusions: In this animal model, T2*-weighted magnetic resonance imaging proved to be the most sensitive imaging modality in the detection of acute intracerebral hemorrhage and is by far more sensitive than CT.
    Notes: Zusammenfassung Hintergrund und Ziel: Die Symptome eines Schlaganfalls sind in 10 bis 15% durch eine intrazerebrale Blutung verursacht. Oft ist es in der klinischen Untersuchung nicht möglich, zwischen einer intrazerebralen Blutung und einer zerebralen Ischämie zu differenzieren. Um eine intrazerebrale Blutung bei Schlaganfallsymptomatik auszuschließen, wird in der Regel zuerst eine Computertomographie (CT) durchgeführt. Ziel der vorliegenden Studie ist ein direkter Vergleich der Sensitivität der CT mit verschiedenen magnetresonanztomographischen (MR) Sequenzen in der Diagnostik der akuten intrazerebralen Blutung. Material und Methoden: Durch intrazerebrale Applikation von Kollagenase wurde bei 8 männlichen Wistar-Ratten eine intrazerebrale Blutung im linken Nucleus caudatus induziert. Nach einer Stunde wurden die Gehirne zunächst im CT und direkt anschließend in einem klinischen MR-Tomographen unter Verwendung von Protonendiche-, T2- und T1-gewichteten Spinechosequenzen, T2*-gewichten Gradientenechosequenzen, FLAIR-Sequenzen sowie diffusions- und perfusionsgewichteten Gradientenechosequenzen untersucht. Die Visibilität der Blutung wurde anhand einer Skala von 1 (=nicht sichtbar) bis 5 (=klar sichtbar) bewertet. Die Größe der Blutungsherde wurde für jede Untersuchungstechnik bestimmt und mit der Histologie verglichen. Ergebnisse: Bei allen Tieren konnte die Blutung in den T2*-gewichteten Gradientenecho-, FLAIR- sowie diffusionsgewichteten MRT-Bildern 1 h nach Kollagenaseinfusion erkannt werden. Auch in den T2- und Protonendichte-gewichteten Bildern konnte die Blutung bei 8/8 Ratten erkannt werden, wohingegen sie in den T1-gewichteten Aufnahmen nur bei 5/8 Ratten zu erkennen war. In der CT war die intrazerebrale Blutung nur bei 3/8 Ratten sichtbar, wobei bei diesen Tieren eine Zunahme der Dichte in Hounsfield-Einheiten (HE) in der Läsion um 15% auftrat. Schlußfolgerung: In dem verwendeten Tiermodell erwiesen sich T2*-und diffusionsgewichtete Aufnahmen sowie FLAIR-Sequenzen als sehr sensitive Methode in der Diagnostik der akuten intrazerebralen Blutung. Sie waren hierbei sensitiver als die CT. Deshalb sollte ein MR-tomographisches Untersuchungsprotokoll zur Diagnostik des akuten Schlaganfalls T2*- und diffusionsgewichtete Sequenzen beinhalten. Hierdurch gelingt eine rasche Unterscheidung zwischen der akuten intrazerebralen Blutung und der Frühphase der zerebralen Ischämie.
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  • 115
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    Experimental brain research 125 (1999), S. 417-425 
    ISSN: 1432-1106
    Keywords: Key words Motor learning ; Motor cortex ; Magnetic resonance imaging ; Musicians ; Hand motor skill
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  In this study, we investigated blood-flow-related magnetic-resonance (MR) signal changes and the time course underlying short-term motor learning of the dominant right hand in ten piano players (PPs) and 23 non-musicians (NMs), using a complex finger-tapping task. The activation patterns were analyzed for selected regions of interest (ROIs) within the two examined groups and were related to the subjects’ performance. A functional learning profile, based on the regional blood-oxygenation-level-dependent (BOLD) signal changes, was assessed in both groups. All subjects achieved significant increases in tapping frequency during the training session of 35 min in the scanner. PPs, however, performed significantly better than NMs and showed increasing activation in the contralateral primary motor cortex throughout motor learning in the scanner. At the same time, involvement of secondary motor areas, such as bilateral supplementary motor area, premotor, and cerebellar areas, diminished relative to the NMs throughout the training session. Extended activation of primary and secondary motor areas in the initial training stage (7–14 min) and rapid attenuation were the main functional patterns underlying short-term learning in the NM group; attenuation was particularly marked in the primary motor cortices as compared with the PPs. When tapping of the rehearsed sequence was performed with the left hand, transfer effects of motor learning were evident in both groups. Involvement of all relevant motor components was smaller than after initial training with the right hand. Ipsilateral premotor and primary motor contributions, however, showed slight increases of activation, indicating that dominant cortices influence complex sequence learning of the non-dominant hand. In summary, the involvement of primary and secondary motor cortices in motor learning is dependent on experience. Interhemispheric transfer effects are present.
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  • 116
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    European radiology 9 (1999), S. 457-459 
    ISSN: 1432-1084
    Keywords: Key words: Retroperitoneal neoplasms ; Retroperitoneal space ; Computed tomography ; Magnetic resonance imaging ; Ultrasonography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. We report a rare case of pseudomyxoma retroperitonei in a 58-year-old woman with a past history of severe appendicitis. The imaging showed a multicystic mass similar to pseudomyxoma peritonei, but the tumor was located in the retroperitoneal space.
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  • 117
    ISSN: 1432-1459
    Keywords: Key words Parkinson’s disease ; Depression ; Brainstem midline ; changes ; Transcranial sonography ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Recent studies using transcranial sonography (TCS) have provided evidence of alterations in the mesencephalic midline structures in patients with unipolar depression and depression in Parkinson’s disease (PD), suggesting an involvement of the basal limbic system in primary and secondary mood disorders. This study tested the hypothesis of brainstem midline abnormality in depression and investigated 31 PD patients by magnetic resonance imaging (MRI) and TCS. Signal intensity of the pontine and mesencephalic brainstem midline was rated on T2-weighted images and measured by relaxometry. In addition, two blinded investigators assessed the echogenicity of the brainstem midline by TCS. The severity of motor symptoms and depression were graded independently using standard research scales. Rating of signal intensity and T2 relaxometry of the pontomesencephalic midline structures revealed significant difference between depressed and nondepressed PD patients (P 〈 0.05). This corresponded to a significant reduction in mesencephalic midline echogenicity of depressed PD patients on TCS images. No correlation was found between raphe signal intensity, T2 relaxation times, or TCS echogenicity and the severity of motor symptoms or depression. This study is the first to show changes in signal intensity and T2 relaxation time of the pontomesencephalic midline structures on MRI in depressed PD patients confirming previous TCS findings. As these midline structures comprise fiber tracts and nuclei of the basal limbic system, the findings may support the hypothesis of an alteration in the basal limbic system in mood disorders.
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  • 118
    ISSN: 1432-1459
    Keywords: Key words Multiple sclerosis ; Magnetic resonance imaging ; Enhancing lesions ; Interferon-β1a
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. We investigated whether interferon-β1a modifies the course of new enhancing lesions in relapsing-remitting multiple sclerosis. Sixty-eight patients were studied by monthly magnetic resonance imaging (MRI) in a pretest-posttest design including 6 months of observation and 6 months of treatment. We examined the course of new Gd-enhancing lesions on two consecutive scans during observation and during treatment. Lesions detected during treatment were also analyzed by MRI 1 year later for persistence of enhancement, persistence of T2 hyperintensity, development of T1 hypointensity, or disappearance. Among the enhancing lesions detected by observation and treatment MRI, respectively, Gd-enhancement persisted at 2 months in 20% and 3% (P 〈 0.001), T2 hyperintensity persisted in 86% and 63% (P 〈 0.03), and T1 hypointensity developed in 49% and 15% (P 〈 0.01). Progression to T1 hypointensity was significantly more frequent in larger lesions during both the observation and treatment periods (P 〈 0.01). No reenhancement of plaques was present at 1-year follow-up; a further reduction in T2 hyperintensity (63% vs. 39%) was observed while T1 hypointensity remained unchanged. Both the duration of Gd enhancement and the short-term MRI course of new enhancing lesions benefited by treatment with recombinant interferon-β1a treatment.
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  • 119
    ISSN: 1432-1459
    Keywords: Key words Multiple sclerosis ; Magnetic resonance imaging ; Disease activity ; Fast spin echo ; Fast fluid-attenuated inversion ; recovery ; Reproducibility
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Previous studies have addressed the question of the precision in assessing multiple sclerosis (MS) activity by counting enhancing lesions on gadolinium enhanced brain magnetic resonance imaging (MRI). However, counting the active lesions on serial unenhanced MRI obtained by various pulse sequences has not been yet considered. We compared the interobserver levels of agreement in reporting active MS lesions on serial enhanced and unenhanced MRI to assess whether the use of various unenhanced techniques may change the degree of interobserver measurement reproducibility. Dual-echo conventional spin echo (CSE), dual-echo fast spin echo (FSE), fast fluid-attenuated inversion recovery (FLAIR) and Gd-enhanced T1-weighted brain MRI were obtained from five MS patients at baseline and monthly for 2 months. Six experienced observers independently identified and counted active MS lesions on the two follow-up MRI scans. Active lesions were considered to be all the enhancing lesions and any new or enlarging lesion on enhanced and unenhanced scans. Interobserver levels of agreement were calculated by weighted κ values. Very good agreement was reached only for counting total and new Gd-enhancing lesions. Good agreement was achieved for counting new lesions on the three unenhanced techniques, whereas the agreement for counting enlarging lesions was poor with all the MRI techniques. The level of agreement was significantly heterogeneous for various MRI techniques but not for various lesion sites. These results confirm that counting enhancing lesions is the most reliable method for assessing MS activity, but the use of any of the available unenhanced MRI techniques did not result in different levels of interobserver agreement when reporting new and enlarging MS lesions on serial scans.
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  • 120
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    Journal of neurology 246 (1999), S. 1169-1171 
    ISSN: 1432-1459
    Keywords: Key words European tick-borne encephalitis ; Magnetic resonance imaging ; Central nervous system
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report a case of central European tick-borne encephalitis with cervical myelitis presenting clinically as a lower motor neuron syndrome of the upper limbs with proximal asymmetrical pareses and atrophies. There were no sensory deficits nor signs of lesions of the spinal pathways or signs of encephalitis or meningitis. The affected motor fibers of the upper limbs were electrically inexcitable, but sensory findings were normal. Electromyography of the paralyzed muscles revealed pathological denervation activity without voluntary activation. The initial magnetic resonance imaging (MRI) showed a large hyperdense lesion in the anterior part of the cervical cord from C3 to T1. Despite the fact that MRI changes disappeared completely within 6 weeks the patient showed only little improvement in the paralyzed muscles after 6 months. To our knowledge, these MRI changes in patients with tick-borne encephalitis, consistent with an isolated anterior horn lesion, have never been reported previously. The course may have been aggravated by an initial antibiotic treatment with cephalosporins.
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  • 121
    ISSN: 1432-1459
    Keywords: Key words Temporal lobe epilepsy ; Hippocampus ; Magnetic resonance imaging ; Fluoro-2-deoxy-d-glucose positron-emission tomography ; Wada test
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In refractory temporal lobe epilepsy (TLE) temporal lobe structures and functions are continuously or intermittently affected by abnormal brain electrical events, noxious neurochemical agents, and metabolic disturbances. There is conflicting evidence regarding the relationship between the duration of refractory mesial TLE and quantitative measures of temporal lobe functions and volumes of the hippocampi. Twenty patients (aged 28 ± 7 years, 14 males) with an initial precipitating injury before the age of 5 years were subjected to high-resolution magnetic resonance imaging, fluoro-2-deoxy-d-glucose positron-emission tomography (PET), and the Wada test. We investigated whether the duration of unilateral refractory TLE (12 left, 8 right) affects hippocampal volume, glucose metabolism, or Wada hemispheric memory performance. Ipsilateral to the epileptogenic zone the hippocampal volume, metabolism, and Wada hemispheric memory performance were reduced compared to the corresponding contralateral measures. The duration of epilepsy controlled for age at investigation, side of seizure origin, underlying cause, and sex were negatively correlated with ipsi- and contralateral hippocampal volume, hippocampal metabolism, and Wada hemispheric memory performance. Moreover, ipsilateral Wada hemispheric memory performance and contralateral hippocampal glucose metabolism were correlated with the frequency of habitual seizures. Refractory TLE seems to be associated with a slow but ongoing bilateral temporal lobe damage. These cross-sectional results require verification by longitudinal studies carried out over a period of more than two decades.
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  • 122
    ISSN: 1432-1459
    Keywords: Key words Multiple sclerosis ; Magnetic resonance imaging ; Gadolinium-DTPA ; Triple dose ; Blood-brain barrier
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract This study assessed whether dysfunction of the blood-brain barrier is an obligatory early event in lesion formation in multiple sclerosis. Dual-echo and T1-weighted magnetic resonance imaging after the injection of a triple dose (0.3 mmol/kg) of gadolinium-DTPA were obtained from ten patients with relapsing-remitting multiple sclerosis every week for 2 months. Sixty-four newly active lesions were detected by the two techniques. All the 44 new lesions seen on dual-echo scans enhanced during the early phases of their formation: 33 at their first appearance, 10 1 week before their appearance on the dual-echo scans, and one the week thereafter. When the every fourth (monthly) scan was analyzed, a total of 55 newly active lesions were detected (i.e., 14% active lesions would have been missed compared to the number found on weekly scanning). Thirty-one of them were detected by both dual-echo and triple-dose scans, 15 only by enhanced scans, and nine only by dual-echo scans. This study confirms that with highly sensitive magnetic resonance imaging techniques dysfunction of the blood-brain barrier is an obligatory early event in new lesion formation in relapsing-remitting multiple sclerosis.
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  • 123
    ISSN: 1432-1327
    Keywords: Gadolinium(III) complexes ; Contrast agents ; Magnetic resonance imaging ; Human serum albumin ; Proton relaxation enhancement
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Chemistry and Pharmacology
    Notes: N,N′,N″,N‴ -pentaacetic acid) bearing different substituents for binding to human serum albumin (HSA) are compared. In spite of the structural differences of the recognition synthon and of the residual electric charge, the two chelates display an analogous binding affinity for the serum protein. Upon formation of the adducts with HSA, the exchange rates of the coordinated water appear slowed down by an amount corresponding to ca. 50% of the rates found for the free complexes. The relaxivity of [Gd(BOM)3DTPA (H2O)]2 −  is significantly higher than that of MS-325 either in the free complex or in the macromolecular adduct. Finally, the effect of pH on the stability of the HSA adducts and on the values of their relaxivities has been investigated.
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  • 124
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    Child's nervous system 15 (1999), S. 624-634 
    ISSN: 1433-0350
    Keywords: Key words Brain imaging ; Magnetic resonance imaging ; brain ; Magnetic resonance spectroscopy ; brain ; Computed tomography ; brain ; Diffusion imaging ; brain
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  The last century has seen the evolution of neuroimaging from nonexistent to a group of techniques that, in our eyes, appears to be highly sophisticated. The rapidity of advancement in imaging has been concentrated in the last quarter century. There is no reason to expect this continual forward expansion of neuroradiology to abate; rather it seems likely that it will continue to increase at an even faster rate. The near future is one of refinement in imaging, faster and higher resolution as well as a much greater emphasis on physiology and biochemistry.
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  • 125
    ISSN: 1433-0350
    Keywords: Key words Abscess ; Spinal cord ; Dermal sinus ; Epidermoid ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Intramedullary abscesses of the spinal cord are uncommon. Most of them occur in association with heart, pulmonary or urogenital infections. We report two cases of intramedullary spinal cord abscesses secondary to congenital dermal sinus. Only 14 cases of such an association have previously been reported. In our cases, dermal sinus was associated with an epidermoid tumour. The clinical presentation, pathogenesis, magnetic resonance imaging findings, surgical management and outcome are discussed.
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  • 126
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    Child's nervous system 15 (1999), S. 359-361 
    ISSN: 1433-0350
    Keywords: Key words Computerized tomography ; Intracranial tumor ; Magnetic resonance imaging ; Posterior fossa ; Teratoma
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  In this study we report a rare case of a giant midline posterior fossa teratoma; its clinical presentation, radiological appearance, treatment and outcome, with an extensive review of the literature.
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  • 127
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    Skeletal radiology 28 (1999), S. 383-389 
    ISSN: 1432-2161
    Keywords: Key words Allografts ; Osteoarticular ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Objective. To investigate the magnetic resonance imaging (MRI) features of allografts at various time intervals after surgery in patients with osteoarticular allografts. Design and patients. Sixteen patients who were treated with osteoarticular allografts and who were followed over time with MRI studies as part of their long-term follow-up were retrospectively selected for this study. T1-weighted images were obtained both before and after gadolinium administration along with T2-weighted images. All images were reviewed by an experienced musculoseletal radiologist, with two other experienced radiologists used for consultation. Imaging studies were organized into three groups for ease of discussion: early postoperative period (2 days to 2 months), intermediate postoperative period (3 months to 2 years), and late postoperative period (greater than 2 years). Results. In the early postoperative period, no gadolinium enhancement of the allograft was visible in any of the MR images. A linear, thin layer of periosteal and endosteal tissue enhancement along the margin of the allograft was visible in images obtained at 3–4 months. This enhancement apeared gradually to increase in images from later periods, and appears to have stabilized in the images obtained approximately 2–3 years after allograft placement. The endosteal enhancement diminished after several years, with examinations conducted between 6 and 8 years following surgery showing minimal endosteal enhancement. However, focal enhancement was noted adjacent to areas of pressure erosion or degenerative cysts. All the cases showed inhomogeneity in the marrow signal (scattered low signal foci on T1 with corresponding bright signal on T2), and a diffuse, inhomogeneous marrow enhancement later on. Conclusion. We have characterized the basic MRI features of osteoarticular allografts in 16 patients who underwent imaging studies at various time points as part of routine follow-up. We believe that the endosteal and periosteal enhancement observed on MRI during the first few months to 2 years following surgery represents vascular ingrowth and early skeletal repair. The zone of periosteal enhancement could also include the new bone laid on the surface of the allograft through which the soft tissues bind to the cortex. The exact reason for the inhomogeneity in the marrow signal, and the diffuse, inhomogeneous marrow enhancement is not clear. This may represent saponified and/or necrotic marrow fat interspersed with the fibrovascular tissue. The features noted here should provide radiologists with useful information regarding imaging characteristics they can expect to see in other allograft replacement patients.
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  • 128
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    Skeletal radiology 28 (1999), S. 447-452 
    ISSN: 1432-2161
    Keywords: Key words Plantar fascia ; aponeurosis ; Fasciitis ; Fasciotomy ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Objective. To determine the postoperative appearance of the plantar fascia on MR imaging after a fasciotomy has been performed, and to compare the postsurgical appearance of the fascia after an open and endoscopic procedure.〈@head-abs-p1.lf〉Design and patients. Fifteen asymptomatic volunteers (12 women, 3 men; age range 22–49 years, mean age 33 years) with prior fasciotomies for treatment of longstanding plantar fasciitis were studied. Fourteen volunteers had a unilateral release and one volunteer had bilateral releases, allowing for assessment of 16 ankles. Eight fasciotomies were performed through an open incision and eight were performed endoscopically. The average time between surgery and imaging was 24 months (range 11–46 months). The site of surgery was established from the operative reports. Proton density (PD)-weighted and T2-weighted images in three orthogonal planes were obtained on a 1.5-T magnet. In eight studies, T1-weighted sagittal and STIR sagittal images were included. The fascia in each ankle was assessed for morphology and signal intensity. Perifascial soft tissues and bone marrow were assessed for edema. Preoperative MR studies were available in five volunteers.〈@head-abs-p1.lf〉Results. There was no apparent difference in the postoperative appearance of the ankle after an open or endoscopic procedure except for scar formation in the subcutaneous fat which was common after an open procedure (P〈0.05). Three ankles had a gap in the fascia (one open, two endoscopic). The plantar fascia measured a mean of 7.0 mm (range 5–10 mm) at the fasciotomy, and 8.3 mm (range 6–12 mm) at the enthesis. At the fasciotomy, 11 of 13 ankles had an indistinct deep contour and 9 of 13 had an indistinct superficial contour. At the enthesis, 13 of 16 ankles had an indistinct deep contour and 6 of 16 had an indistinct superficial contour. Compared with preoperative MR studies there was an average reduction in the fascial thickness at the enthesis of 14% (range 9–20%), but the thickness at the fasciotomy nearly doubled. No edema was evident in the fascia, perifascial tissues, deep plantar muscles, or calcaneal bone marrow.〈@head-abs-p1.lf〉Conclusions. The average thickness of the plantar fascia in asymptomatic volunteers after surgery is nearly 2–3 times that of normal. While there is increased thickness at the site of surgery, the changes in morphology and signal intensity were most prominent at the enthesis. The key observation was absence of edema in the fascia and perifascial soft tissues. This baseline information may be of value when assessing MR studies of symptomatic patients.
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  • 129
    ISSN: 1432-2161
    Keywords: Key words Hand ; Wrist ; Magnetic resonance imaging ; Soft tissue mass ; Neoplasm ; Tumour ; Tendon diseases
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract   Objective. To assess the utility of magnetic resonance imaging (MRI) in the investigation of palpable masses in the hand or wrist.〈@head-abs-p1.lf〉Design and patients. We retrospectively reviewed the MRI examinations and case records of 134 patients referred because of a palpable mass in the hand or wrist. MRI was performed on a 1.0 T magnet using an extremity coil. Intravenous gadolinium-DTPA was injected when considered appropriate.〈@head-abs-p1.lf〉Results and conclusions. MRI demonstrated the cause of the palpable mass in 126 cases (94.02%). Soft tissue neoplasms were found in 34 cases (25.37%). The majority were benign and included giant cell tumours of tendon sheath, lipomas and hemangiomas and had a characteristic appearance. There were three malignant tumours (myxoid liposarcoma, malignant fibroushistiocytoma and rhabdomyosarcoma). Ganglia were found in 36 cases (26.86%) and non-tumour tendon pathology in 31 cases (23.13%). Less common causes included articular diseases (5.97%) and anatomical variants (4.47%). No focal lesion was present in 8 cases (5.97%). In conclusion, MRI is an accurate diagnostic technique in patients who present with a palpable mass of the hand and wrist.
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  • 130
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    Skeletal radiology 28 (1999), S. 96-99 
    ISSN: 1432-2161
    Keywords: Key words Computed tomography ; Granular cell tumor ; Magnetic resonance imaging ; Subcutis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Three cases of granular cell tumor (GCT) of the subcutis are presented. Computed tomography showed a mass isodense with muscle with an ill-defined margin. Magnetic resonance imaging showed a mass with inhomogeneous low signal intensity on both T1- and T2-weighted images. Another characteristic feature of subcutaneous GCT is its attachment in part to muscle. Histological examination confirmed the diagnosis in all cases.
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  • 131
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    Child's nervous system 15 (1999), S. 8-10 
    ISSN: 1433-0350
    Keywords: Key words Cavernous sinus ; Meningioma ; Child ; Ophthalmoplegia ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Intracranial meningiomas in children are rare, representing 1–4.2% of central nervous system tumors and 1.5–1.8% of all intracranial meningiomas. Meningiomas arising from the lateral wall of the cavernous sinus account for less than 1% of all intracranial meningiomas. To our knowledge, only one case of a meningioma arising from the cavernous sinus has been reported in childhood. A 6-year-old boy presented with left ophthalmoplegia. A slight drooping of the left eyelid was noted at the age of 1 year. Magnetic resonance imaging (MRI) with contrast administration revealed an enhancing mass lesion located in the left cavernous sinus. The tumor, arising from the lateral wall of the cavernous sinus, was totally removed and the oculomotor nerve was reconstructed with a sural nerve graft. MRI displayed total tumor removal 1 month after the surgery. The pathological diagnosis was of a psammomatous meningioma.
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  • 132
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    Child's nervous system 15 (1999), S. 209-211 
    ISSN: 1433-0350
    Keywords: Key words Anterior sacral meningocele ; Epidermoid tumor ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A 2-year-old girl presented with an anterior sacral meningocele completely occupied by an epidermoid tumor. Preoperative magnetic resonance imaging had shown the meningocele with contents of the same intensity as cerebrospinal fluid. Surgery via a posterior sacral approach disclosed the tumor beneath an unexpected membrane inside the meningocele. Additionally, the presence of pus inside epidermoid tumor suggested that possible episodes of asymptomatic meningitis or other infection might have occurred before treatment, these being the major complication in anterior sacral meningocele. Therefore, we recommend that surgical treatment should be performed at the earliest possible stage in childhood, once the diagnosis is established, and dural plasty carried out to prevent infectious complications.
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  • 133
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    Der Radiologe 39 (1999), S. 847-854 
    ISSN: 1432-2102
    Keywords: Schlüsselwörter Zerebrale Amyloidangiopathie ; Intrazerebrale Blutung ; Computertomographie ; Kernspintomographie ; Key words Cerebral amyloid angiopathy ; Intracerebral hemorrhage ; Computed tomography ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary The purpose of our study was to evaluate the characteristic findings of acute hemorrhage due to amyloid angiopathy with computed tomography. 14 patients of intracranial hemorrhage with histologically confirmed cerebral amyloid angiopathy were observed over a period of 4 years. Characteristic findings were a lobar hemorrhage in superficial localisation, cortical involvment, subarachnoid hemorrhage, the multiplicity of hemorrhages and repeated episodes. Severe cerebral amyloid angiopathy is often accompanied by multiple petechial hemorrhages, restricted to a cortical-subcortical distribution, detectable by magnetic resonance imaging. These findings suggest that cerebral amyloid angiopathy is not a rare cause of atraumatic lobar hemorrhage. Amyloid angiopathy should be considered in any elderly patient with superficial intracerebral hemorrhage in an atypical location.
    Notes: Zusammenfassung In der Arbeit werden die computertomographischen Befunde der intrazerebralen Blutung im Rahmen der Amyloidangiopathie untersucht. 14 Patienten mit Massenblutung und histologisch bestätigter Amyloidangiopathie wurden in einem Zeitraum von 4 Jahren beobachtet. Charakteristische Befunde waren eine lobäre, oberflächlich gelegene Blutung, eine kortikale Beteiligung, eine begleitende Subarachnoidalblutung sowie ein mehrfaches und mehrzeitiges Auftreten der Blutungen. Eine schwere Amyloidangiopathie geht oft mit multiplen petechialen Blutungen in kortiko-subkortikaler Lokalisation einher, die sich kernspintomographisch nachweisen lassen. Die Befunde zeigen, daß die Amyloidangiopathie keine seltene Ursache einer nicht traumatischen lobären Blutung ist. Sie sollte daher bei jedem älteren Patienten mit einer intrazerebralen, oberflächlich gelegenen Blutung in atypischer Lokalisation in Betracht gezogen werden.
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  • 134
    ISSN: 1432-2102
    Keywords: Schlüsselwörter Staging thorakoabdominaler Tumoren ; Kinder ; Computertomographie (CT) ; Magnetresonanztomographie (MRT) ; Malignome ; Key words Staging of tumors ; Thoracoabdominal tumors ; Childhood ; Computed tomography ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Thoracoabdominal tumors in childhood can arise from all organs and affect children from the neonate to the adolescent. Better prognosis of childhood tumors, due to better biological understanding and improvement of chemotherapy, require sufficient radiological staging. Sufficiency in radiological staging needs modern cross-sectional techniques with high resolution, good availability and lower radiation dose. In general computed tomography (CT) is being used for radiological staging; increasingly MR imaging is being used because of multiplanar imaging techniques. Replacement of invasive techniques such as myelography and lymphography and modern cross-sectional techniques create painless staging conditions. Nevertheless, scintigraphy will always be a major examination technique, especially for evaluation of metastases and postoperative control examinations. The most common thoracoabdominal tumors in childhood and their staging are described.
    Notes: Zusammenfassung Thorakale und abdominale Tumoren im Kindesalter nehmen ihren Ausgang von allen Organsystemen und können vom Neugeborenen bis zum Adoleszenten auftreten. Verbesserte Prognose, bedingt durch das bessere biologische Verständnis der Tumorerkrankung, sowie der effiziente Einsatz von Chemotherapeutika machen ein radiologisches Staging unumgänglich. Üblicherweise wird zum Staging die Computertomographie (CT) eingesetzt. Durch die Möglichkeit der multiplanaren Schnittführung und die bessere Auflösung bei Tumoren mit Beteiligung des ZNS wird in zunehmendem Maße die Magnetresonanztomographie (MRT) eingesetzt. Diese modernsten Schnittbildverfahren haben invasive Methoden wie Lymphographie und Angiographie in den Hintergrund gedrängt. Im weiteren werden die häufigsten thorakalen und abdominalen Tumoren im Kindesalter besprochen und deren Stagingsysteme erläutert.
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    Der Radiologe 39 (1999), S. 562-567 
    ISSN: 1432-2102
    Keywords: Schlüsselwörter Kolorektales Karzinom ; Präoperatives Staging ; Endosonographie ; CT ; MRT ; Key words Colorectal cancer ; Preoperative staging ; Endosonography ; Computed tomography ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Carcinoma of the colorectum is one of the most frequent neoplasias, with an incidence of 40 in 100 000. For the effective use of new, differentiated, less invasive treatment options, exact preoperative staging of the tumor is essential. The introduction of endosonography in rectal tumor staging allows for exact differentiation of the rectal wall layers and thus of tumor stages 1–3 with median accuracy of 89%. Magnetic resonance imaging of the rectum, especially in double-contrast technique, can also be employed in high and stenosing tumors and leads to an average accuracy of 85% for the stages 1–4. Computed tomography is the method of choice in screening for metastases. In lymph node staging, all modalities show only moderate accuracy around 75%.
    Notes: Zusammenfassung Das kolorektale Karzinom stellt mit einer Inzidenz von 40 auf 100000 eine der häufigsten Neoplasien dar. Für den effektiven Einsatz neuer differenzierter Therapien mit geringerer Invasivität ist ein exaktes präoperatives Staging erforderlich. Die Einführung der Endosonographie im Tumorstaging erlaubt eine exakte Differenzierung der Wandschichten und damit der Tumorstadien 1–3 mit einer mittleren Genauigkeit von 89%, die Magnetresonanztomographie des Rektums, insbesondere in Doppelkontrasttechnik, kann auch bei hohen und stenosierenden Tumoren angewendet werden, bei einer Genauigkeit von durchschnittlich 85% für die Stadien 1–4. Die Computertomographie ist Methode der Wahl im Metastasenscreening. Im Lymphknotenstaging zeigen alle Modalitäten nur bescheidene Genauigkeiten um 75%.
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  • 136
    ISSN: 1433-7347
    Keywords: Key words Donor site morbidity ; Anterior cruciate ligament ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine , Sports Science
    Notes: Abstract The aim of this prospective study was to follow the development of repair tissue in the donor-site area using serial magnetic resonance imaging (MRI) evaluation and to assess whether the MRI findings were correlated with donor-site morbidity. Thirty-seven consecutive patients with unilateral anterior cruciate ligament injuries undergoing elective reconstruction of the ligament were included in the study. They were aged 27 (range 14–50) years. The graft was harvested through two 25-mm vertical incisions with the aim of protecting the infrapatellar nerve and sparing the paratenon. The tendon defect was left open. The patients underwent MRI evaluation at 6 weeks, 6 months and 27 months postoperatively. A final clinical follow-up was made 25 (range 23–29) months postoperatively. MRI demonstrated that the donor-site gap, i.e. the area corresponding to a pathological non-tendinous-like tissue signal, was 9 (range 4–18) mm at 6 weeks, 5 (range 2–14) mm at 6 months and 2 (range 0–5) mm at 27 months. The size of the donor-site gap had significantly decreased at 6 months compared with 6 weeks (P = 0.0001), as well as at 27 months compared with 6 months (P = 0.0001). We conclude that the patellar tendon at the donor site healed gradually, as expressed by a decrease in the area of non-tendinous-like tissue signal on the serial MRI evaluations.
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  • 137
    ISSN: 1433-7347
    Keywords: Key words Meniscus ; Degeneration ; Magnetic resonance imaging ; Histology ; Chronicity of the meniscal tear
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine , Sports Science
    Notes: Abstract Signal anomalies observed in magnetic resonance imaging of the intrameniscal tissue adjacent to the tear were compared between stable knees (group 1, 54 menisci) and anterior cruciate ligament (ACL) deficient knees (group 2, 98 menisci). The histological significance of these signal anomalies was also studied (n = 25). The frequency of intrameniscal signal anomalies adjacent to the tear was significantly lower in ACL-deficient knees than in ACL-stable knees (P = 0.0022). There was a close correlation between the imaging anomalies and the presence of histological lesions (fissures, degeneration) within meniscal tissues adjacent to the tear (sensitivity: 0.95, specificity: 0.60). Our results suggest that the severity of intrameniscal degenerative changes adjacent to the tear are lower in ACL-deficient knees than in ACL-stable knees.
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  • 138
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    Journal of neurology 246 (1999), S. 16-20 
    ISSN: 1432-1459
    Keywords: Key words Dementia ; Alzheimer’s disease ; Neuroimaging ; Magnetic resonance imaging ; Single photon emission computed tomography ; Atrophy ; Hippocampus
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The use of neuroimaging is reviewed in the diagnosis of dementia, especially Alzheimer’s disease (AD). Computed tomography (CT) may be used to exclude other causes of dementia than AD. The finding of cortical or subcortical atrophy on CT or magnetic resonance imaging (MRI) itself does not indicate AD. Hippocampal atrophy on CT/MRI provides a useful early marker, although further longitudinal and neuropathological study is required. CT- and MRI-based measurements of hippocampal atrophy show promise in providing useful diagnostic information for discriminating patients with probable AD from normal elderly individuals. Using a standardized imaging protocol, including some assessment of hippocampal atrophy, can save costs since patients with suspected AD must undergo a cross-sectional imaging study to exclude other (treatable) causes of dementia. Combining an assessment of hippocampal atrophy with cerebral blood flow measurements by single photon emission computed tomography is not warranted either from a clinical or from an economic point of view.
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  • 139
    ISSN: 1432-1459
    Keywords: Key words Spinocerebellar ataxia type 2 ; Magnetic resonance imaging ; Cerebral atrophy ; Disease duration
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract There have been only few studies of brain magnetic resonance imaging (MRI) in spinocerebellar ataxia (SCA) type 2. We investigated 20 SCA2 patients, from 11 Sicilian families, and 20 age-matched control subjects using MRI. Our data confirm that olivopontocerebellar atrophy (OPCA) is the typical pattern in SCA2. We found no significant correlation between infratentorial atrophy, disease duration, or the number of CAG repeats in our SCA2 patients, but there was supratentorial atrophy in 12 patients, with a significant correlation between supratentorial atrophy and disease duration. OPCA appears to represent the “core” of the SCA2: however, central nervous system involvement is not limited to pontocerebellar structures. We therefore consider central nervous system degeneration in SCA2 as a widespread atrophy. MRI is helpful in diagnosing SCA, but it is not diagnostic in the absence of clinical and molecular studies. We suggest that serial MRI may play a role in evaluating “in vivo” the progressive steps of neurodegeneration in SCA2, for a better comprehension of the pathophysiology of this disorder.
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  • 140
    ISSN: 1615-3146
    Keywords: Kerspintomographie ; Kollateralbandruptur ; Knorpelläsion ; Hochauflösende Oberflächenspule ; Magnetic resonance imaging ; Collateral ligament rupture ; Cartilage lesion ; High-resolution coil
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Aim of this study was the evaluation of a prototype of a new high-resolution MRI coil for the detection of finger trauma. The practicability of this new coil for the assessment of traumatic lesions of the finger joints and the diagnostic value of this new method in clinical practice was assessed. Twenty patients between 13 and 50 years of age (mean 28 years) were examined with a 1.5-T whole-body-imager Magnetom SP 63 scanner (Siemens, Erlangen, Germany). A prototype of a high-resolution MRI coil with a diameter of 2.5 cm was used. T1- and T2-weighted images with an in plane resolution of 0.I95 x 0.098 mm were acquired. Bone structures, joint cartilage and capsule, ligaments, tendons and soft tissue alterations were assessed. All 19 patients with pathological changes at the finger joints had a joint effusion. With MR imaging, fractures were detected in almost all patients, compared with the X-ray examinations. Cartilage contusion showed high signal intensity. The collateral ligaments could best be assessed in the transversal, and ligament ruptures in the coronal plane. Hemorrhage in the tendon showed an increased signal intensity in T1- and T2-weighted, edema only in T2-weighted images. Especially traumatic lesions of cartilage and of ligaments can be sufficiently assessed by the high-resolution MRI due to its high anatomic resolution compared to common methods like X-ray. High-resolution MRI is practicable in clinical routine.
    Notes: Zusammenfassung Ziel der vorliegenden prospektiven Untersuchung war es, die Wertigkeit der hochauflösenden Kernspintomographie mittels einer speziellen Oberflächenspule in der Beurteilung von traumatischen Veränderungen der Fingergelenke zu evaluieren. Ferner sollte die Praktikabilität der Methode in der klinischen Routine überprüft werden. Es wurden 20 Patienten im Alter zwischen 13 und 50 Jahren (im Mittel 28 Jahre) an einem 1,5-T-Ganzkörpertomographen (Magnetom SP 63, Firma Siemens, Erlangen) untersucht. Als Spule wurde ein Prototyp einer hochauflösenden Oberflächenspule mit einem Durchmesser von 2,5 cm benutzt. T1- und T2-gewichtete Sequenzen mit einer maximalen Auflbsung in der Bildebene von 0,195 x 0,098 mm wurden zur Beurteilung von Knochen, Gelenkknorpel und -kapsel, der Sehnen und des Weichteilgewebes akquiriert. Kernspintomographisch fand sich bei 19 Patienten ein pathologischer Befund. Bei all diesen Patienten konnte ein Gelenkerguß nachgewiesen werden. Knöcherne Absprengungen, die anhand konventioneller Röntgenaufnahmen diagnostiziert wurden, zeigten sich kernspintomographisch als dislozierte signalreiche Strukturen. Gelenkknorpelkontusionen stellten sich hyperintens dar. Zur Beurteilung der Kollateralbānder eignete sich vor allem die koronare Schichtebene, da in dieser die Kollateralbdnder per continuitatem darstellbar sind. Sehneneinblutungen wiesen eine Signalerhöhung in T1- und T2-Wichtung auf. Ödeme der Weichteile und Bandstrukturen imponierten in T2-gewichteten Aufnahmen als signalreiche Strukturveränderungen. Aufgrund der hohen anatomischen Detailerkennbarkeit eignet sich die hochauflbsende Kernspintomographie als ergänzendes diagnostisches Verfahren zur nichtinvasiven Diagnostik von traumatischen Knorpel- und Bandläsionen. Unter Berücksichtigung des Zeitaufwandes handelt es sich dabei um eine im klinischen Alltag praktikable Methode.
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  • 141
    ISSN: 1619-7089
    Keywords: Key words: Autism ; Brain ; Technetium-99m ethyl cysteinate dimer ; Single-photon emission tomography ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. The neuro-anatomical substrate of autism has been the subject of detailed investigation. Because previous studies have not demonstrated consistent and specific neuro-imaging findings in autism and most such studies have been performed in adults and school-aged children, we performed a retrospective review in young children in search of common functional and anatomical abnormalities with brain single-photon emission tomography (SPET) using technetium-99m ethyl cysteinate dimer (ECD) and correlative magnetic resonance imaging (MRI). The patient population was composed of 23 children aged 28–92 months (mean: 54 months) who met the diagnostic criteria of autism as defined in the DSM-IV and CARS. Brain SPET was performed after intravenous injection of 185–370 MBq of 99mTc-ECD using a brain-dedicated annular crystal gamma camera. MRI was performed in all patients, including T1, T2 axial and T1 sagittal sequences. SPET data were assessed visually. Twenty patients had abnormal SPET scans revealing focal areas of decreased perfusion. Decreased perfusion of the cerebellar hemisphere (20/23), thalami (19/23), basal ganglia (5/23) and posterior parietal (10/23) and temporal (7/23) areas were noted on brain SPET. By contrast all patients had normal MRI findings without evidence of abnormalities of the cerebellar vermis, cerebellar hemisphere, thalami, basal ganglia or parietotemporal cortex. In conclusion, extensive perfusion impairments involving the cerebellum, thalami and parietal cortex were found in this study. SPET may be more sensitive in reflecting the pathophysiology of autism than MRI. However, further studies are necessary to determine the significance of thalamic and parietal perfusion impairment in autism.
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  • 142
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    European journal of applied physiology 79 (1999), S. 367-373 
    ISSN: 1439-6327
    Keywords: Key words Cerebral edema ; Cerebrospinal fluid ; Head-down tilt ; Intracranial pressure ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Vascular and tissue fluid dynamics in the microgravity of space environments is commonly simulated by head-down tilt (HDT). Previous reports have indicated that intracranial pressure and extracranial vascular pressures increase during acute HDT and may cause cerebral edema. Tissue water changes within the cranium are detectable by T 2 magnetic resonance imaging. We obtained T 2 images of sagittal slices from five subjects while they were supine and during −13° HDT using a 1.5-Tesla whole-body magnet. The analysis of difference images demonstrated that HDT leads to a 21% reduction of T 2 in the subarachnoid cerebrospinal fluid (CSF) compartment and a 11% reduction in the eyes, which implies a reduction of water content; no increase in T 2 was observed in other brain regions that have been associated with cerebral edema. These findings suggest that water leaves the CSF and ocular compartments by exudation as a result of increased transmural pressure causing water to leave the cranium via the spinal CSF compartment or the venous circulation.
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  • 143
    ISSN: 1573-9686
    Keywords: Blood flow ; Magnetic resonance imaging ; Numerical flow modeling ; Carotid artery ; Three-dimensional ; Wall shear stress ; Atherosclerosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine , Technology
    Notes: Abstract Purpose: Combining computational blood flow modeling with three-dimensional medical imaging provides a new approach for studying links between hemodynamic factors and arterial disease. Although this provides patient-specific hemodynamic information, it is subject to several potential errors. This study quantifies some of these errors and identifies optimal reconstruction methodologies. Methods: A carotid artery bifurcation phantom of known geometry was imaged using a commercial magnetic resonance (MR) imager. Three-dimensional models were reconstructed from the images using several reconstruction techniques, and steady and unsteady blood flow simulations were performed. The carotid bifurcation from a healthy, human volunteer was then imaged in vivo, and geometric models were reconstructed. Results: Reconstructed models of the phantom showed good agreement with the gold standard geometry, with a mean error of approximately 15% between the computed wall shear stress fields. Reconstructed models of the in vivo carotid bifurcation were unacceptably noisy, unless lumenal profile smoothing and approximating surface splines were used. Conclusions: All reconstruction methods gave acceptable results for the phantom model, but in vivo models appear to require smoothing. If proper attention is paid to smoothing and geometric fidelity issues, models reconstructed from MR images appear to be suitable for use in computational studies of in vivo hemodynamics. © 1999 Biomedical Engineering Society. PAC99: 8719Uv, 8761-c, 0705Pj, 8710+e
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  • 144
    ISSN: 1573-9686
    Keywords: Medical imaging ; Magnetic resonance imaging ; Biomechanics ; Tendon moment arm ; Functional neuromuscular stimulation ; Tendon transfer surgery ; Hand biomechanics
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine , Technology
    Notes: Abstract New three-dimensional (3D) magnetic resonance imaging (MRI) methods for measuring the tendon moment arm were created and were evaluated on the tendon moment arm of the flexor digitorum profundus at the third metacarpophalangeal joint. Using an open magnet MRI system and a hand holder, a series of static images were acquired at four joint angles and analyzed using specially created computer programs. Three methods were evaluated: (1) a 3D tendon excursion method that extended the method of Landsmeer; (2) a 3D geometric method whereby the moment arm was the perpendicular distance between the joint axis of rotation and the tendon path, and (3) a two-dimensional (2D) geometric method whereby single image slices were analyzed. Repeating the imaging and measurement processes, the 3D tendon excursion method was more reproducible (6% variation) than the 3D geometric method (12%), and both were much more reproducible than the 2D geometric method (27%). By having three operators analyze a single set of image data, we found that the precision of the 3D tendon excursion method was much less affected by segmentation error than the 3D geometric method. With the 3D imaging methods, tendon bowstringing and a displacement of the joint center of rotation toward the dorsal side of the hand were evident, leading to as much as a 60% increase in moment arm with joint flexion. Because of the dependence on flexion and variation between subjects, we recommend patient-specific measurements for target applications in functional neuromuscular stimulation interventions and tendon transfer surgery. © 1999 Biomedical Engineering Society. PAC99: 8761Pk, 8719Rr, 0705Pj
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  • 145
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    Diseases of the colon & rectum 41 (1998), S. 1062-1066 
    ISSN: 1530-0358
    Keywords: Colonic neoplasms, complication ; Hemangioma, cavernous ; Magnetic resonance imaging ; Tomography, x-ray computed
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract PURPOSE: We present two cases of diffuse cavernous hemangioma of the rectum that invaded the pelvic structures. METHODS: Two young women suffering from intermittent rectal bleeding were studied using computed tomography and magnetic resonance imaging. RESULTS: Beside the rectal hemangioma, computed tomography and magnetic resonance imaging revealed that the pelvic ureter and the iliac vessels were each eroded by the tumor that produced symptoms in these two patients. CONCLUSION: Computed tomography and magnetic resonance imaging permit direct visualization for tumor staging and also for recognition of any pelvic structure invasion, which facilitate preoperative assessment of diffuse cavernous hemangioma of the rectum.
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  • 146
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    Diseases of the colon & rectum 41 (1998), S. 514-516 
    ISSN: 1530-0358
    Keywords: Angiomyxoma ; Intraoperative radiation therapy ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Aggressive angiomyxomas are rare soft tissue tumors found mainly in the female reproductive mesenchyme and pelvis. They are low-grade sarcomas that have a propensity to recur locally. These tumors are encapsulated and have the same consistency as normal connective tissue, thus making wide excision difficult. We report a case of a large aggressive angiomyxoma in the perirectal tissues treated with preoperative angiographic embolization, causing ischemia of the tumor and, thus, improved visualization of the lesion. In addition, preoperative external beam irradiation and intraoperative electron beam radiotherapy were used to decrease the chances of local recurrence.
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  • 147
    ISSN: 1534-4681
    Keywords: Magnetic resonance imaging ; Breast cancer ; Locoregional recurrence
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: Dynamic contrast-enhanced magnetic resonance imaging (MRI) of the breast is highly sensitive for the diagnosis of primary breast malignancy. We investigated the clinical application of dedicated dynamic breast MR for routine screening for local recurrence following breast-conserving therapy. Methods: Patients underwent a single dynamic MR of the breast routinely in the period 1 to 2 years following treatment, or earlier if recurrence was suspected. A biopsy was performed if there was suspicion of recurrence on MR. Results: One hundred and five patients with a median age of 58 years (range 50 to 65 years) were recruited for the study. Sixteen biopsies were performed and nine recurrences were confirmed histologically. Patients not undergoing biopsy have been followed up for a median of 341 days (range 168 to 451 days) following the MR. The sensitivity for clinical examination, mammography, examination combined with mammography, and MRI alone for the detection of recurrent cancer were 89%, 67%, 100%, and 100%, respectively, and the specificity was 76%, 85%, 67%, and 93%. Conclusion: Combined clinical examination and mammography are as sensitive as dedicated dynamic MR of the breast for the detection of locoregional recurrence, but breast MRI is associated with a far greater specificity. Therefore, dedicated dynamic breast MRI should be used when there is clinical or mammographic suspicion of recurrence to confirm or refute its presence.
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  • 148
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    Surgical and radiologic anatomy 20 (1998), S. 299-302 
    ISSN: 1279-8517
    Keywords: Magnetic resonance imaging ; Anatomical variant ; Hook of hamate ; Wrist ; Carpal tunnel
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Normal skeletal variants are a common occurrence in clinical practice and may lead to misinterpretation. As part of a case control study investigating the carpal tunnel, our asymptomatic and voluntary participant underwent magnetic resonance (MR) imaging of both wrists from the metacarpal bases to the distal radiocarpal joint. The imaging techniques included spin echo (SE), turbo spin echo (TSE) and fast field echo (FFE) sequences using 4 mm-slice thickness. As an incidental finding bipartite hamulus was detected bilaterally. The anomaly was evident in both hamuli with similar MRI characteristics. The congenital origin was further supported by the absence of trauma or surgery to the wrists. In this case report the authors discuss the anatomical variant, bilateral bipartite hook of the hamate, and demonstrate the reliability of contiguous slices of MR axial slices in displaying an anatomical variant of the carpus. This normal variant of the hamate is not commonly encountered in MR imaging of the wrist and can be misinterpreted as fracture or post-traumatic sequelae. Images of the normal hamulus are presented for comparison.
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  • 149
    ISSN: 1279-8517
    Keywords: Ocular development ; Orbit ; Fetus ; Eye ; Magnetic resonance imaging ; Anatomy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The aim of this study was to measure fetal ocular development and to determine a growth curve by means of measurements in utero. Fetal ocular development was recorded by analysis of the results of magnetic resonance imaging (MRI). An anatomic study allowed definition of the best contrasted MRI sequences for calculation of the ocular surface. Biometric analysis of the values of the ocular surface in the neuro-ocular plane in 35 fetuses allowed establishment of a linear model of ocular growth curve in utero. Evaluation of ocular development may allow the detection and confirmation of malformational ocular anomalies such as microphthalmia.
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  • 150
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    Surgical and radiologic anatomy 20 (1998), S. 299-302 
    ISSN: 1279-8517
    Keywords: Magnetic resonance imaging ; Anatomical variant ; Hook of hamate ; Wrist ; Carpal tunnel
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé Les variations squelettiques normales sont fréquemment rencontrées en pratique clinique et peuvent conduire à des erreurs d'interprétation. Lors d'une étude contrôle concernant le canal carpien, des sujets asymptomatiques et volontaires ont subi une imagerie par résonance magnétique (IRM) des deux poignets depuis les bases des métacarpiens jusqu'à l'interligne radio-carpien. Les techniques d'imagerie utilisaient des coupes de 4 mm en spin-écho (SE), en turbo spin-écho (TSE) et en écho de champ rapide (FFE). Fortuitement, nous avons trouvé un hamulus bipartite bilatéral. L'anomalie était évidente sur les deux hamulus et présentait les mêmes caractéristiques IRM. L'origine congénitale a été retenue en l'absence de traumatisme ou de chirurgie des poignets. Dans le cas rapporté, les auteurs discutent la variante anatomique, un hamulus bipartite de l'hamatum, et montrent la fiabilité des coupes axiales IRM contiguës pour décrire une variante anatomique du carpe. Cette variante normale de l'hamatum est rarement rencontrée en IRM du poignet et pourrait être prise par erreur comme une fracture ou une séquelle post-traumatique. Les images d'un hamulus normal sont présentées pour comparaison.
    Notes: Summary Normal skeletal variants are a common occurrence in clinical practice and may lead to misinterpretation. As part of a case control study investigating the carpal tunnel, our asymptomatic and voluntary participant underwent magnetic resonance (MR) imaging of both wrists from the metacarpal bases to the distal radiocarpal joint. The imaging techniques included spin echo (SE), turbo spin echo (TSE) and fast field echo (FFE) sequences using 4 mm-slice thickness. As an incidental finding bipartite hamulus was detected bilaterally. The anomaly was evident in both hamuli with similar MRI characteristics. The congenital origin was further supported by the absence of trauma or surgery to the wrists. In this case report the authors discuss the anatomical variant, bilateral bipartite hook of the hamate, and demonstrate the reliability of contiguous slices of MR axial slices in displaying an anatomical variant of the carpus. This normal variant of the hamate is not commonly encountered in MR imaging of the wrist and can be misinterpreted as fracture or post-traumatic sequelae. Images of the normal hamulus are presented for comparison.
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  • 151
    ISSN: 1437-160X
    Keywords: Key words Myositis ; Diagnosis ; Biopsy ; 99mtechnetium-pyrophosphate scintigraphy ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Our objective was to study the value of 99mtechnetium-pyrophosphate (99mTc-PYP) muscle scintigraphy and magnetic resonance imaging (MRI) in detecting areas of likely muscle inflammation and in increasing the rate of positive muscle biopsies in patients with suspected myositis. The results showed that in 13 out of 13 patients with clinical and/or signs of inflammatory muscle disease, increased 99mTc-PYP uptake was demonstrated at different muscle sites 3 h after isotope injection. Subsequent MRI of symmetric muscle areas with enhanced 99mTc-PYP uptake revealed signal patterns suggesting inflammation in all cases. Biopsy of these targeted muscles demonstrated characteristic histopathologic signs of muscle inflammation in 9 out of 13 patients. Four of these 9 patients had clinically atypical disease or did not show elevated creatine phosphokinase levels. Seven of these 9 patients had not been pretreated with corticosteroids. In 4 patients only muscle fiber atrophy and/or necrosis without cellular infiltrations was seen. These 4 patients had received either high doses of corticosteroids or low doses over longer periods of time before muscle biopsy. In conclusion, the combination of 99mTc-PYP muscle scintigraphy and MRI demonstrated muscle areas with maximum inflammatory signal patterns. Targeting of muscles by MRI only will probably yield reliable results of muscle biopsy in cases of clinically and serologically characteristic myositis. 99mTc-PYP muscle scintigraphy may provide useful initial information about localization of inflamed muscle tissue, especially in atypical disease. Treatment with corticosteroids prior to histologic diagnosis may abolish inflammatory infiltrations in affected muscle tissue.
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  • 152
    ISSN: 1437-9813
    Keywords: Key words Myofibromatosis ; Fibromatosis ; Soft-tissue tumor ; Interspinous ligament ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The authors describe an extremely rare presentation of congenital infantile myofibromatosis. A full-term newborn boy presented with a thumb-sized subcutaneous mass on the mid-spinal line between the 2nd and 3rd lumbar spinous processes. A solid tumor arising from the interspinous ligament was resected. Microscopic and immunohistochemical studies revealed myofibromatosis.
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  • 153
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    Pediatric surgery international 13 (1998), S. 442-444 
    ISSN: 1437-9813
    Keywords: Key words Lymphangioma ; Scrotum ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A 7-year-old boy who presented with a painful left hemiscrotal mass was diagnosed with acquired lymphangioma of the scrotum. Chronic friction from a cast for Perthes' disease might have been the cause of sudden enlargement of a congenital lymphangioma of the scrotum. Magnetic resonance imaging (MRI) was useful for preoperative diagnosis and determining the extent of the scrotal lesions. Total excision of the mass leaving the overlying skin was successfully performed. The clinical significance of MRI for preoperative diagnosis and planning surgical resection of this lesion is discussed.
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  • 154
    ISSN: 1437-9813
    Keywords: Key words Accessory hepatic lobe ; Torsion ; Ultrasonography ; Computed tomography ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A case of acute epigastric pain resulting from torsion of an accessory hepatic lobe is reported. Sonographic, computerized tomographic, and magnetic resonance findings are illustrated and the surgical management is discussed.
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  • 155
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    Skeletal radiology 27 (1998), S. 13-17 
    ISSN: 1432-2161
    Keywords: Key words Silicone implants ; Synovitis ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Silicone synovitis is a known complication of silicone implants used in orthopedic surgery for joint reconstruction. It has been studied with routine radiography; however, no report on magnetic resonance imaging abnormalities of this condition exist in the literature. This article reports on five patients with silicone synovitis studied by magnetic resonance imaging. All patients showed hypointense implants that were deformed, fragmented or subluxed, and intra- and periarticular silicone particles were evident on T1- and T2-weighted images.
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  • 156
    ISSN: 1432-2161
    Keywords: Key words Lipoma arborescens ; Synovial membrane ; Magnetic resonance imaging ; Hip
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Objective. The imaging characteristics of lipoma arborescens using plain radiographs, computed tomography (CT), and magnetic resonance imaging (MRI) are described. Design and patients. Five patients with a diagnosis of lipoma arborescens are presented. Three had monoarticular involvement of the knee joint. In the remaining two patients both knees and both hips, respectively, were affected. All patients were examined using plain radiographs and MRI. CT was employed in two cases. Results and conclusions. A conclusive diagnosis with exclusion of other synovial pathologies having similar clinical and radiological behaviour can be achieved on the basis of the MRI characteristics of lipoma arborescens. The aetiology of lipoma arborescens remains unknown, but its association with previous pathology of the affected joints in all our patients supports the theory of a non-neoplastic reactive process involving the synovial membrane.
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  • 157
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    Acta neuropathologica 96 (1998), S. 537-540 
    ISSN: 1432-0533
    Keywords: Key words Central pontine myelinolysis ; AIDS ; Magnetic resonance imaging ; Autopsy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Central pontine myelinolysis (CPM) is an uncommon complication in sick patients with severe underlying disorders such as chronic alcoholism, malignancy, malnutrition and hyponatraemia. We report two patients with advanced HIV infection who developed CPM. In one case the diagnosis was not suspected in life, in the other the diagnosis was made just before death, on the basis of magnetic resonance (MR) imaging appearances. At post mortem there was a close correlation between the MR abnormalities and the anatomic changes in the pons.
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  • 158
    ISSN: 1432-0584
    Keywords: Key words High-grade non-Hodgkin's lymphoma ; Methotrexate ; Leukoencephalopathy ; Neurotoxicity ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Aggressive polychemotherapy, intrathecal cytostatic prophylaxis and cranial irradiation have contributed to the remarkable improvement in the prognosis of acute lymphoblastic leukemia (ALL) and subtypes of high-grade non-Hodgkin's lymphoma (NHL) and the reduction of central nervous system (CNS) relapses. Early and late neurologic changes have been observed after different CNS-directed therapies. We report on the rare event of an acute tetraparesis after methotrexate (MTX) without other CNS-directed therapy. A young female with a diffuse large B-cell lymphoma developed signs of meningeal irritation a few hours after intrathecal prophylaxis with MTX, cytosine-arabinoside and dexamethasone. She recovered quickly. Ten days after her last course of systemic chemotherapy including high dose MTX she was admitted with a tetraparesis and motoric aphasia. A computer assisted tomography (CT) scan was normal. On magnetic resonance imaging (MRI) hyperintense white matter lesions were visible in the periventricular white matter. Initially, the radiologic signs were progressive while the patient's clinical condition improved. MRI controls after complete neurologic normalization revealed delayed partial regression of the white matter abnormalities. The patient has now been free of neurologic symptoms for 16 months. This case report demonstrates acute and subacute neurotoxic effects of MTX in the same patient and illustrates that radiologic CNS changes can persist irrespective of the disappearance of clinical symptoms.
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  • 159
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    European radiology 8 (1998), S. 66-68 
    ISSN: 1432-1084
    Keywords: Key words: Heart angiosarcoma ; Computed tomography ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. We report a case of primary heart angiosarcoma and its appearance on plain and post-contrast computed tomography and magnetic resonance imaging in 21-year-old woman. The tumour involved the right atrium, expanded superiorly among the superior vena cava, ascending aorta and innominate vein, and infiltrated the pericardium. The tumour was disseminated into lungs, liver and bones at the time of its clinical presentation.
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  • 160
    ISSN: 1432-1920
    Keywords: Key words Stroke recurrent ; Diffusion-weighted imaging ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We performed MRI, including diffusion-weighted imaging, in 15 patients with recurrent strokes with acute ischaemia and at least one old lesion according to the clinical history and/or CT. Routine MRI showed similar signal intensity changes in both situations. Diffusion-weighted images, however, were positive in all acute or subacute infarcts. The high signal of acutely disturbed diffusion due to intracellular oedema could also be identified in small brain stem lesions. Spatial resolution was increased by applying separate gradients in each axis instead of creating anisotropy-independent trace images.
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  • 161
    ISSN: 1432-1920
    Keywords: Key words Creutzfeldt-Jakob disease ; Prion disease ; Magnetic resonance imaging ; Dementia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract To ascertain whether increased grey matter signal intensity on T2-weighted images in patients with sporadic Creutzfeldt-Jakob disease (CJD) corresponds to the stage and severity of this disease, we correlated MRI findings in four of our own and previously reported patients with sporadic CJD with the clinical variants, neuropathological changes at autopsy, duration of the disease and survival time after MRI examination. Of 15 patients with the extrapyramidal type of CJD, 10 showed increased signal in the basal ganglia on T2-weighted images. One of seven patients with the Heidenhain variant had increased signal in the occipital cortex. Patients without increased grey matter signal intensity had a longer overall duration of CJD (P = 0.035). Although the interval between onset of neurological symptoms and MRI was not different, patients without increased grey matter signal also survived longer after MRI examination (P = 0.022).
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  • 162
    ISSN: 1432-1920
    Keywords: Key words Pituitary ; Adenohypophysitis ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report the skull radiograph, CT and MRI findings in three patients with lymphocytic adenohypophysitis mimicking pituitary adenoma. All cases were associated with pregnancy. CT demonstrated a pituitary mass but did not differentiate lymphocytic adenohypophysitis from pituitary adenoma. The skull radiographs showed either a normal sella turcica or minimal abnormalities; they did not show ballooning or destruction. The MRI appearances were distinctive: relatively low signal on T1-weighted images; preservation of the bright posterior pituitary lobe despite the presence of a relatively large pituitary mass, less common in macroadenomas; marked contrast enhancement compared with pituitary macroadenomas; and dural enhancement adjacent to a pituitary mass.
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  • 163
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    Neuroradiology 40 (1998), S. 126-127 
    ISSN: 1432-1920
    Keywords: Key words Lyme disease ; Spinal cord ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report a child with Borrelia burgdorferi meningoradiculitis. This entity, also known as Bannwarth syndrome, is rare and its presentation with low back pain only is even more unusual. The MRI findings can suggest the diagnosis.
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  • 164
    ISSN: 1432-1920
    Keywords: Key words Methanol ; intoxication ; Magnetic resonance imaging ; Putaminal necrosis ; Putaminal haemorrhage ; Toxic encephalopathy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Methanol, a highly toxic substance, is used as an industrial solvent and in automobile antifreeze. Acute methanol poisoning produces severe metabolic acidosis and serious neurologic sequelae. We describe a 50-year-old woman with accidental methanol intoxication who was in a vegetative state. MRI showed haemorrhagic necrosis of the putamina and oedema in the deep white matter.
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  • 165
    ISSN: 1432-1920
    Keywords: Key words Spinocerebellar ataxia type 6 ; Cerebellar cortical atrophy ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We describe the MRI findings in three Japanese patients with spinocerebellar ataxia type 6 (SCA6) in which a polymorphic CAG repeat was identified in the gene encoding the α1A voltage-dependent P/Q-type Ca2+ channel subunit (CACNL1A4). All showed slowly progressive cerebellar ataxia and mild pyramidal signs. Neuroradiologically, they had moderate cerebellar atrophy, most prominently in the superior vermis, whereas the brain stem appeared to be spared. No abnormal signal intensity was identified.
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  • 166
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    Neuroradiology 40 (1998), S. 238-241 
    ISSN: 1432-1920
    Keywords: Key words Leiomyoma ; brain ; Magnetic resonance imaging ; Computed tomography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We present a case of intracranial parenchymal leiomyoma in a 20-year-old woman with a chief complaint of numbness and a painful sensation over the right limbs for several years. CT and MRI revealed an intensely enhancing calcified mass. The patient was well, without recurrence, 2 years after surgery.
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  • 167
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    Neuroradiology 40 (1998), S. 255-257 
    ISSN: 1432-1920
    Keywords: Key words Behçet's disease ; Spinal cord ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract MRI demonstrated well-defined areas of signal change and moderate contrast enhancement in the thoracic spinal cord of a patient with Behçet's disease presenting with subacute myelopathy. The patient improved after intravenous steroids, and MRI 5 months later showed a normal spinal cord.
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  • 168
    ISSN: 1432-1920
    Keywords: Key words Central nervous system diseases ; Temporal bone ; Magnetic resonance imaging ; Siderosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We present a 50-year-old man who was investigated for sensorineural hearing loss. On MRI of the brain superficial siderosis of the central nervous system was seen, while MRI of the spine revealed an ependymoma of the cauda equina. This case illustrates the importance of performing T2-weighted imaging of the brain and posterior fossa when sensorineural hearing loss is present. Spine imaging is mandatory when superficial siderosis of the brain is diagnosed without identification of a bleeding source in the brain.
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  • 169
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    Neuroradiology 40 (1998), S. 734-738 
    ISSN: 1432-1920
    Keywords: Key words Unilateral megalencephaly ; Myelination ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We reviewed the MRI of 17 patients with hemimegalencephaly to investigate abnormal myelination in this condition. On images of seven patients aged 18 months or less, the white matter on the affected side suggested advanced myelination for the age. On T1-weighted images of three patients aged 1 month, the anterior limb of the internal capsule in the affected hemisphere was myelinated, and T1 shortening was not clearly seen in the pre- and postcentral gyri. The cortical grey matter and subcortical white matter was isointense in two patients. Images of two patients aged 4 to 5 months and of five patients aged 8–18 months showed myelination that extended more peripherally in the white matter of the affected hemisphere.
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  • 170
    ISSN: 1432-1920
    Keywords: Key words Brain metastases ; Magnetic resonance imaging ; Magnetisation transfer ; Contrast enhancement
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Our purpose was to compare prospectively the sensitivity of contrast-enhanced magnetisation transfer (MT) MRI and gradient-echo (GE) T1-weighted images in metastatic disease of the brain. We studied 52 patients with brain metastases, using conventional T1-weighted GE and MT spin-echo (SE) images after the same standard dose of gadolinium. Axial 5-mm reconstructions of GE data were compared with 5-mm MT images in the same plane. Metastases were counted independently by two neuroradiologists. In 12 patients (23 %) MT imaging showed more metastases than GE images (P = 0.03). We detected 68 more metastases with the former technique.
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  • 171
    ISSN: 1432-1920
    Keywords: Key words Multiple sclerosis ; Spinal cord ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report assessment of a new three-dimensional fast spin echo (3D FSE) sequence in ten patients with clinically definite multiple sclerosis, comparing it with standard 2D FSE, and in ten normal controls. We saw 29 focal lesions on the 2D images and 53 on the 3D FSE imgages (P = 0.05); none were seen in controls. Lesion length was significantly smaller on the 3D FSE than on to the 2D FSE images (3D: 1.36; 2D 2,0; P = 0.03). This may relate in part to separation into several lesions on the 3D images of confluent abnormal signal seen on 2D and in part to detection of small lesions missed by the thicker 2D FSE slices (3 mm compared to 1.5 mm). The 3D FSE sequence looks promising in improving spinal cord imaging.
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  • 172
    ISSN: 1432-1920
    Keywords: Key words Radiation injury ; Optic chiasm ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report a case of radiation-induced optic neuropathy in a 32-year-old man with Cushing's disease and a recurrent tumour of the left cavernous sinus. The patient experienced rapid, painless loss of vision 4 years after treatment without recurrence of tumour or other visual disorder. MRI showed enlargement and contrast enhancement of the optic chiasm. A year later the patient was almost blind and MRI showed atrophy and persistent contrast enhancement of the chiasm.
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  • 173
    ISSN: 1432-1920
    Keywords: Key words Sinuses ; dural ; Epidermoid cyst ; skull ; Magnetic resonance imaging ; Tinnitus
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report an intradiploic epidermoid cyst of the skull responsible for transverse sinus compression and presenting with nonpulsatile tinnitus. Plain films and CT both demonstrated the tumour. Cerebral angiography showed best the degree of narrowing of the right transverse sinus, accompanied with turbulent flow probably leading to tinnitus. MRI demonstrated accurately both the tumour and the dural sinus compression. The tumour was totally removed, cranioplasty was performed, and the patient was discharged free of symptoms.
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  • 174
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    Neuroradiology 40 (1998), S. 477-482 
    ISSN: 1432-1920
    Keywords: Key words Brain ; anatomy ; Brain ; white matter ; Brain ; oedema ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract MRI was obtained in eight normal volunteers and seven patients with brain oedema around the trigone. In addition to the conventional sequences, diffusion-weighted and intravoxel-incoherent-motion images using motion-proving anteroposterior and/or lateral direction gradients were obtained to show the white matter pathways better. Coronal proton-density-weighted images showed three thin relatively high-intensity layers in addition to the tapetum and the internal and external sagittal strata. Although they have not been confirmed anatomically, the thin layer between the internal and the external sagittal strata was corroborated by diffusion-weighted and intravoxel-incoherent-motion images, and by characteristics of the spread of oedema into the sagittal stratum. We propose that this layer be named the central sagittal lamina. The other two layers medial and lateral to the sagittal stratum were outside, but in contact with the medial and lateral parts of the sagittal stratum, respectively. We provisionally named them medial and lateral sagittal laminae; they were not evident on any other images. The low-intensity layer on T2-weighting was the internal sagittal stratum. The optic radiation, comprising the external sagittal stratum, appeared as an intermediate to slightly high-intensity layer on T2-weighted images and a low-intensity layer on T1-weighted images as did the corticospinal tract in the posterior internal capsule.
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  • 175
    ISSN: 1432-1920
    Keywords: Key words Vascular dementia ; Subcortical arteriosclerotic encephalopathy ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Previous cross-sectional studies in patients with subcortical vascular encephalopathy (SVE) have shown little or no correlation between brain lesion load and clinical disability, which could be due to the low specificity of T2-weighted MRI. Recent studies have indicated that T1-weighted MRI may be more specific than T2-weighted MRI for severe tissue destruction. We studied 37 patients with a diagnosis of SVE and 11 normal controls with standardised T1- and T2-weighted MRI. All patients underwent detailed clinical assessment including a neuropsychological test battery and computerised gait analysis. Both the T2- and T1-weighted total MRI lesion loads different between patients and controls different, particularly T1. The ratio of T2-/T1-weighted lesion load was lower in controls than in patients. There was no overall correlation of T1- or T2-weighted lesion load with clinical disability, but group comparison of patients with severe and mild clinical deficits showed different lesion loads. We suggest that T1- and T2-weighted MRI lesion loads demonstrate relevant structural abnormality in patients with SVE.
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  • 176
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    Neuroradiology 40 (1998), S. 512-515 
    ISSN: 1432-1920
    Keywords: Key words Behçet's disease ; Magnetic resonance imaging ; Meninges
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Behçet's disease is a multisystem disease that involves the central nervous system up to half of cases. Presentation with neurologic symptoms occurs in 5 % of cases and cerebral venous thrombosis is one of its major manifestations. A feature not previously reported is progressive meningeal thickening with involvement of both optic nerves. We report a patient with cerebral venous thrombosis, meningeal thickening and contrast enhancement on MRI. This patient had two other unusual features: positive antineutrophil cytoplasmic antibodies and later development of central diabetes insipidus.
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  • 177
    ISSN: 1432-1920
    Keywords: Key words Brain ; Calcification ; perivenous ; Lupus erythematosus ; Computed tomography ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We present a case of neuropsychiatric lupus erythematosus with granular calcification in the basal ganglia and cerebral white matter on CT. Histopathologically, these were identified as perivenous necrotising lesions, with loss of axons and myelin sheaths and prominent dystrophic calcification.
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  • 178
    ISSN: 1432-1920
    Keywords: Key words Dysequilibrium syndrome ; Osmotic demyelination syndrome ; Magnetic resonance imaging ; Haemodialysis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Neurological disorders may be seen in end-stage renal disease patients due to uraemia or to complications of dialysis. A dysequilibrium syndrome may be seen, usually soon after or towards the end of haemodialysis. This group of patients has no particular findings on MRI. On the other hand, the osmotic demyelination syndrome has definitive MRI findings, not to date reported with the dysequilibrium syndrome. We report a patient with end-stage renal disease and the dysequilibrium syndrome who showed findings of osmotic demyelination on MRI. The patient had a convulsion after a first haemodialysis, with quadriparesis and hyperactive deep tendon reflexes and bilateral Babinski signs. The upper motor neurone signs lasted for a week. Meanwhile, he was also dysarthric and had dysphagia. He recovered neurologically without any residuum following appropriate treatment and there was improvement on MRI.
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  • 179
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    Neuroradiology 40 (1998), S. 303-307 
    ISSN: 1432-1920
    Keywords: Key words Choroid plexus ; infection ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Four cases of choroid plexitis of the brain (two with cryptococcosis and two with tuberculosis) are presented. The four patients showed either unilateral enlargement (3) or bilateral enlargement (1) and dense enhancement of the choroid plexus in the lateral ventricles (4) and fourth ventricle (1) in association with clinical findings of leptomeningitis. All patients had unilateral cystic dilatation of the temporal horn of the lateral ventricle presumably secondary to entrapment of the temporal horn and extensive oedema around the ipsilateral ventricle.
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  • 180
    ISSN: 1432-1920
    Keywords: Key words Neurenteric cyst ; Posterior cranial fossa ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Neurenteric cysts are cystic masses lined by a columnar epithelium of endodermal origin. They are rare in the central nervous system. We report two neurenteric cysts in the posterior cranial fossa and describe their neuroradiological features. The lesions were of low density on CT and more accurately delineated on MRI. They gave the same signal as cerebrospinal fluid on all sequences. There was no contrast enhancement.
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  • 181
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    Neuroradiology 40 (1998), S. 383-384 
    ISSN: 1432-1920
    Keywords: Key words Brucellosis ; intracranial ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report a rare case of neurobrucellosis in a 25-year-old woman with visual impairment, bilateral hearing loss, hyperprolactinaemia and meningitis. MRI revealed a sellar and suprasellar mass with enlargement of the optic chiasm.
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  • 182
    ISSN: 1432-1920
    Keywords: Key words Brain ; basal ganglia ; Pituitary gland ; Manganese ; Parenteral nutrition ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Hypermanganesaemia is reported in patients on long-term parenteral nutrition. Deposition of manganese, giving high signal on T1-weighted images, may involve the basal ganglia. MRI in nine patients (mean age 51 years, range 31–75 years) on long-term parenteral nutrition (mean duration 30 months, range 6–126 months), demonstrated high signal in the anterior pituitary gland on T1-weighted sagittal and coronal images. The gland appeared normal on T2-weighted images. Signal intensity in the basal ganglia on T1-weighted images was increased in all patients. Endocrine assessment showed no significant abnormality. Neurological examination showed a mild parkinsonian movement disorder in one patient. Hypermanganaesemia was present in all nine (1.3–2.8 μmol/l, mean 1.87 μmol/l). The high signal in the anterior pituitary gland was probably related to deposition of paramagnetic substances, especially manganese.
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  • 183
    ISSN: 1432-1920
    Keywords: Key words Cervical spine ; trauma ; Magnetic resonance imaging ; Children
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We carried out a retrospective analysis of imaging and clinical findings in 52 children with a history of cervical spinal trauma. No patient had evidence of a fracture on plain films or CT. All had MRI at 1.5 T because of persistent or delayed symptoms, unexplained findings of injury or instability, or as further assessment of the extent of soft-tissue injury. Clinical follow-up ranged from 6 months to 3.5 years. MRI was evaluated for its influence on therapy and outcome. MRI was positive in 16 (31 %) of 52 patients. Posterior soft-tissue or ligamentous injury was the most common finding in the 10 patients with mild to moderate trauma, while acute disc bulges and longitudinal ligament disruption, each seen in one case, were uncommon. MRI was superior to CT for assessment of the extent of soft-tissue injury and for identification of spinal cord injuries and intracanalicular hemorrhage in the six patients with more severe trauma. MRI specifically influenced the management of all four patients requiring surgery by extending the level of posterior stabilization. No patients with normal MRI or any of the 10 with radiographically stable soft-tissue injury on MRI, developed delayed clinical or radiographic evidence of instability or deformity.
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  • 184
    ISSN: 1432-1920
    Keywords: Key words Myotonic dystrophy ; Magnetic resonance imaging ; Fluid-attenuated inversion-recovery pulse sequence
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We compared the fluid-attenuated inversion recovery (FLAIR) sequence with conventional spin-echo (SE) imaging for detection of involvement of the central nervous system in five patients with myotonic dystrophy (MD). The diagnosis was made based on clinical features and DNA analysis. All patients showed abnormal high-intensity lesions in the white matter on T2-weighted images, although these were more clearly visible using FLAIR.
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  • 185
    ISSN: 1432-1920
    Keywords: Key words Spontaneous intracranial hypotension ; Headache ; Magnetic resonance imaging ; Radionuclide cisternography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Spontaneous intracranial hypotension is an unusual syndrome of postural headache and low cerebrospinal fluid pressure without an established cause. We present four cases, analyze those previously reported in the literature, examine the MRI, CT, angiographic and cisternographic finding and discuss the clinical picture, proposed pathophysiologic mechanisms and potential treatment.
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  • 186
    ISSN: 1432-1920
    Keywords: Key words Inner ear ; Aqueduct ; vestibular ; Endolymphatic duct ; Hearing loss ; Computed tomography ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We studied ten inner ears of five patients with a bilateral large vestibular aqueduct syndrome, using CT and MRI. Although the large vestibular aqueduct varied in size, a markedly dilated endolymphatic sac extending to the sigmoid sinus was demonstrated bilaterally on MRI in all patients. The cause of hearing loss in this syndrome is unclear. However, it is suggested that reflux of the protein-rich, hyperosmolar endolymph from the enlarged endolymphatic sac (EES) into the cochlea through a widely patent endolymphatic duct may damage the neuroepithelium. CT density and spin-echo MRI signal intensity of the endolymph in EES were markedly higher than those of CSF in eight inner ears of four patients. Increased density and high signal may indicate protein-rich, hyperosmolar endolymph. In some patients with sensorineural hearing loss and EES, the vestibular aqueduct may not appear dilated on CT. MRI is therefore necessary for correct diagnosis of this syndrome, which should more correctly be termed “large endolymphatic duct and sac syndrome”. Prominent EES may predict poor prognosis in this syndrome.
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  • 187
    ISSN: 1432-1920
    Keywords: Key words Aneurysm intracranial ; Magnetic resonance imaging ; Embolisation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract To determine when and how intracranial aneurysms causing mass effect change following endovascular treatment, we used MRI to assess patients for 2–3 years after the interventional procedure. Nine patients who had aneurysms compressing the surrounding structures underwent endovascular treatment. Proximal occlusion of the parent artery was performed in seven cases, and in two the aneurysm was embolised with microcoils. After embolisation, signal intensity within aneurysms tended to be high on both T1- and T2-weighted images. When there was rapid reduction in size high-signal zones within aneurysms became isointense or gave low signal on T1-weighted images. On T2-weighted images, isointense or low-signal foci appeared within high-signal areas in the aneurysm, giving mixed intensity. In typical cases, the mean volume of the aneurysm fell to approximately 30 % of its initial value 2–12 months after treatment. After this, no additional reduction was observed. The aneurysms which showed little signal intensity change tended to shrink more slowly and to a lesser degree than the more typical cases. Aneurysms which gave high signal on both T1- and T2-weighted images early following embolisation shrank more quickly than those showing little signal change.
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  • 188
    ISSN: 1432-1920
    Keywords: Key words Amyloid ; Cerebral amyloid angiopathy ; Congophilic angiopathy ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The case of a 70-year-old woman with cerebral amyloid angiopathy (CAA) is presented. MRI of the head showed widespread miliary foci of haemorrhage within the cerebrum and cerebellum, with some additional linear lesions within the cerebral cortex and patchy lesions in the white matter. This is in contrast to the more usual pattern of intracranial haemorrhage in CAA, i. e., a lobar haematoma.
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  • 189
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    Neuroradiology 40 (1998), S. 401-403 
    ISSN: 1432-1920
    Keywords: Key words Amyloidosis ; larynx ; Laryngocele ; Magnetic resonance imaging ; Computed tomography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A case of laryngeal amyloidosis associated with a laryngocele is reported. Preoperative CT showed diffuse thickening of the epiglottis, aryepiglottic folds and false vocal cords with well-defined calcific foci. MRI revealed contrast enhancement and increased signal intensity on T2-weighted images.
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  • 190
    ISSN: 1432-1920
    Keywords: Key words Myotonic dystrophy ; Intellectual impairment ; Magnetic resonance imaging ; Neuropathology
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We studied 12 patients with myotonic dystrophy using MRI and the Mini-mental state examination (MMSE), to see it specific MRI findings were associated with intellectual impairment. We also compared them with the neuropathological findings in an autopsy case of MD with intellectual impairment. Mild intellectual impairment was found in 8 of the 12 patients. On T 2-weighted and proton density-weighted images, high-intensity areas were seen in cerebral white matter in 10 of the 12 patients. In seven of these, anterior temporal white-matter lesions (ATWML) were found; all seven had mild intellectual impairment (MMSE 22–26), whereas none of the four patients with normal mentation had ATWML. In only one of the eight patients with intellectual impairment were white-matter lesions not found. Pathological findings were severe loss and disordered arrangement of myelin sheaths and axons in addition to heterotopic neurons within anterior temporal white matter. Bilateral ATWML might be a factor for intellectual impairment in MD. The retrospective pathological study raised the possibility that the ATWML are compatible with focal dysplasia of white matter.
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  • 191
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    Neuroradiology 40 (1998), S. 398-400 
    ISSN: 1432-1920
    Keywords: Key words Spine ; Cervical spinal cord ; Posterior column ; Subacute combined degeneration ; Vitamin B12 deficiency ; Degenerative process ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The specific spinal cord lesion caused by vitamin B12 deficiency is known as subacute combined degeneration (SCD). Neuropathological studies of SCD show lesions mainly in the posterior and lateral columns, involving the cortico-spinal and spino-cerebellar tracts. We report a case of SCD in a 19-year-old man who presented with 4 weeks history of gradually progressing tingling in both hands. MRI of the cervical spine demonstrated symmetrical areas of T2 signal abnormality involving the dorsal columns of the cervical cord from the C2 through C5 levels associated with spinal cord expansion. He was treated with vitamin B12 supplements and experienced gradual improvement in his clinical symptoms. Repeat MRI of the cervical spine after 2 months revealed slight decrease in the area of abnormal signal.
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  • 192
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    Neuroradiology 40 (1998), S. 462-465 
    ISSN: 1432-1920
    Keywords: Key words Temporal bone ; abnormalities ; CHARGE association ; Computed tomography ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We reviewed the CT examinations of the temporal bone, performed with 1-mm-thick contiguous sections, of seven patients with the CHARGE association. We found abnormalities of the incus and stapes, with ossicular chain fixation, absence of the stapedius muscle and oval window, hypoplasia or dysplasia of the vestibule and absence of the semicircular canals in all ears. The pyramidal eminence and tympanic sinus were absent and there were anomalies of the cochlea in 13 of 14 ears. Absence of the semicircular canals is the most specific change in patients with the CHARGE association.
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  • 193
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    Neuroradiology 40 (1998), S. 507-511 
    ISSN: 1432-1920
    Keywords: Key words Germ-cell tumours ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We reviewed the MRI findings of germinomas originating from the basal ganglia, thalamus or deep white matter in 13 patients with 14 germinomas, excluding those in the suprasellar or pineal regions. Ten cases were confirmed as germinomas by stereotaxic biopsy, three by partial and one by total removal of the tumour. Analysis was focussed on the location and the signal characteristic of the tumour, haemorrhage, cysts within the tumour and any other associated findings. Thirteen of the tumours were in the basal ganglia and one in the thalamus. Haemorrhage was observed in seven patients, while twelve showed multiple cysts. Associated ipsilateral cerebral hemiatrophy was seen in three patients. The signal intensity of the parenchymal germinomas was heterogeneous on T1- and T2-weighted images due to haemorrhage, cysts and solid portions. We also report the MRI findings of germinomas in an early stage in two patients.
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  • 194
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    Neuroradiology 40 (1998), S. 519-521 
    ISSN: 1432-1920
    Keywords: Key words Toluene ; Organic solvents ; Magnetic resonance imaging ; Iron ; brain
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract MRI may be helpful in showing brain toxicity associated with chronic toluene inhalation. We report clinical and MRI findings over 3 years in a man with gradual neurologic decline secondary to toluene abuse. Cerebral atrophy most prominently involved the corpus callosum and cerebellar vermis. On T2-weighted images, loss of gray-white matter contrast, diffuse supratentorial white matter high-signal lesions, and low signal in the basal ganglia and midbrain were seen. In addition, MRI showed abnormal labor cortical low signal on T2-weighted images, most prominent in the primary motor and visual cortex. This cortical T2 shortening, not previously described in this condition, may reflect iron deposition.
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  • 195
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    Neuroradiology 40 (1998), S. 524-526 
    ISSN: 1432-1920
    Keywords: Key words Haemangioma ; sacral ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report a 55-year-old woman with coccydynia due to a sacral mass. The histological diagnosis was haemangioma. The MRI findings and the unusual location of this lesion are discussed.
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  • 196
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    Neuroradiology 40 (1998), S. 716-719 
    ISSN: 1432-1920
    Keywords: Key words Degeneration subacute combined ; Spinal cord ; Brain ; Magnetic resonance imaging ; Vitamin B12 deficiency
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Subacute combined degeneration is a rare cause of demyelination of the dorsal and lateral columns of the spinal cord and even more rarely of the pyramidal and spinocerebellar tracts and cerebellum. We present the initial and follow-up MRI appearances in a patient with subacute combined degeneration of the spinal cord, brain stem and cerebellum, due to vitamin B12 deficiency. The lesions in these structures were demonstrated clearly as pathologically high-signal areas on T2-weighted images. These lesions, except those of the brain stem and cerebellum, disappeared 4 months after therapy. MRI 14 months after the patient's discharge on vitamin B12 therapy showed the same picture.
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  • 197
    ISSN: 1432-1920
    Keywords: Key words Congenital muscular dystrophy ; Merosin ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We present the MRI findings in five patients with congenital muscular dystrophy (CMD) and merosin (laminin α 2) deficiency, which was total in one and partial in four. In one patient with partial merosin deficiency, MRI was normal. The other four patients had supratentorial white matter abnormalities. In three, T2-weighted images revealed subcortical, deep lobar and periventricular high signal in white matter, while in the other there were only small peritrigonal areas of increased signal. On T1-weighted images, there was slightly low signal. Cortical abnormalities were absent. None of these changes were accompanied by symptoms or signs of central nervous system involvement. White matter abnormalities in a patient with CMD should prompt investigation of merosin.
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  • 198
    ISSN: 1432-1920
    Keywords: Key words Vein of Galen aneurysmal malformation ; Magnetic resonance imaging ; Angiography ; Treatment
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We studied three patients with aneurysmal malformations of the vein of Galen: all underwent embolisation followed by MRI and conventional angiography; two also underwent postembolisation magnetic resonance angiography (MRA). MRI was performed before treatment in two patients, MRA in only one, diagnosed prenatally. Two patients had normal appearances on follow-up MR studies and were completely cured by embolisation. However, the last patient, after two embolisations, despite the stabilisation of the clinical condition, underwent surgery and died. We think MRI is mandatory before endoarterial treatment, to assess the conditions of the brain. Angiography is mandatory only at the time of endovascular treatment, while MRA and MRI have a role in follow-up. Endoarterial embolisation remains the treatment of choice, and surgery is not advisable.
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  • 199
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    Neuroradiology 40 (1998), S. 81-87 
    ISSN: 1432-1920
    Keywords: Key words Heterotopic greymatter ; Brain ; developmental anomalies ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report unusual MRI patterns in patients with grey matter heterotopia. Standard T1- and T2-weighted spin-echo and inversion-recovery sequences were used in 22 patients presenting with seizures or developmental delay. The images were reviewed for signal change surrounding white matter and for atypical size, morphology or topography. We found 10 cases of subependymal heterotopias 11 of focal subcortical heterotopia and of diffuse subcortical heterotopia. On clinical or MRI grounds, 8 cases were considered unusual: 2 of the subependymal type, 2 of focal subcortical heterotopia with white matter abnormalities, 2 of focal subcortical heterotopia with no clinicoradiological correlation 1 of extensive hemispheric subcortical heterotopia and 1 of diffuse subcortical heterotopia confined to the frontal lobe. The classical classification of heterotopia enables easy radiological diagnosis even in cases with unusual patterns. In some cases, heterogeneity and high signal in surrounding white matter can be found. Cortical dysplasia is the most frequent associated malformation.
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  • 200
    ISSN: 1432-1920
    Keywords: Key words Limbic system ; Magnetic resonance imaging ; Volume measurements
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The limbic system comprises the hippocampal formation, fornix, mamillary bodies, thalamus, and other integrated structures. It is involved in complex functions including memory and emotion and in diseases such as temporal lobe epilepsy. Volume measurements of the amygdala and hippocampus have been used reliably to study patients with temporal lobe epilepsy but have not extended to other limbic structures. We performed volume measurements of hippocampus, amygdala, fornix and mamillary bodies in healthy individuals. Measurements of the amygdala, hippocampus, fornix and mamillary bodies revealed significant differences in volume between right and left sides (P 〈 0.001). The intraclass coefficient of variation for measurements was high for all structures except the mamillary bodies. Qualitative image assessment of the same structures revealed no asymmetries between the hemispheres. This technique can be applied to the study of disorders affecting the limbic system.
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