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  • 1990-1994  (496)
  • Theoretical, Physical and Computational Chemistry
  • Magnetic resonance imaging
  • Nuclear reactions
  • 1
    ISSN: 1530-0358
    Keywords: Rectal cancer ; Preoperative staging ; Endoluminal ultrasound ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract PURPOSE: The aim of this study was to compare the value of endoluminal ultrasonography (ELUS) with magnetic resonance imaging (MRI) for preoperative staging of rectal carcinoma. METHODS: Thirty-seven consecutive patients were examined by ELUS and MRI. Imaging results were compared with pathohistologic studies. A tumor extending beyond the bowel wall was considered to be “positive” and one within the bowel wall was considered “negative.” Lymph node involvement was considered present if nodes equal to or greater than 5 mm in diameter were found in the perirectal tissue. For evaluating the differences between the two methods, the Mc Nemar test was performed. RESULTS: T-Staging was correct in 88.2 percent (30/34) of patients by ELUS and in 82.3 percent (28/34) by MRI (difference not significant). N-Staging was correct in 80 percent (20/25) by ELUS and in 60 percent (15/25) by MRI (difference of borderline significance). A comprehensive preoperative staging (T + N) was made correctly in 68 percent (17/25) by ELUS and in 48 percent only (12/25) by MRI (difference not significant). CONCLUSIONS: We suggest that ELUS and MRI must be evaluated within the framework of established parameters when treatment modalities such as preoperative radiation therapy and local or radical surgical approach must be decided.
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  • 2
    ISSN: 1530-0358
    Keywords: Anterior rectocele ; Defecography ; Magnetic resonance imaging ; Clinical assessment
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract PURPOSE: The aim of this study was to devise a measuring method for an anterior rectocele on standardized defecographies and magnetic resonance images (MRI) to quantify anterior rectocele and to test whether this could substantiate clinical decision making for operative treatment for anterior rectocele. METHODS: Quantitative analysis by the measuring method as proposed was compared with qualitative scores on defecographies and MRI from the same patients. Thirty-eight patients with symptoms compatible with an anterior rectocele were subjected to physical examination in the left decubitis position and supine position and to defecography. Findings on defecography were compared with findings on physical examination. Thirteen patients were examined before and after surgical correction of the anterior rectocele for a total of 51 qualitative and quantitative examinations. The group of operated patients was analyzed for treatment results. Nineteen controls were included. RESULTS: Sixtysix radiographs of 33 defecographies were qualified in three grading classes and quantified with the proposed method by two observers. The mean measured value of the anterior rectocele in the three subjective grading classes is significantly different (P 〈 0.001). Anterior rectoceles qualified as severe had a measured value of 20 mm or more in 96 percent of the radiographs. Lower gradings were never 〉20 mm. On MRI severe anterior rectoceles were not scored and measured values did not correlate with qualitative scores. When findings on physical examination were compared with defecographic measurement, the coefficient of correlation (r)between the radiologic assessment and clinical examination in the left decubitis position is r = 0.87, for the examination in the supine position,r = 0.77. All 15 cases scored as severe anterior rectocele in the left decubitis position had a measured anterior rectocele of ≥20 mm. In the 13 cases that received surgery, there was a significant reduction of the anterior rectocele (P 〈 0.001) and clinical improvement. Patients with small or moderate anterior rectocele on physical examination with a size ≥20 mm on defecography were cured by surgical correction. None of the controls had an anterior rectocele on physical examination or an anterior rectocele ≥20 mm on defecography. CONCLUSIONS: An anterior rectocele with a size of 20 mm or more corresponds with a qualitative score of “severe” on Radiographic defecography. Physical examination for anterior rectocele in the left decubitis position corresponds best with quantitative Radiographic assessment and anterior rectocele with a size ≥20 mm on defecography is pathologic. Patients with complaints compatible with anterior rectocele can be assessed in objective and quantitative terms by radiography and can be successfully surgically treated, even if at physical examination the anterior rectocele is not classified as large, provided that dynamic defecography shows an anterior rectocele of ≥20 mm. The potential of dynamic MRI with regard to anterior rectoceles presently seems absent.
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  • 3
    ISSN: 1530-0358
    Keywords: Magnetic resonance imaging ; Fistula-in-ano
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract PURPOSE: Successful management of anal fistulas depends upon accurate assessment of the primary tract and any secondary extensions. Preoperative imaging has, to date, been disappointing. METHODS: A prospective study of 35 patients with a clinical diagnosis of fistula-in-ano was performed comparing magnetic resonance imaging with the independently documented operative findings. Magnetic resonance imaging was also compared with anal endosonography in 20 patients. RESULTS: Magnetic resonance imaging is accurate and demonstrates pathology missed at surgery by experienced coloproctologists. Magnetic resonance imaging is superior to anal endosonography. CONCLUSIONS: Magnetic resonance imaging is advocated as the method of choice when imaging is required for anal fistulas.
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    Diseases of the colon & rectum 37 (1994), S. 777-781 
    ISSN: 1530-0358
    Keywords: Anal ultrasound ; Magnetic resonance imaging ; Internal anal sphincter ; External anal sphincter
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract PURPOSE: A recent application of endosonography in the evaluation of anal sphincter morphology has led to controversy about the possibility of precisely assessing the diameter of external and internal anal sphincter muscles. On the other hand, magnetic resonance imaging (MRI) has been proposed to allow a more detailed view of the anatomy of the pelvic floor. However, both techniques have not yet been compared directly. METHODS: Eight healthy volunteers (age range, 25–40 years; 5∶3, male∶female) participated. Anal ultrasound was performed using a 7.5-MHz rectal transducer which produced a transversal panorama display of 360, allowing an image perpendicular to the anal canal. Imaging of the diameter of the internal and external anal sphincter muscles was performed with the transducer placed in the midanal canal, and measurement was always performed by the same investigator in dorsal projection. MRI was performed using a 1.5 Tesla Magnetom (Siemens, Erlangen, Germany) to obtain sagittal and angled axial (perpendicular to the anal canal) planes for consecutive 3-mm slices which were evaluated by four independent raters. RESULTS: Muscle thickness of the sphincter muscles in dorsal projection was 1.96±0.61 mm for the internal sphincter and 6.35±1.07 mm for the external sphincter using ultrasound. It was 1.72±0.13 mm and 3.99±0.99 mm, respectively, using MRI. When both measures were compared, only the internal sphincter data correlated significantly (r=0.818,P=0.0023) between both measures. Sagittal resonance imaging of the anal canal did not allow for differentiation of both muscles at all. Differentiation among mucosa, submucosa, and internal anal sphincter is not possible with MRI but may well be performed with high-resolution ultrasound. CONCLUSION: Anal ultrasound carries the potential of becoming a routine clinical procedure for evaluation of the anal anatomy and morphology in defecation disorders, but current MRI assessment of the anal anatomy is elaborate, costly, and does not provide any further insights.
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  • 5
    Electronic Resource
    Electronic Resource
    Springer
    Surgical and radiologic anatomy 16 (1994), S. 183-192 
    ISSN: 1279-8517
    Keywords: Magnetic resonance imaging ; Knee ; Anatomy ; Cadaver ; Correlative studies
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé Pour guider ou valider une interprétation d'examens IRM, on a souvent recours au cadavre. On obtient une corrélation directe par confrontation de la coupe IRM d'une pièce avec la coupe anatomique faite dans le même plan. Une autre méthode plus facile et plus usuelle dite de corrélation indirecte est celle où une coupe IRM prise sur le vif est comparée avec des coupes sur le cadavre sans rapport direct. Elle ne présente pas les difficultés techniques d'une corrélation directe, qui requiert d'une part la préservation de forme et de la composition des tissus, et d'autre part l'exactitude du plan de coupe sur le cadavre qui doit coïncider avec la coupe IRM. Une règle IRM-compatible, conçue pour réaliser cette corrélation directe, a permis l'étude de 10 genoux de sujets embaumés, avec des séquences différentes d'IRM, à plusieurs reprises. En dépit des variations, la corrélation s'avère satisfaisante. Sur 54 coupes IRM soumises à cette corrélation, la corrélation est bonne ou parfaite pour 47 d'entre elles selon des observateurs differents, soit pour 87% des coupes. Cette méthode nouvelle, souple et simple, permet de tirer le meilleur usage du matériel humain conservé, avec un champ d'applications potentielles large. Nous sommes en train de la développer davantage pour l'évaluation des capacités techniques de nouvelles séquences d'image.
    Notes: Summary Cadaveric material is often used to guide and validate the interpretation of magnetic resonance imaging (MRI) studies. Direct correlation is achieved when the cadaver material is imaged and then directly sectioned in the plane of the image. Indirect correlation, where the cadaveric sections are compared with unrelated in-vivo images, is easier and more commonly used. Technical difficulties associated with the direct method include preservation of form and composition of the tissues, and the choice of the correct location and plane in which to section the cadaver. Using an MRI compatible ruler, designed to assist the direct correlation of MRI and cadaveric sections, we have examined 10 preserved (embalmed) cadaveric knees using different MRI sequences on several occasions. Despite these variations, subsequent sectioning of the cadaveric knees has shown good correlation with the MR images. Of 54 MR images compared with cadaveric sections, anatomical correlation was rated by independent observers as good or perfect in 47 (87%). This new, versatile and simple method can make better use of our preserved human cadaveric material and has potentially wide application; we are now developing it further to assess the technical capabilities of novel imaging sequences.
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  • 6
    Electronic Resource
    Electronic Resource
    Springer
    Surgical and radiologic anatomy 16 (1994), S. 429-438 
    ISSN: 1279-8517
    Keywords: Articular cartilage ; Magnetic resonance imaging ; Cartilage thickness ; Patella ; Knee joint
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé L'évaluation quantitative de l'épaisseur et du volume du cartilage de patellas humaines, fixées dans un mélange d'alcool et de formol, a été réalisée en imagerie par résonance magnétique (IRM) car on ne sait encore avec exactitude si l'aspect morphologique du cartilage normal ou lésé peut être parfaitement démontré par cette technique. L'IRM a été réalisée sur un appareil 1.0 T (épaisseur de coupe : 2 mm, résolution : 0,39–0,58 mm) avec les séquences suivantes : 1) séquence en spin écho pondéré T1, 2) 3D-MRAGE, 3) 3D-FISP, 4) 3D-MTC-FISP, 5) 3D-DESS, 6) 3D-FLASH. Après la réalisation de l'IRM, la patella était sectionnée tous les 2 mm, perpendiculairement à sa surface articulaire, à l'aide d'une scie à ruban. Le volume de son cartilage était déterminé sur les coupes anatomiques et les images IRM grâce à un système d'analyse d'images Vidas IPS 10 (Kontron). Les mesures étaient réalisées avec et sans la couche en hyposignal correspondant à la zone transitionnelle située entre le cartilage articulaire et l'os sous-chondral. Lorsque cette couche en hyposignal était prise en compte, le volume était surestimé par l'IRM de 16 à 19%. Lorsque cette couche en hyposignal n'était pas prise en compte, les volumes étaient inférieurs à ceux déterminés par les coupes anatomiques : T1-SE : −18,2%, MPRAGE : −22,6%, FISP : − 17,1%, MTC-FISP : − 9,5%, DESS : − 9,3% et FLASH : −6,1%. La séquence FLASH permettait l'appréciation la plus correcte et la plus reproductible de la morphologie du cartilage. La différence persistante par rapport au volume réel du cartilage peut être due au fait que la zone calcifiée du cartilage n'est pas délimitée par l'IRM.
    Notes: Summary Quantitative assessment of cartilage volume and thickness in a formalin-alcohol fixed specimen of a human patella was conducted with magnetic resonance imaging (MRI), as it is still unclear whether the morphology of normal and damaged cartilage can be accurately demonstrated with this technique. MR imaging was carried out at 1.0 T (section thickness 2 mm, in-plane-resolution 0.39 – 0.58 mm) with the following pulse sequences: 1) T1-weighted spin-echo, 2) 3D-MPRA-GE, 3) 3D-FISP, 4) 3D-MTC-FISP, 5) 3D-DESS, 6) 3D-FLASH. Following imaging, the patella was sectioned perpendicular to the articular surface at intervals of 2 mm with a diamond band-saw. The volume of its cartilage was determined from the anatomical sections and the MR images, using a Vidas IPS 10 image analysing system (Kontron). Measurements were carried out with and without the low-signal layer in the transitional zone between the articular cartilage and the subchondral bone. If the low-signal layer was included, the volume was overestimated with MRI by 16 to 19 %. Without the low-signal layer the volumes were less than those determined from the anatomical sections: T1-SE −18,2 %, MPRAGE −22.6 %, FISP −17.1 %, MTC-FISP −9.5 %, DESS −9,3% and FLASH −6.1 %. The coefficient of variation for a 6-fold determination of the volume amounted to between 6.2 % (T1-SE) and 2.6 % (FLASH). The FLASH sequence allowed the most valid and reproducible assessment of the cartilage morphology. The remaining difference from the real volume of the cartilage may be due to the fact that the calcified zone of the cartilage is not delineated by MRI.
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  • 7
    ISSN: 1437-2320
    Keywords: Magnetic resonance imaging ; normal pressure hydrocephalus ; schwannoma ; spinal accessory nerve
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Schwannomas of the spinal accessory nerve are rare lesions. They can be characterized by their locations as either intrajugular or intracisternal schwannomas, most of them being intrajugular. Only five cases arising in the cisterna magna are reported in literature. Clinical symptoms generally consist of 11th cranial nerve palsy associated with cerebellar signs and myelopathy. An additional case, studied by MRI, is described. The patient showed a mild cerebellar syndrome and normal pressure hydrocephalus symptoms. He was operated on and the mass completely removed with good postoperative results. The role of MRI for diagnosis of lower cranial nerve schwannomas is stressed, even though does not detect the exact nerve of origin. Total removal of these lesions is recommended, since their benign nature and unavoidable recurrence in case of partial excision.
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  • 8
    Electronic Resource
    Electronic Resource
    Springer
    Pediatric surgery international 9 (1994), S. 441-443 
    ISSN: 1437-9813
    Keywords: Lymphangioma ; Scrotum ; Ultrasound ; Magnetic resonance imaging ; Pediatric
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Lymphangiomas are unusual benign neoplasms originating from the lymphatic system that are rarely found in the scrotal area. Ultrasound and magnetic resonance findings in a 4-year-old boy with a scrotal lymphangioma are presented. There was no recurrence after surgical excision.
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  • 9
    Electronic Resource
    Electronic Resource
    Springer
    Skeletal radiology 23 (1994), S. 455-457 
    ISSN: 1432-2161
    Keywords: Bone marrow ; Blood supply ; Magnetic resonance imaging ; Enhancement ; Lumbar spine ; Gadopentetate dimeglumine
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A retrospective study was performed to determine whether bone blood supply can be assessed on gadolinium-enhanced magnetic resonance imaging. Lumbar spine magnetic resonance imaging (MRI) examinations of 49 patients attending for post-laminectomy examination were reviewed (30 male, 19 female, mean age 46.4 years, age range 23–84 years). Each study included sagittal T1-weighted spin echo sequences before and after gadolinium administration. Regions of interest were drawn within the L3 vertebral body from a parasagittal slice from each sequence. Signal intensity (SI) values were ascertained and the percentage increase in SI was calculated. For each patient, changes in receiver gain for pre and post-gadolinium images were corrected by an image scaling factor. In all cases, a measurable increase in SI was found (mean 15.3%, range 4.4–55.7) due to bone vascularity. The results give no indication of the quantity or timing of blood supply but provide a basis for further work.
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  • 10
    Electronic Resource
    Electronic Resource
    Springer
    Skeletal radiology 23 (1994), S. 327-332 
    ISSN: 1432-2161
    Keywords: Soft tissue tumors ; Magnetic resonance imaging ; Wrist
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We reviewed 20 cases of soft tissue masses of the hand and wrist, and compared the impressions from the original magnetic resonance (MR) imaging reports with the preoperative clinical impression and postoperative pathological diagnoses. The most commonly occurring masses were ganglia, lipomas, and giant cell tumors of tendon sheaths. MR imaging suggested the correct diagnosis in 16 of the 20 cases, whereas the clinical impression was correct in 10 instances. Confident preoperative diagnosis may be made with MR imaging due to the characteristic appearances of many benign soft tissue tumors.
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  • 11
    Electronic Resource
    Electronic Resource
    Springer
    Skeletal radiology 23 (1994), S. 337-341 
    ISSN: 1432-2161
    Keywords: Infantile Fibrosarcoma ; Computed tomography ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Two cases of infantile fibrosarcoma are described. This rare childhood malignancy of mesodermal origin usually affects the lower limbs, as it did in both of our cases. Previously, the only treatment option available involved some form of radical and often mutilating surgery. More recently, combination chemotherapy has given good results, with the effect that various imaging modalities have become important in assessing both the initial extent of disease and the response to treatment. Computed tomography has the advantage of demonstrating the amount of osseous involvement, but at the expense of a considerable dose of ionizing radiation. On the other hand, magnetic resonance imaging, with its multiplanar capacity, gives superior demonstration of breaching of tissue planes, which has important implications for planning of surgery. However, as in other soft tissue tumours, changes in signal characteristics with treatment have proved less specific than was originally anticipated.
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  • 12
    ISSN: 1432-2161
    Keywords: Malignant fibrous histiocytoma ; Magnetic resonance imaging ; Soft tissue tumors ; Pathology
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We reviewed the magnetic resonance (MR) appearances of 13 malignant fibrous histiocytomas (MFH) of soft tissue and correlated each with the respective lesion's histopathology. The MR images were evaluated for signal intensity on T1- and T2-weighted spin echo sequences, homogeneity of the lesion, presence of internal low signal septations, and margin definition. Histologic subtypes of MFH included storiform-pleomorphic, giant cell, myxoid, and inflammatory. We could not establish a correlation between MR appearance and histopathology. Instead, our series exhibited general features suggestive of malignant soft tissue neoplasms, namely poor margin definition, internal low signal septation, and heterogeneous high signal intensity on T2-weighted images.
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  • 13
    ISSN: 1432-2161
    Keywords: Distal radioulnar joint ; Radioulnar ligaments ; Magnetic resonance imaging ; Ulnar wrist pain ; Wrist injury
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Previously developed criteria of normal distal radioulnar joint (DRUJ) axial geometry were applied to routine magnetic resonance (MR) images of 50 wrists. All wrists lacked clinically evident DRUJ instability. An attempt to apply the three geometric criteria to seven of the cases was not possible, since the prescribed landmarks were not visible. The remaining 43 cases were retrospectively divided into a symptomatic group (25 wrists), with clinical abnormalities referable to the ulnar side of the wrist, and an asymptomatic group (18 wrists), with no such abnormalities. Abnormal DRUJ geometry was found in 12 symptomatic and 2 asymptomatic wrists. This difference between the groups is significant (p=0.02), suggesting that many symptomatic wrists exhibit different DRUJ geometry than is found in most asymptomatic wrists.
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  • 14
    ISSN: 1432-2161
    Keywords: Osteoarthritis ; Magnetic resonance imaging ; Histopathology ; Radiography ; Marrow
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Subchondral signal abnormalities are often present on magnetic resonance (MR) images of patients with osteoarthritis, but no study correlating these changes with histopathology has been published. We selected nine consecutive patients with clinical and radiographic diagnosis of moderate to severe osteoarthritis of the knee scheduled to undergo joint replacement surgery, and performed MR imaging and conventional radiographs preoperatively. After surgery, the resected portions of the femur and tibia underwent gross and microscopic examination, and the findings were correlated with the corresponding findings on the imaging studies. Subchondral MR signal abnormalities of the femur or tibia were present in seven of the nine patients, with intermediate signal on T1-weighted images and low or isointense signal on T2-weighted images. The subchondral signal abnormalities were hemispherical in configuration and corresponded predominantly to fibrous tissue replacing the fatty marrow. A component of trabecular thickening was also present.
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  • 15
    Electronic Resource
    Electronic Resource
    Springer
    Virchows Archiv 424 (1994), S. 113-119 
    ISSN: 1432-2307
    Keywords: Lethal osteochondrodysplasia ; Dwarfism ; Acrodysplasia ; Magnetic resonance imaging ; Molecular biology
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A hydropic stillborn female fetus of 22 weeks' gestation with shortlimbed skeletal dysplasia and brachyphalangy is described. The markedly shortened phalanges of both hands had a most unusual angel-like configuration radiologically. Histological examination and comparison with a normal hand of the same gestational age revealed this appearance to be due to disturbed enchondral ossification with premature calcification of epiphyseal cartilage and thickening and outfolding of diaphyseal bone as wing-shaped appositions. Magnetic resonance imaging of the fetus demonstrated marked hyperplasia of cartilage, most impressive in the pelvis. This new type of lethal bone dysplasia may be placed in the group of metatropic dysplasias and similar disorders.
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  • 16
    Electronic Resource
    Electronic Resource
    Springer
    Urological research 22 (1994), S. 209-212 
    ISSN: 1434-0879
    Keywords: Extracorporeal shockwave lithotripsy ; Magnetic resonance imaging ; Stone hardness
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Accurate prediction of the response of an individual patient to lithotripsy remains impossible. Certain factors such as the chemical composition, size, and position of the calculus are known to be important in determining the success rate. This paper reports the use of magnetic resonance imaging (MRI) to evaluate 141 urinary calculi in vitro. A wide range of signals for each chemical type of calculus was found on each of the three imaging sequences used (T1-weighted, T2-weighted, and proton density). None of the chemical groups examined showed a typical MRI profile allowing it to be distinguished from the other groups. Analysis of variance showed a statistical difference between signals for apatite and struvite on the T1-weighted sequence, and between struvite and uric acid on the proton density sequence (both, P〈0.05). These results show for the first time that MRI is capable of distinguishing between different chemical types of stones. This is particularly important for the comparison of struvite and apatite which appear to be similar in conventional investigations but have quite different hardness values. Further work is in progress correlating the results of this study with stone microhardness and extracorporeal shockwave lithotripsy fragility tests to determine whether MRI accurately predicts the success of lithotripsy.
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  • 17
    ISSN: 1432-0533
    Keywords: Krabbe disease ; Globoidcellleukodystrophy ; Magnetic resonance imaging ; Neuropathology ; paramagnetic effect
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Previous imaging studies in infants with globoid cell leukodystrophy (GLD) using computed tomography have demonstrated a reduction in cerebral white matter and increased density symmetrically in the regions of the thalami, periventricular white matter, and the internal capsules. Correlation of these findings with morphologic studies at necropsy has not been made. In particular, deposition of calcium has not been described. We have evaluated two children with GLD confirmed by the absence of leukocyte galactosylceramide β-galactosidase activity using repeated magnetic resonance (MR) scans in each and correlated the imaging results with post-mortem analyses in one. Neuropathologic examination revealed abnormalities typical for GLD. In addition to the absence of normal myelination throughout cerebral and cerebellar white matter, MR images demonstrated the presence of a paramagnetic effect in the regions of the thalami, corona radiata, and centra semiovale. We have observed in histologic preparations from these areas a dense accumulation of globoid cells and some calcium, which we suggest may be responsible for producing the paramagnetic effect.
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  • 18
    Electronic Resource
    Electronic Resource
    Springer
    Surgical and radiologic anatomy 16 (1994), S. 303-305 
    ISSN: 1279-8517
    Keywords: Myology ; Three-dimensional reconstruction ; Computed tomography ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé Lors d'un examen radiologique de routine (TDM, IRM) pratiqué chez une femme de 72 ans, une image tissulaire molle fut mise en évidence dans le triangle cervical postérieur gauche. La reconstruction tridimensionnelle de cette structure a suggéré qu'il pouvait s'agir d'une variante musculaire, en l'occurrence d'un muscle élévateur de la clavicule. Dans notre cas, l'origine musculaire était située au niveau de la colonne cervicale supérieure et son insertion distale sur le tiers latéral de la clavicule. Cette exemple nous amène à rappeler l'aspect général des variantes anatomiques musculaires dans le contexte des techniques d'imagerie moderne.
    Notes: Summary During routine radiological examination of a 72 year-old woman a soft-tissue shadow in the left posterior triangle of the neck was observed. Three-dimensional reconstruction of this structure suggested that it might be a muscular variant: a levator claviculae muscle. In our case it took origin from the upper part of the cervical column and was inserted into the lateral third of the clavicle. With this example as a background, the general significance of anatomical muscular variants for modern imaging techniques is discussed.
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  • 19
    Electronic Resource
    Electronic Resource
    Springer
    Abdominal imaging 19 (1994), S. 150-152 
    ISSN: 1432-0509
    Keywords: Intrahepatic foregut cysts ; Magnetic resonance imaging ; Contrast-enhanced MRI ; Computed tomography ; Ultrasound
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Hepatic foregut cysts are uncommon lesions of the liver. In this report we prospectively examined two patients by means of computed tomography (CT), ultrasound, and contrast-enhanced magnetic resonance imaging. Ciliated hepatic foregut cysts were subsequently demonstrated in both patients following CT-guided biopsy. Magnetic resonance imaging was found to be useful in differentiating these cysts from other lesions.
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  • 20
    Electronic Resource
    Electronic Resource
    Springer
    Abdominal imaging 19 (1994), S. 347-348 
    ISSN: 1432-0509
    Keywords: Mesenteric cyst, milk of calcium ; Ultrasound ; Computed tomography ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A mesenteric cyst with milk of calcium in an adult patient is presented. Preoperative evaluation included plain film, ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI). To our knowledge, the presence of milk of calcium in a mesenteric cyst has not been previously described.
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  • 21
    ISSN: 1432-0509
    Keywords: Hepatocellular carcinoma ; Tumor thrombus ; Inferior vena cava ; Right atrium ; Brain metastasis ; Computed tomography ; Magnetic resonance imaging ; Angiography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Tumor thrombus (TT) in the inferior vena cava (IVC) and right atrium (RA) is rarely encountered. We have diagnosed before death and treated a case of hepatocellular carcinoma (HCC) with TT in the IVC and RA, accompanied by a brain metastasis. The image characteristics on computed tomography (CT), magnetic resonance imaging (MRI), and conventional angiography are discussed.
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  • 22
    Electronic Resource
    Electronic Resource
    Springer
    Abdominal imaging 19 (1994), S. 67-69 
    ISSN: 1432-0509
    Keywords: Leiomyoma ; Kidney ; Magnetic resonance imaging ; Computed tomography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Renal leiomyoma are rare, benign tumors of the kidney. There is little information about the imaging of these tumors with modern modalities. We present a case of computed tomographic (CT) and magnetic resonance (MR) imaging of a large renal leiomyoma.
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  • 23
    Electronic Resource
    Electronic Resource
    Springer
    Abdominal imaging 19 (1994), S. 180-181 
    ISSN: 1432-0509
    Keywords: Prostate, MR ; Prostate, neoplasm ; Magnetic resonance imaging ; Cystosarcoma phyllodes
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Cystosarcoma phyllodes of the prostate is a rare, relatively benign sarcoma of the prostate. We describe the magnetic resonance imaging findings in an unusual case of cystosarcoma phyllodes which resulted in extensive local recurrence and sarcomatous degeneration. Although uncommon, radiologists should be aware of the existence of cystosarcoma phyllodes of the prostate.
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  • 24
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    Abdominal imaging 19 (1994), S. 61-63 
    ISSN: 1432-0509
    Keywords: Choledochal cyst ; Magnetic resonance imaging ; Pregnancy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Choledochal cyst presenting during pregnancy is a rare condition, associated with potentially life-threatening complications for both the mother and developing fetus. Clinical symptoms are nonspecific, and radiographic evaluation is complicated by the presence of the gravid uterus. The authors describe a 34-year-old pregnant female presenting in the third trimester with obstructive jaundice and a right upper quadrant mass. Multiplanar and multisequence imaging with MR established the antepartum diagnosis of choledochal cyst, avoiding the use of ionizing radiation during pregnancy.
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  • 25
    ISSN: 1432-0509
    Keywords: Liver ; Visceral larva migrans ; Toxocariasis ; Diagnosis ; Ultrasound ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Visceral larva migrans is a syndrome characteristically involving children with a history of pica, and usually presents with fever, abdominal pain, tender hepatomegaly, and hypereosinophilia. Hepatic granulomas of visceral larva migrans are rare in adults. We describe three adult patients with hepatic lesions which on histopathology demonstrated characteristic granulomas of visceral larva migrans. All patients had abdominal sonograms and two had additional MR scans of the liver. Both ultrasound and magnetic resonance imaging demonstrated characteristic appearances which have not been described previously (viz., ill-defined central necrotic areas surrounded by concentric thick walls and perifocal edema in the liver parenchyma).
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  • 26
    ISSN: 1432-086X
    Keywords: Liver ; interventional procedure ; Liver neoplasms, therapy ; Computed tomography ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Purpose The aim of this study was to evaluate the effectiveness of transcatheter arterial embolization (TAE) followed by percutaneous ethanol injection (PEI) in the treatment of large hepatocellular carcinoma (HCC) lesions. Methods Fifteen patients with HCC were treated by means of TAE followed by 6–16 ethanol injections. In 10 patients, the HCC was solitary (3–8 cm); 3 patients had 1, and 2 patients had 2 daughter nodules (3 cm or smaller) in addition. In 12 of 15 main tumors and in 4 of 7 daughter nodules, a tumor capsule was observed by computed tomography or magnetic resonance imaging. Results Combined treatment with TAE and PEI resulted in complete necrosis of 12 of 15 main tumors and 7 of 7 daughter nodules on biopsy. Treatment failure (incomplete necrosis) occurred in 3 unencapsulated main tumors. The 1-year survival rate in 10 patients was 100%. Conclusion The combination of TAE and PEI proved to be an effective treatment for large HCC, including those with 1–2 small daughter nodules. The presence of a tumor capsule significantly correlates (p 〈 0.05) with a favorable outcome of treatment.
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  • 27
    ISSN: 1432-1106
    Keywords: Radiography ; Magnetic resonance imaging ; Microlesion ; Single-Unit ; Monkey
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A technique is described for in vivo localization of microelectrodes during single-unit recording in the alert monkey. Four hollow glass spheres filled with copper sulfate and iohexol were affixed to the surface of the animal's skull prior to the acquisition of a series of coronal magnetic resonance (MR) images. These reference beads were visible in both X-ray and MR images. Cranial recording chambers were then implanted bilaterally over the amygdaloid complex. A microelectrode was advanced to various depths in the subject's brain. At each selected microelectrode site, five radiographs were obtained and a small electrolytic lesion was made. Based on the data from the radiographs, we computed the position of the microelectrode tip at each site relative to the reference beads. With a precision of 625 μm, this method was used to predict the neuroanatomical location of ten microlesions placed in both subcortical and cortical structures. Postmortem histological analysis revealed that the actual location of the lesions closely matched predictions arrived at using the X-ray/MRI localization technique. This technique thus provides an accurate, reliable and noninvasive method for in vivo localization of microelectrode recording sites.
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  • 28
    ISSN: 1432-1084
    Keywords: Brain oedema ; Dehydration ; Magnetic resonance imaging ; Middle cerebral artery occlusion ; Rat
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Mannitol and furosemide treatment of ischaemic brain oedema caused by middle cerebral artery occlusion (MCAO) was studied by MRI in 87 rats. MRI was performed in all rats before and 30–360 min after drug infusion. The examinations were performed in the presence of an intact blood-brain barrier (BBB) 6 h after MCAO, and 3 days after MCAO at the time of maximal disruption of the BBB. Spin echo (SE) sequences were used for imaging and for determination of the relaxation times T1 and T2. Subtraction images were constructed. Furosemide dehydrated healthy and ischaemic brain. Mannitol had no dehydrating effect on healthy brain tissue. However, when the BBB was disrupted in severe oedema mannitol produced a decrease in water content, a shortening of T1 and T2, and a decrease in intracranial pressure (ICP), while in less severe oedema mannitol could increase brain water content, thus aggravating ICP. The subtraction technique allowed visualisation of the transient change in bulk in water animals with disruption of the BBB after mannitol treatment.
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  • 29
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    European radiology 4 (1994), S. 175-178 
    ISSN: 1432-1084
    Keywords: Actinomycosis ; Computed tomography ; Heart diseases ; Magnetic resonance imaging ; Mediastinal diseases
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Widespread use of antibiotics facilitates the development of some uncommon chronic infections such as actinomycosis. The clinical and radiographic findings overlap those of other inflammatory and neoplastic conditions. With a review of the literature, we report the CT and MRI findings in a case of thoracic actinomycosis, presenting with right ventricular failure caused by heart involvement. CT was helpful in identifying the mediastinal extent of the disease and in demonstrating the absence of pulmonary involvement. MRI, however, offered complementary information, especially in assessing heart involvement without the need for intravenous contrast media. On T2-weighted images the mediastinal process was noted to be of relatively low signal intensity, possibly indicating its benign nature. The association with heart involvement was suggestive of thoracic actinomycosis.
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  • 30
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    European radiology 4 (1994), S. 265-267 
    ISSN: 1432-1084
    Keywords: Liver ; Extramedullary plasmocytoma ; Ultrasound ; Computed tomography ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The case of a 72-year-old man with a solitary hepatic extramedullary plasmocytoma (EMP) is presented. Preoperative MRI and CT findings showed a homogeneous solitary unspecific lesion with an early brief enhancement after IV contrast administration. Differential diagnoses are reviewed and discussed. Imaging findings were not specific but could be observed in a hypervascular hepatic metastasis. However associated with IgG monoclonal spike, without bone marrow involvement, EMP should be suspected.
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  • 31
    ISSN: 1432-1084
    Keywords: Liver neoplasm ; Magnetic resonance imaging ; Tissue characterisation ; Turbo spin echo sequences
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract To determine whether turbo spin echo (TSE) sequences can replace conventional T2-weighted spin echo (SE) sequences in MRI of the liver, 40 patients with focal liver lesions were imaged at 0.5 T. A T2-weighted SE sequences (TR/TE 1800/90 ms, number of signals averaged [NEX]=2, scan time=7:16 min), a TSE sequence (TR/TE 1800/90 ms, NEX=4, number of echos per excitation=13, echo spacing=12.9 ms, scan time=4:16 min) and a T1-weighted SE sequence (TR/TE 350/15 ms, NEX=2, scan time=4:21 min) were obtained and image quality, lesion detectability and lesion differentiation were evaluated qualitatively by subjective assessment using scores and quantitatively by lesion-liver contrast-to-noise (CNR) and tumour/liver signal intensity (SI) ratios. The image quality of the TSE sequence was substantially better compared with the T2-weighted SE sequence due to a reduction in motion artefacts and better delineation of anatomical details. Of a total of 158 visible lesions the T1-weighted SE, TSE, and T2-weighted SE sequences showed 91%, 81% and 65% of the lesions, respectively. Thus the TSE sequence depicted 24% (P〈 0.001) more lesions than the T2-weighted SE sequence. In all types of pathology the lesion-liver CNR of the TSE sequence was significantly (P〈 0.001) higher compared to the CNR of the T2-weighted SE sequence (+ 55–65%), indicating superior lesion conspicuity. Lesion characterization was equally good on the two T2-weighted sequences with no difference in the tumour/liver SI ratio. Using a criterion of tumour/liver SI ratio equal to or higher than 2, haemangiomas larger than 1 cm in diameter could be differentiated from other lesions with a sensitivity and specificity of 95% and 96%, respectively. Our results indicate that the TSE sequence is suitable for replacing the conventional T2-weighted SE sequence in MRI of focal liver lesions.
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  • 32
    ISSN: 1432-1920
    Keywords: Pituitary adenoma ; Craniopharyngioma ; Rathke cleft cyst ; Magnetic resonance imaging ; Gadolinium DTPA ; Normal pituitary gland
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We compared the position of the normal pituitary gland as estimated by gadolinium (Gd)-DTPA-enhanced MRI, with its position at surgery in 40 patients with intra- and juxtasellar tumours: 22 pituitary adenomas, 4 craniopharyngiomas, 7 meningiomas, 2 germinomas, and 5 Rathke cleft cysts. In 37 of these, the normal gland showed more intense contrast enhancement than the adjacent tumour, from which it could be differentiated by Gd-DTPA-enhanced MRI, especially in the sagittal plane. The direction of displacement of the normal pituitary gland correlated well with tumour type, so that its position proved helpful in the differential diagnosis. The normal gland was typically displaced superiorly by pituitary adenomas, inferiorly by craniopharyngiomas, and anteriorly by germinomas. It showed variable displacement by Rathke cleft cysts, and was not usually displaced by meningiomas.
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  • 33
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    Neuroradiology 36 (1994), S. 426-429 
    ISSN: 1432-1920
    Keywords: Basilar artery thrombosis ; Stroke ; Infarct ; Magnetic resonance imaging ; Magnetic resonance angiography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The aim of this study was to review the imaging features in acute (〈24 h) basilar artery thrombosis. CT and MR studies in 11 patients with clinical diagnosis of acute basilar artery thrombosis were retrospectively reviewed. MR angiography was obtained in 4 patients. Correlation with clinical symptoms was performed. Multiple cranial nerve palsies and hemiparesis were the most common clincal symptoms at presentation. CT revealed hyperdense basilar arteries (n=7) and hypodensities in the posterior circulation territory (n=8). In one instance, the infarction was hemorrhagic. MR imaging showed absence of flow void within the basilar in 6 patients and MRA (using both PC and TOF techniques) confirmed absence of blood flow in 4 basilar arteries. One week after presentation, 5 patients died. Autopsy was obtained in 1 case and confirmed the diagnosis of basilar artery thrombosis. Basilar artery thrombosis has fairly typical imaging features by both CT and MR. MRA may be used to confirm the diagnosis. Prompt recognition may lead to early thrombolytic treatment and may improve survival.
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  • 34
    ISSN: 1432-1920
    Keywords: Magnetic resonance imaging ; Rat spinal cord ; Experimental spinal cord injury ; Gadolinium
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We assessed the capacity of MRI to show and characterise the spinal cord (SC) in vivo in normal and chronically injured adult rats. In the chronically injured animals the SC was studied by MRI and histological examination. MRI was performed at 1.5 T, using gradient-echo and spin-echo (SE) sequences, the latter with and without gadolinium-DTPA (Gd-DTPA). Several positions were tried for good alignment and to diminish interference by respiratory movements. Images of the SC were obtained in sagittal, coronal, and axial planes. Normal SC was observed as a continuous intensity in both sequences, although contrast resolution was better using SE; it was not possible to differentiate the grey and white matter. Low signal was seen in the damaged area in chronically injured rats, which corresponded to cysts, trabeculae, mononuclear infiltrate, and fibroglial wall on histological examination. Gd-DTPA failed to enhance the SC in normal or chronically injured rats. It did, however, cause enhancement of the lesion after acute SC injury.
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  • 35
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    Neuroradiology 36 (1994), S. 649-651 
    ISSN: 1432-1920
    Keywords: Brain, growth and development ; Magnetic resonance imaging ; children
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We examined 66 healthy volunteers aged 4 to 50 years by magnetic resonance imaging (MRI) and the signal intensity was measured on T2-weighted images in numerous sites and correlated with age and sex. Using distilled water and cerebrospinal fluid (CSF) as references on each slice, we calculated the signal intensities of the brain structures. Calculated ratios between structures did not change with age, except for those of the globus pallidus and thalamus, in which the signal intensities decreased more rapidly. The signal intensities of other brain structures changed equally but this could not be discerned visually and quantitative measurements were required. The signal intensities in the white and deep grey matter decreased rapidly in the first decade and then gradually to reach a plateau after the age of 18 years. Maturation of the brain thus seems to continue until near the end of the second decade of life. No sex differences were found. Quantitative analysis requires intensity references. The CSF in the tips of the frontal horns seems to be as reliable as an external fluid reference for intensity, and can be used in routine examinations provided the frontal horns are large enough to avoid partial volume effect.
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  • 36
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    Neuroradiology 36 (1994), S. 644-648 
    ISSN: 1432-1920
    Keywords: Brain, growth and development ; Magnetic resonance imaging ; Children ; High signal foci
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The magnetic resonance images of 67 healthy subjects aged 4–50 years were studied for differences in general signal intensity between the different brain structures, the frequency of focal intensity changes in the brain, and variations in size of the cerebrospinal fluid (CSF) spaces. In adults over 25 years of age the thalamus gave lower signal than the putamen or caudate nucleus. Definite periventricular high signal was found in the white matter of one third of subjects of all ages. Small (〈5 mm in diameter) high signal foci were found in the cerebral white matter on T2-weighted images in 27% of subjects (20% of healthy children and adolescents and 34% of adults). They gave high signal on both short and long echoes in 11% of children and adolescents and in 22% of adults; 51% of all foci gave high signal with both echoes. This does not support the hypothesis that they are caused mainly by enlarged Virchow-Robin spaces. Of the high signal foci on T2-weighted images, 86% were in watershead areas. Two foci were found in one subject in the periventricular watershed area (beside the tips of the frontal horns) and they were never seen in the other deep white matter regions. In healthy, relatively young subjects with no known risk factors, high signal foci other than Virchow-Robin spaces, were common; neither their prevalence nor their number correlated with age in this series. A few slightly large sulci were found in some adults.
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  • 37
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    Neuroradiology 36 (1994), S. 652-655 
    ISSN: 1432-1920
    Keywords: Brain ; Magnetic resonance imaging ; Acute lymphoblastic leukaemia ; Radiotherapy ; Meningioma
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We carried out MRI on 43 survivors of childhood cancer after different treatment protocols with or without cranial radiotherapy. They were free of disease, therapy having been discontinued 2–20 years earlier. Treatment had been for various malignancies, excluding brain tumours; 27 had received cranial irradiation for acute lymphoblastic leukaemia (ALL) or lymphoma. Two asymptomatic young women treated for ALL had falx meningiomas. White matter changes, low intensity foci (representing calcification or old haemorrhage) and heterogeneous intensity focic old haemorrhages) were seen only in patients who had undergone radiotherapy. Because of the possibility of benign, potentially curable brain tumours occurring after cranial irradiation, it may be wise to carry out occasional cranial imaging in the follow-up of these patients. No routine imaging follow-up is needed after chemotherapy alone.
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  • 38
    ISSN: 1432-1920
    Keywords: Cerebral ischaemia ; Magnetic resonance imaging ; Contrast media ; Superparamagnetic iron oxide ; Stroke model ; Cerebral blood flow
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract An imaging technique capable of detecting ischaemic cerebral injury at an early stage could improve diagnosis in acute or transient cerebral ischaemia. We compared the ability of superparamagnetically contrastenhanced MRI and conventional T2-weighted MRI to detect ischaemic injury early after unilateral occlusion of the middle cerebral artery in 12 male Wistar rats. Permanent vessel occlusion was achieved by a transvascular approach, which has the advantage of not requiring a craniectomy. At 45–60 min after the procedure, the animals had conventional T2-weighted MRI before and after administration of a superparamagnetic contrast agent (iron oxide particles). Unenhanced images were normal in all animals. After administration of iron oxide particles, the presumed ischaemic area was clearly visible, as relatively increased signal, in all animals; this high signal area corresponded to the area of ischaemic brain infarction seen on histological studies. Magnetic susceptibility effects of iron particles cause low signal in normally perfused cerebral tissue, whereas tissue with reduced or absent blood flow continues to give relatively high signal. Our results suggest that superparamagnetic iron particles may significantly reduce the interval between an ischaemic insult and the appearance of parenchymal changes on MRI.
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  • 39
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    Neuroradiology 36 (1994), S. 35-36 
    ISSN: 1432-1920
    Keywords: Craniopharyngioma ; Salmonella typhi ; Abscess ; Computed tomography ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract ASalmonella typhi abscess within a craniopharyngioma in a 28-year-old woman is reported. CT and MRI demonstration of cerebral edema adjacent to the tumor suggested an atypical presentation of craniopharyngioma.
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  • 40
    ISSN: 1432-1920
    Keywords: Spinal infection ; Abscess ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We reviewed serial MRI with and without gadolinium-DTPA in eight patients with spinal epidural abscess and correlated the findings and the clinical manifestations. In four patients, diffuse abscesses spanned four vertebral bodies or more; the others had focal abscesses associated with osteomyelitis and/or diskitis. In three of the four patients with diffuse abscesses, MRI (NCMRI) showed diffuse encasement of the subarachnoid space. Contrast-enhanced MRI (CEMRI) demonstrated linear enhancement surrounding unenhanced pus. In the four patients with focal abscesses, CEMR delineated the inflammatory process more clearly than NCMR. On follow-up studies, decrease in abscess size and better visualization of the subarachnoid space correlated with clinical improvement in both diffuse and focal abscesses. Despite clinical improvement, contrast enhancement persisted in the disk or epidural space of three patients, and was thought to represent chronic granulomatous change or postsurgical scar. CEMR is very valvable for the initial diagnosis of an epidural abscess, particularly if it involves lengthy segments. During follow-up, CEMR can document responses to therapy, and provide information for determining appropriate treatment.
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  • 41
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    Neuroradiology 36 (1994), S. 63-64 
    ISSN: 1432-1920
    Keywords: Acoustic neuroma ; Magnetic resonance imaging ; Temporal bone tumours
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Intralabyrinthine schwannomas are rare benign tumours which present with progressive or fluctuant audiovestibular symptoms and may mimic Meniéres discase. The size and position of these lesions make preoperative diagnosis unusual and most are discovered incidentally at labyrinthectomy. A case is reported which was diagnosed on magnetic resonance imaging and confirmed at surgery.
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  • 42
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    Neuroradiology 36 (1994), S. 93-96 
    ISSN: 1432-1920
    Keywords: Tuberculosis ; Central nervous system ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The MRI findings of 18 proven cases of central nervous system (CNS) tuberculosis were reviewed; 10 patients were seropositive for HIV. All had medical, laboratory, or surgical proof of CNS tuberculosis. Eleven patients had meningitis, of whom two also had arachnoiditis. Five patients had focal intra-axial tuberculomas: four brain masses and one an intramedullary spinal lesion. Two patients had focal extra-axial tuberculomas: one in the pontine cistern, and one in the spine. In all 11 patients with meningitis MRI showed diffuse, thick, meningeal enhancement. All intraparenchymal tuberculomas showed low signal intensity on T2-weighted images and ring or nodular enhancement. The extra-axial tuberculomas had areas isointense or hypoitense relative to normal brain and spinal cord on T2-weighted images. Although tuberculous meningitis cannot be differentiated from other meningitides on the basis of MR findings, intraparenchymal tuberculomas show characteristic T2 shortening, not found in most other space-occupying lesions. In the appropriate clinical setting, tuberculoma should be considered.
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  • 43
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    Neuroradiology 36 (1994), S. 111-114 
    ISSN: 1432-1920
    Keywords: Pituitary tumour ; Haemorrhage ; Magnetic resonance imaging ; Bromocriptine medication
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In a group of 69 patients with pituitary tumours, 12 were found to have evidence of intratumoral haemorrhage on MRI, characterized by high signal intensity on short TR/TE sequences. This was verified in all but 1 patient. The majority of the bleedings occurred in macroadenomas. Five (42%) were prolactinomas and 4 (33%) were non-functioning adenomas. There were 2 GH- and 1 ACTH-secreting tumours. All 5 patients with prolactinomas were on bromocriptine medication. Two of the patients had a clinical picture of pituitary apoplexy. The haemorrhage was not large enough to prompt surgery in any of the patients. However, surgical verification of the diagnosis was obtained in 5 cases, while 6 patients were examined with follow-up MRI.
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  • 44
    ISSN: 1432-1920
    Keywords: Hallucinations ; Peduncular hallucinosis ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report a case of peduncular hallucinosis (Lhermitte's syndrome), unusual in that there were no associated neurological signs and the symptoms persisted over many years. Magnetic resonance imaging demonstrated the typical midbrain lesion.
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  • 45
    ISSN: 1432-1920
    Keywords: Chiari malformation ; Syringomyelia ; Magnetic resonance imaging ; Cine-MRI
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Cine-MRI with presaturation bolus tracking was used in patients with syringomyelia associated with a Chiari malformation to study pulsatile movement of the hindbrain, cervical spinal cord, cerebrospinal fluid and the fluid within the syrinx. Nine patients had 13 examinations, 6 preoperative, 3 after syringosubarachnoid shunting and 4 after posterior fossa decompression. Five controls were also examined. Dynamic display of the acquired images demonstrated downward displacement of the presaturation bolus on the cerebellar tonsils and medulla oblongata (or upper cervical cord) at the C1 level in all preoperative examinations and in two patients after syringo-subarachnoid shunting but with residual foramen magnum obstruction. Downward displacement of the bolus on the cervical spinal cord was also demonstrated in 7 examintions, but not observed in the controls. Thus, the hind-brain-spinal cord axis showed larger pulsatile movements in patients with foramen magnum obstruction. Based on these observations and a review of the literature, a new theory on the mode of extension of syringomyelia, emphasising the role of increased pulsatile movement of the hind-brain-spinal cord axis is proposed: that the pulsatile movements, together with a one-way valve mechanism in the syrinx cavity act as a “vacuum-pump” to enlarge the syrinx.
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  • 46
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    Neuroradiology 36 (1994), S. 139-140 
    ISSN: 1432-1920
    Keywords: Magnetic resonance imaging ; polyneuritis ; Guillain Barré syndrome
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report gadolinium-enhancing nerve root lesions in a 52-year-old man with typical Guillain-Barré syndrome (GBS). This enhancement correlates well with the perineurial inflammatory and demyelinating processes known to characterize GBS and other inflammatory neuropathies. MRI should enable further exploration of patterns of disease in GBS and, with further study, perhaps assist in evaluating therapy.
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  • 47
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    Neuroradiology 36 (1994), S. 148-151 
    ISSN: 1432-1920
    Keywords: Cerebellum ; Hypoplasia ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Cerebellar hypoplasia may present with a wide variety of neurological and systemic features, ranging from aplasia causing neonatal death to mild hypoplasia in an asymptomatic adult. MRI clearly documents the size of the cerebellum and any associated abnormalities. We describe 7 cases of cerebellar hypoplasia of varying aetiology-3 inherited, 2 associated with spinal dysraphism, 1 with Joubert's syndrome and 1 with pontine agenesis, probably as a result of basilar artery infarction in utero. T1- and T2-weighted images were obtained in each case and gadolinium-DTPA was administered in one. Associated features such as a Chiari malformation (2 cases), brain stem hypoplasia (2 cases), Dandy-Walker cyst and pachygyria (3 cases) and spinal dysraphism (2 cases) were clearly identified. Accurate documentation of these appearances assists in genetic counselling.
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  • 48
    ISSN: 1432-1920
    Keywords: Cerebrospinal fluid flow ; Cerebrospinal fluid production ; Magnetic resonance imaging ; Normal pressure hydrocephalus
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract An interleaved velocity-sensitised fast low-angle shot pulse sequence was used to study cerebrospinal fluid (CSF) flow in the cerebral aqueduct, and supratentorial CSF production in 9 patients with normal pressure hydrocephalus (NPH) and 9 healthy volunteers. The peak aqueduct CSF flow, both caudal and rostral, was significantly increased in patients with NPH. No significant difference in the supratentorial CSF production rate was found between patients (mean 0.60+/−0.59 ml/min) and healthy volunteers (mean 0.68+/−0.31 ml/min). Our method may be useful for investigation and monitoring of patients with NPH before and after ventriculoperitoneal shunt operations.
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  • 49
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    Neuroradiology 36 (1994), S. 216-220 
    ISSN: 1432-1920
    Keywords: Acute disseminated encephalomyelitis ; Postviral encephalitis ; Brain, demyelination ; Magnetic resonance imaging ; Gadolinium ; Central nervous system
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A retrospective analysis of CT and MRI studies in 12 patients with a clinical diagnosis of acute disseminated encephalomyelitis (ADEM) was performed. MRI was the definitive modality for the assessment of the lesions of ADEM: all patients had abnormalities consistent with the clinical diagnosis. Ten had abnormalities in the brain, three spinal cord lesions, and three showed evidence of optic neuritis. CT was normal in 6 of the 7 patients in which it was performed.
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  • 50
    ISSN: 1432-1920
    Keywords: Basal ganglia ; Encephalitis ; Computed tomography ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report a case of acute bilateral striatal necrosis in an infant. CT and MRI findings are described.
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  • 51
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    Neuroradiology 36 (1994), S. 247-248 
    ISSN: 1432-1920
    Keywords: Hallervorden-Spatz disease ; Magnetic resonance imaging ; Iron ; Gradient-echo
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In a 10-year-old girl, with progressive motor disturbance since the age of seven years and dominant pyramidal signs, MRI revealed marked overall low signal from the globus pallidus on each side, with central zones of high signal. There was also strikingly low signal in the zona reticularis of the substantia nigra, indicative of Hallervorden-Spatz disease (HSD).
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  • 52
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    Neuroradiology 36 (1994), S. 271-272 
    ISSN: 1432-1920
    Keywords: Atrial myxoma ; Cerebral infarction ; Magnetic resonance imaging ; Echocardiography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We describe the radiologic investigation of two patients with primary left atrial myxoma who presented with embolic manifestations in the brain. MRI and CT showed multiple infarcts, while the cardiac atrial mass was demonstrated in one of the patients by MRI and in both by echocardiography.
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  • 53
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    Neuroradiology 36 (1994), S. 269-270 
    ISSN: 1432-1920
    Keywords: Lateral medullary infarction ; cerebellar infarction ; Wallenberg's syndrome ; Magnetic resonance imaging ; Magnetic resonance angiography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In a case of Wallenberg's syndrome, infarction of the dorsolateral medulla was shown to be caused by thrombosis of the left vertebral artery, as demonstrated by T1-weighted magnetic resonance imaging, magnetic resonance angiography and conventional angiography.
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  • 54
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    Neuroradiology 36 (1994), S. 292-294 
    ISSN: 1432-1920
    Keywords: Hypertrophic pachymeningitis ; Tentorium ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Hypertrophic pachymeningitis is a rare fibrosing inflamatory process involving dura mater and tentorium. In this report we are presenting contrast enhanced MRI findings of an unusual case of pachymeningitis which presented with a periorbital mass due to dural sinuses occlusion and retrograde filling of periorbital veins through superior sagittal sinus.
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  • 55
    ISSN: 1432-1920
    Keywords: Pituitary adenoma ; Magnetic resonance imaging ; Gadolinium ; DTPA ; Normal pituitary gland
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The position of the normal pituitary gland, assessed using gadolinium-enhanced MRI was compared with the position found at surgery for pituitary adenoma in 25 patients. The tumours were five microadenomas and 20 macroadenomas. Using T1-weighted imaging, the anterior lobe could be differentiated on the sagittal image in five patients (20%) and on the coronal image in four (16%). The high intensity of the posterior lobe could be differentiated using T1-weighted sagittal imaging in 13 patients (52%). The normal pituitary gland, which enhanced more strongly than tumour, could be differentiated using Gd-DTPA-enhanced MRI on the sagittal images in 22 cases (88%) and on the coronal image in 17 (68%). In seven patients, the normal pituitary gland surrounded the tumour; it was displaced superiorly in 14 cases and superioposterorly in two but in no case was it displaced anteriorly or downwards.
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  • 56
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    Neuroradiology 36 (1994), S. 311-312 
    ISSN: 1432-1920
    Keywords: Ganglioglioma ; Central nervous system ; Computed tomography ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We describe a ganglioglioma with atypical radiological appearances, in an uncommon location. CT showed a nonenhancing low-density lesion without calcification. On MRI the lesion gave nonspecific low signal on T1-weighted images and high signal on T2-weighted images. The tumour was in the right frontal lobe, producing bulging and thinning of the calvarium.
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  • 57
    ISSN: 1432-1920
    Keywords: Magnetic resonance imaging ; Fast spin-echo ; Multiple sclerosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Long repetition time (TR) spin-echo (SE) with T2- or proton density weighting is the sequence of choice to detect the brain lesions of multiple sclerosis (MS). Fast spin-echo (FSE) permits the generation of T2-weighted images with similar contrast to SE but in a fraction of the time. We compared the sensitivity of FSE and SE in the detection of the brain lesions of MS. Six patients with clinically definite MS underwent brain imaging with both dual echo (long TR, long and short echo time (TE) SE and dual echo FSE. The SE and FSE images were first reviewed independently and then compared. A total of 404 lesions was detected on SE and 398 on FSE. Slightly more periventricular lesions were detected using SE than FSE (145 vs 127), whereas more posterior cranial fossa lesions were detected by FSE (77 vs 57). With both SE and FSE the short TE images revealed more lesions than the long echo. These results suggest that FSE could replace SE as the long TR sequence of choice in the investigation of MS.
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  • 58
    ISSN: 1432-1920
    Keywords: Optic nerve injury ; Magnetic resonance imaging ; Short inversion time inversion recovery sequence
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We studied nine patients with optic nerve injury associated with closed head trauma by magnetic resonance imaging (MRI) with short inversion time inversion recovery (STIR) sequences on 11 occasions from 4 days to 14 years after the injury: three studies were within 17 days and eight over 4 months to 14 years. MRI revealed abnormal high signal in 10 of the 11 injured nerves. MRI 4 days after the injury showed no abnormality.
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  • 59
    ISSN: 1432-1920
    Keywords: Magnetic resonance imaging ; Arteriovenous malformations ; Spinal cord ; Contrast media
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Arteriovenous fistulae and malformations (AVFs and AVMs) of the spinal cord are rare, potentially treatable causes of progressive disability. Although a variety of MRI abnormalities has been described, the diagnosis rests on the findings on selective spinal angiography.Collecting T2*-weighted MR images during the passage of a gadolinium bolus gives information about perfusion and blood volume. We carried out dynamic MRI in seven patients with vascular abnormalities (5 dural AVFs, 1 intramedullary AVM, 1 cryptic angioma) and in two patients without an AVM. High resolution T1- and T2-weighted sagittal images of the whole spinal cord were first obtained using a multiarray receiver coil. Sagittal radiofrequency spoilt gradient echo images (GE34/25, flip angle 100) were then obtained during bolus injection of gadolinium-DTPA. Abnormalities were seen in all seven patients with AVFs or AVMs. In the patient with an intramedullary AVM and four of the five with dural AVFs transient signal reduction was seen within the perimedullary venous plexus during passage of the bolus. The findings correlated well with those from selective spinal angiography. We conclude that dynamic MRI offers a useful adjunct to angiography and may localise an arteriovenous shunt when conventional MRI fails to do so. In combination with high-resolution imaging of the entire spinal cord the technique may make myelography redundant; it is simple, well tolerated and can be carried out without significant time penalty.
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  • 60
    ISSN: 1432-1920
    Keywords: Brain ; Magnetic resonance imaging ; Localization
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We assessed reproducible definition of two standardized co-ordinate systems for intersubject analysis of brain images. The baselines in the two co-ordinate systems were a modification of the canthomeatal (inCM) line and the anterior-posterior commissural )AC-PC) line. Axial spin-echo MR images of four subjects at 1.5T were used. Operator error was computed from the replicate analyses of two operators. The mCM line was determined by the lens of the eye and the internal auditory canal, and the AC-PC line was determined by the intersection of the AC and PC with the interhemispheric fissure. Reproducibility of the mCM markers (SD=0.59 mm) did not differ significantly from that of the AC-PC line (SD=0.68 mm). The measurement error of the angle of the baseline (δα), however, was more than 7 times as large for the AC-PC line as for the mCM line. An additional error affecting the rostrocaudal rotation of the co-ordinate systems, attributable to the distance between the anatomic markers, was 2.1 and 3.6° (3 mm and 5 mm slice thickness) for the mCM co-ordinate system and 8.2 and 11.0° (3 mm and 5 mm slice thickness) for the AC-PC system. The AC-PC line based co-ordinate system is therefore, less reproducible than the mCM line based system. this could be improved if a combination of axial and sagittal images were used for the definition of the AC-PC line.
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  • 61
    ISSN: 1432-1920
    Keywords: Multiple sclerosis ; Magnetic resonance imaging ; Corticosteroid ; Gadolinium
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Treatment with methylprednisolone reduces the duration and severity of clinical relapses in multiple sclerosis (MS), while reducing the number of gadolinium-enhancing lesions on T1-weighted MRI. We performed serial MRI imaging after methylprednisolone treatment to see whether suppression of enhancement persists and whether related abnormalities on T2-weighted images disappear at follow-up. Thirteen patients with definite MS received a total of 31 courses of methylprednisolone over an average period of 50 weeks. Gadolinium-enhanced MRI was obtained before and after treatment, then at monthly intervals, using a standardised repositioning and imaging protocol. Two experienced readers in conference defined the number of active (gadolinium-enhancing and new or enlarging nonenhancing) lesions. We detected 609 active lesions on 195 examinations. Directly after treatment the reduction in the number of enhancing lesions was 78%, indicating restoration of the BBB and suppression of inflammation. It was uncommon for a lesion which stopped enhancing to show enhancement on a subsequent examination. No beneficial effect was observed on the rate of disappearance of related abnormalities on T2-weighted images, indicating persistent change such as oedema, cellular infiltration or demyelination. Moreover, in 89% of cases, an increase in the number of active lesions was observed before new clinical activity, if any, was observed (on average 52% earlier). MRI enabled us to demonstrate that the duration of the effect of methylprednisolone treatment is temporary (on average 9.7 weeks).
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  • 62
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    Neuroradiology 36 (1994), S. 399-401 
    ISSN: 1432-1920
    Keywords: Carbon monoxide poisoning ; Cerebral white matter degeneration ; Cerebral cortical atrophy ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We examined 13 patients with chronic carbon monoxide (CO) poisoning by magnetic resonance imaging (MRI); all of them had been in an explosion in a coal mine 25 years previously. Symmetrical globus pallidus lesions were observed in 12, as was degeneration of the white matter, with focal cortical atrophy. The temporal parietal and occipital lobes were usually affected, the parietooccipital region being the most frequently and extensively damaged. Of the 12 patients with white matter degeneration 7 had definitely asymmetrical cortical and subcortical lesions. There were 6 patients with dilated temporal horns, probably due to atrophy of the hippocampal gyri. A history of CO inhalation and an awareness of the typical distributions of lesions are important for recognition of the effects of CO poisoning, especially when patients are in the chronic stage.
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  • 63
    ISSN: 1432-1920
    Keywords: Magnetic resonance imaging ; Basal ganglia ; Thalamus ; Complete cerebral ischaemia ; Cardiac arrest
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report specific changes bilaterally in the basal ganglia and thalamus following reperfusion after complete cerebral ischaemia. A 69-year-old man, resuscitated after cardiac arrest, showed symmetrical lowdensity lesions in the head of the caudate nucleus and lentiform nucleus on CT. MRI revealed methaemoglobin derived from minor haemorrhage in the basal ganglia and thalamus, not evident on CT. We suggest that this haemorrhage results from diapedesis of red blood cells through the damaged capillary endothelium following reperfusion.
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  • 64
    ISSN: 1432-1971
    Keywords: Aneurysmal change ; Ductus arteriosus ; Magnetic resonance imaging ; Prostaglandin E1
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary We report a case of pulmonary atresia in which the ductus arteriosus underwent aneurysmal dilatation after infusion of prostaglandin E1 incorporated in lipid microspheres. To our knowledge this is the first case in which this rare morphological change has been demonstrated with the noninvasive method of magnetic resonance imaging.
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  • 65
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    Pediatric nephrology 8 (1994), S. 587-588 
    ISSN: 1432-198X
    Keywords: Wegener's granulomatosis ; Vasculitis ; Magnetic resonance imaging ; Cyclophosphamide
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Cutaneous manifestations occur in a significant number of patients with Wegener's granulomatosis (WG); however, the presentation and histopathology of these lesions are highly variable and may present problems in diagnosis We report the presentation of a single large skin lesion in a pediatric patient with a history of WG and the characterization of this lesion by magnetic resonance imaging (MRI) and histopathology. MRI was helpful in delineating the extent of the lesion, although a skin biopsy was necessary to confirm the diagnosis of the vasculitic natur of the lesion.
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  • 66
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    Pediatric nephrology 8 (1994), S. 451-457 
    ISSN: 1432-198X
    Keywords: tuberous sclerosis complex ; Angiomyolipomatosis ; Renal cysts ; Haemorrhage ; Ultrasound ; Magnetic resonance imaging ; Renal failure
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In a retrospective survey performed in Germany and Switzerland, 207 patients (ranging in age from newborn to 70 years) were evaluated in order to establish the frequency, prognosis and diagnostic awareness of kidney involvement in the tuberous sclerosis complex. Renal manifestations were observed in 48% of patients: renal cysts (33 patients), renal angiomyolipoma (AML) (30 patients), a combination of both (8 patients), renal cell carcinoma (3 patients), life-threatening events such as haemorrhage (4 patients), hypertensive crisis (2 patients) and chronic renal failure (10 patients) were also documented. The diagnostic imaging techniques of ultrasonography, intravenous urography, computed tomography and magnetic resonance imaging (MRI) are important but do not always yield definitive information. Differentiation between AML and cysts can be achieved using special MRI techniques (RARE). The potential for renal involvement should be monitored in all patients with the tuberous sclerosis complex.
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  • 67
    ISSN: 1432-1971
    Keywords: Magnetic resonance imaging ; Pulmonary arteries
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Pulmonary artery anatomy was studied in 36 patients (age range 12 days to 12.83 years, mean 2.9 years) with right ventricular outflow tract obstruction over a 3-year period using a 1.5 Tesla Magnetic Resonance system. Gated spin-echo sequences were obtained in each patient. Image planes used were straight and oblique transverse, oblique coronal, and oblique sagittal. The studies were analyzed retrospectively and comparative angiographic, surgical, and postmortem data was available in all cases. As previously noted with other imaging modalities, multiple views and oblique cuts were found to increase significantly the quality and accuracy of the information acquired. In 12 of the 15 patients who had axial and coronal imaging of both branch pulmonary arteries, the pulmonary arteries were unequivocally demonstrated to at least the first hilar branch. However, early in our experience we missed a number of branch stenoses that developed following surgical anastomoses. These mistakes were caused by inadequate or inappropriate slice acquisition. Magnetic resonance is an important technique for imaging pulmonary arteries. Careful use of the appropriate imaging planes is essential for accurate demonstration of the anatomy.
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  • 68
    ISSN: 1432-1971
    Keywords: Aneurysm ; Balloon dilation ; Coarctation of aorta ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary An 11-year-old boy developed an acute aortic pseudoaneurysm during balloon dilation of unoperated coarctation of the aorta. The pseudoaneurysm occurred despite the fact that the balloon catheter size did not exceed the diameter of the aorta at the diaphragm. Elective delayed surgical repair was successfully performed after 3 weeks of antihypertensive treatment when serial magnetic resonance imaging had demonstrated a reduction in the local tissue swelling.
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  • 69
    ISSN: 1432-2161
    Keywords: Magnetic resonance imaging ; Neoplasms ; Musculoskeletal neoplasms ; Cryotherapy ; Chondrosarcoma ; Giant cell tumor of bone
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Cryotherapy is an increasingly popular mode of therapy adjunctive to surgical curettage in the treatment of certain skeletal neoplasms, such as giant cell tumors or chondrosarcomas. The magnetic resonance (MR) findings following cryotherapy have not been previously reported. We reviewed the MR findings in seven patients with skeletal neoplasms following curettage and cryotherapy. In six cases we found a zone of varying thickness extending beyond the surgical margins, corresponding to an area of cryoinjury to medullary bone. This zone displayed low signal intensity on T1-weighted images and high signal intensity on T2-weighted images, consistent with the presence of marrow edema. This zone of edema almost certainly reflects underlying thermal osteonecrosis. This zone may vary in size and intensity over time as the area of cryoinjury evolves or resolves. MR is currently the imaging procedure of choice for follow-up of most musculoskeletal neoplasms. Knowledge of the MR findings following cryotherapy should help prevent confusion during the interpretation of follow-up MR examinations.
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  • 70
    ISSN: 1432-2161
    Keywords: Bone tumor ; Bone neoplasm ; Magnetic resonance imaging ; Chemotherapy ; Relaxation time
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract To study the effect of chemotherapy on normal fat, skeletal muscle, and bone marrow, T1 and T2 relaxation times were measured in 15 patients with bone sarcoma before and after each cycle of preoperative chemotherapy. A section plane containing the tumor and if possible the nonaffected extremity was imaged with combined multiecho spin echo and inversion recovery pulse sequences. T1 and T2 relaxation times were calculated in the normal-appearing tissues. Although some variation was found in the values in the individual patient and between patients, no systematic changes of relaxation times of fat, muscle, or bone marrow occurred in the course of treatment. We conclude that the chemotherapy used in bone sarcoma has no effect on relaxation times of normal fat, muscle, and bone marrow, and that therefore these tissues may serve as a reference for the signal intensity of tumor.
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  • 71
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    Skeletal radiology 23 (1994), S. 205-210 
    ISSN: 1432-2161
    Keywords: Clavicle ; Infection ; Osteomyelitis ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Most lesions of the clavicle are traumatic and pose few diagnostic difficulties. Nontraumatic clavicular lesions, on the other hand, are rare and frequently present problems in diagnosis. This report reviews the clinical, radiologic, and bacteriologic findings in ten patients, six of whom were diagnosed as having acute osteomyelitis and four chronic osteomyelitis. The differential diagnosis of clavicular osteomyelitis is also discussed. The clinical duration of the infectious process in these patients ranged from 2 weeks to 1.5 years. All patients presented with pain; six had fever, three had localized swelling or a mass, and three had soft tissue abscesses. The radiographic findings also varied: the lesion was predominantly sclerotic in four patients, lytic in three, and mixed in two patients; in the one patient in whom magnetic resonance imaging was the only imaging study performed, these features could not be properly evaluated. Periosteal reaction was detected in three patients. Staphylococcus aureus was the causal organism in four patients, while in the remaining six patients different microorganisms were cultured, including Coccidioides immitis and Mycobacterium tuberculosis. Six patients required biopsy for final diagnosis. Although clavicular osteomyelitis is rare, particularly in adults, it should be considered in the differential diagnosis of a clavicular lesion. The final diagnosis often depends on the results of biopsy and cultures.
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  • 72
    ISSN: 1432-1084
    Keywords: Liver, neoplasms ; Liver, diseases ; Liver, focal nodular hypersplasia ; Magnetic resonance imaging ; Magnetic resonance imaging ; Magnetic resonance (MR), tissue characterization
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Two cases of local nodular hyperplasia (FNH), in which ultrasound (US), computed tomography (CT), and magnetic resonance imaging (MR) studies detected an atypical hemorrhagic pattern associated with an intrahepatic arterio venous malformation (AVM) around the growths, are presented. In both cases, histology demonstrated a very early regenerative stage — without central scar or fibrosis — and necrotichemorrhagic areas within the lesions. In these cases, the analysis of radiological findings, surgical specimens and histology seemed to confirm the pathogenetic hypothesis suggested by Wanless [1]: in normal liver parenchyma, a “blood steal” phenomenon due to congenital or acquired intrahepatic AVM — arterio portal or porto systemic shunt — could cause ischemic damaged, appering as a hemorrhagic necrotic area, the extent of which depends on the degree of residual portal supply (maintained in Case 1, and markedly reduced in Case 2 due to arterio portal shunting). The subsequent phase of repair could activate the regenerative-hyperplastic process, evolving into final fibrosis, which represents the “mature” pattern of FHN.
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  • 73
    ISSN: 1432-1076
    Keywords: Idiopathic pulmonary haemosiderosis ; Liposteroid Methylprednisolone ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We describe two Japanese children with idiopathic pulmonary haemosiderosis (IPH), whose refractory haemorrhages were treated with an intravenous lipid emulsion containing dexamethasone (liposteroid). A 22-month-old boy and a 14-month-old girl have been observed with similar symptoms; periodic bouts of anaemia, reticulocytosis, diffuse infiltrates on chest X-ray and the finding of siderophages in sputum or gastric lavage fluid. The MRI of the lung was useful for the diagnosis. Methylprednisolone pulse therapy was successful in treating acute massive bleeding. Subsequent oral prednisolone could not prevent chronic recurrent haemorrhages. However, the intermittent administration of liposteroid (0.05 mg/kg/dose IV) led to a cessation of bleeding; the haemoglobin concentration rose to normal levels. This observation emphasizes the usefulness of liposteroid in the management of refractory IPH.
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  • 74
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    European journal of pediatrics 153 (1994), S. S90 
    ISSN: 1432-1076
    Keywords: Tomography X-ray computed ; Magnetic resonance imaging ; Electroencephalography ; Electroretinography ; Evoked potentials
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The diagnosis of a neurometabolic disease is usually suggested by clinical history and physical findings and is confirmed by appropriate special studies which may include neuroradiological and neurophysiological investigations. On the other hand, routine neuroradiological and neurophysiological studies may incidentally produce results suggestive of a neurometabolic disorder. This overview contains a set of tables meant to be helpful in deciding which CT, MRI, and electrophysiological studies are indicated when certain neurometabolic disorders are suspected or which disorders must be considered after such studies have produced certain suggestive results.
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  • 75
    ISSN: 1432-0932
    Keywords: Chemonucleolysis ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary After treatment of a symptomatic herniated disc with chymopapain, 14 patients were re-examined by magnetic resonance imaging (MRI) at a mean follow-up of 72 months. Well-defined MRI findings before chemonucleolysis were compared with those after the procedure by an independent observer. Five MRI parameters were assessed. No significant change was noted in the signal intensity of the affected disc, the extent of osteochondrosis and endplate reaction of the affected segment. The height of the affected disc as well as the size of the disc herniation were reduced significantly. The loss of the height is seen as a direct result of chymopapain activity, whereas the alteration of the size of the herniation seems to depend on the natural history of a disc herniation and is probably not a simple result of the treatment.
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  • 76
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    European spine journal 3 (1994), S. 240-245 
    ISSN: 1432-0932
    Keywords: Spine surgery ; Magnetic resonance imaging ; (MRI) ; Artifacts ; Orthopaedic devices
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Magnetic resonance (MR) imaging is often disturbed after spine surgical procedures with or without an implant. Artifacts are induced by ferromagnetic or nonferromagnetic implants and devices and by small metallic particles left by surgical instruments. All metallic artifacts can affect the quality and usefulness of postoperative spine MR examinations. The physical effects caused by the introduction of metal or other conductive materials into a magnetic field and their consequences are presented. The application to postoperative spine MR examinations and solutions to reduce artifacts are discussed.
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  • 77
    ISSN: 1432-086X
    Keywords: Arteries, pulmonary ; Neoplasms ; Sarcoma ; Computed tomography ; Magnetic resonance imaging ; Embolism, chronic pulmonary
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Purpose The diagnosis of the rare primary malignant tumors of the pulmonary arteries is often delayed as symptoms are nonspecific. Methods Computed tomography (CT) and magnetic resonance imaging (MRI) of three patients with occlusion of the right pulmonary artery, two with sarcoma and one with chronic thromboembolic disease were analyzed for discriminating diagnostic criteria. Results Criteria suggesting pulmonary artery sarcoma are inhomogeneous high or low attenuation (hemorrhage, necrosis), soft-tissue density in pulmonary arteries, vascular distension, enhancement after administration of gadopentetate dimeglumine. Criteria for chronic thromboembolic disease are homogeneous soft-tissue lesions, abrupt vascular narrowings and cutoffs, as well as regional parenchymal hyperdensities. Conclusion CT and MRI provide complementary findings suggesting advanced pulmonary artery sarcoma instead of chronic thromboembolism.
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  • 78
    ISSN: 1432-1076
    Keywords: Key words     Idiopathic pulmonary haemosiderosis ; Liposteroid ; Methylprednisolone ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract      We describe two Japanese children with idiopathic pulmonary haemosiderosis (IPH), whose refractory haemorrhages were treated with an intravenous lipid emulsion containing dexamethasone (liposteroid). A 22-month-old boy and a 14-month-old girl have been observed with similar symptoms; periodic bouts of anaemia, reticulocytosis, diffuse infiltrates on chest X-ray and the finding of siderophages in sputum or gastric lavage fluid. The MRI of the lung was useful for the diagnosis. Methylprednisolone pulse therapy was successful in treating acute massive bleeding. Subsequent oral prednisolone could not prevent chronic recurrent haemorrhages. However, the intermittent administration of liposteroid (0.05 mg/kg/dose IV) led to a cessation of bleeding; the haemoglobin concentration rose to normal levels. This observation emphasizes the usefulness of liposteroid in the management of refractory IPH.
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  • 79
    ISSN: 1432-1459
    Keywords: Idiopathic cerebellar ataxia ; Eye movements ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Extensive oculomotor testing and quantitative MRI evaluation was performed in seven patients with idiopathic cerebellar ataxia without extracerebellar symptoms (IDCA-C) and in ten patients with additional extracerebellar symptoms (IDCA-P). The most severe oculomotor deficits were disturbed smooth pursuit, optokinetic nystagmus and suppression of the vestibulo-ocular reflex (VOR). The symptoms correlated well and consistently with the amount of atrophy of the flocculus and the dorsal vermis. These correlations, however, were not specific, and deficits also correlated with the amount of atrophy of other cerebellar structures. No correlation was found between saccade velocity and brain-stem atrophy or between saccade metrics and atrophy of the dorsal vermis. Although patients with IDCA-P had more severe oculomotor deficits than patients with IDCA-C, the pattern of the oculomotor disturbances was the same for both groups. Thus, eye movement analysis alone is not sufficient to distinguish between patients with pure cerebellar ataxia and those with additional extracerebellar symptoms.
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  • 80
    ISSN: 1432-1459
    Keywords: Olivopontocerebellar atrophy ; Late cerebellar cortical atrophy ; Positron emission tomography ; Cerebellar metabolism ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Fourteen patients with spinocerebellar degeneration (SCD) were subjected to MRI and PET studies. The quantitative MRI data revealed significant cerebellar and pontine atrophy in the patients with olivopontocerebellar atrophy (OPCA), and cerebellar atrophy in the patients with late cerebellar cortical atrophy (LCCA). We failed to demonstrate significant differences in the pons between LCCA patients and normal controls. PET measurements revealed decreases in cerebral oxygen metabolic rate (CMRO2) in the cerebellar hemisphere and vermis in both groups of patients. The markedly decreased cerebral blood flow (CBF) and CMRO2 in the pons were found only in the patients with OPCA. PET data corrected for the tissue shrinkage on the basis of MRI morphometry indicated a net reduction in cerebellar CMRO2 and CBE The present study has demonstrated that a combination of functional and anatomical data offers further evidence in favour of the current acceptable classification of SCD based on clinicopathological grounds. Our data further suggest that the amount of atrophy in the cerebellum could not fully account for the decreased metabolic rates observed in PET studies.
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  • 81
    ISSN: 1432-1459
    Keywords: Myositis ; Skeletal muscles ; Magnetic resonance imaging ; Creatine kinase ; Electromyography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The purpose of the study was to describe typical MRI findings in various types of idiopathic inflammatory myopathies in adulthood and to correlate the MRI with histopathological and electromyographic findings, and the serum creatine kinase (CK) activity. A third goal was to assess the diagnostic value of the use of gadolinium-DTPA (Gd-DTPA). Fifty-eight patients (35 women, 23 men), aged 21–83 years (median age 59 years), suffering from idiopathic myositides (13 with acute and 45 chronic diseases; 25 with polymyositis, 14 with dermatomyositis, 8 with granulomatous and 11 with inclusion body myositides) were examined with MRI. Seventeen of them received an intravenous infusion of Gd-DTPA. Histopathological and MRI findings of 21 muscles of 18 patients were compared. MRI of skeletal muscles showed abnormal signal intensities in 56 (96.6%) of the 58 patients. MRI abnormalities were found more often than elevated CK activity (P 〈 0.001). The hyperintensity of T2-weighted images was more conspicuous than on T1-weighted images in 26 (44.8%) patients, indicating oedema-like abnormalities. MRI of 50 (86.2%) patients showed fat replacement. In acute myositides, oedema-like abnormalities were more often visible and in muscle lipomatosis less often visible than in chronic diseases (P 〈 0.05 each). In dermatomyositis oedema-like abnormalities were more and lipomatosis less frequent than in the other types of myositis (P 〈 0.005) and correlated with the acuteness of the disease. In 3 of 17 patients in whom contrast-enhanced T1-weighted images were obtained in addition to plain T1- and T2-weighted images, T2-weighted images were more sensitive in the detection of oedema-like abnormalities than the contrast-enhanced T1-weighted images. In no patient was the opposite true. Thus, contrast-enhanced T1-weighted images did not provide more information than T2-weighted images. Nine patients with poly-, dermato- and inclusion body myositis showed clearly asymmetrical findings. Imaging of the thighs and legs was of similar sensitivity. The different types of myositides showed typical but not specific distributions of the mesenchymal abnormalities in MRI. The findings indicate that MRI of skeletal muscles in myositides can visualize the presence and distribution of oedema-like abnormalities and intramuscular lipomatosis and is suitable for the assessment of the chronicity and severity of the disease.
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  • 82
    ISSN: 1432-1459
    Keywords: Magnetic resonance imaging ; Computed tomography ; Fahr's syndrome ; Intracerebral calcification
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Twenty-two patients aged 36–63 years were diagnosed as having Fahr's syndrome on the basis of the presence on CT of unexpected extensive calcification of the basal ganglia. Even when associated with calcification of other brain areas, the main diagnostic criterion remained basal ganglia calcification larger than 800 mm2. Normal values of parathormone, serum calcium and phosphorus excluded hypercalcaemia and hypoparathyroidism. Mitochondrial CNS disease was excluded clinically. MRI and repeated CT and neurological examination were performed in all of the patients. The patients were divided into two groups: neurologically asymptomatic (group 1) and neurologically symptomatic (group 2). T2-weighted sequences demonstrated hyperintense areas in all of the patients involving the white and the grey matter of the brain. In group 1 the hyperintense lesions were significantly smaller than in group 2. The neurological symptoms correlated better with the hyperintensities on T2-weighted MR images than with the calcification demonstrated on CT. Hyperintensities in T2-weighted MRI and the areas shown by CT to have calcification had different locations. In 15 patients with dementia, the white matter of the entire centrum semiovale was bilaterally hyperintense. In another 3 patients with hemiparesis, hyperintense areas in the internal capsule, contralateral to the side of hemiparesis, were demonstrated in the T2-weighted sequence. The hyperintense T2 signals may reflect a slowly progressive, metabolic or inflammatory process in the brain which subsequently calcifies and are probably responsible for the neurological deficit observed.
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  • 83
    ISSN: 1432-1459
    Keywords: Optic neuritis ; Multiple sclerosis ; Magnetic resonance imaging ; Cerebrospinal fluid ; Immunoglobulin G
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Optic neuritis (ON) is a common first manifestation of multiple sclerosis (MS), and examination of patients with ON provides opportunities to study the early clinical stages of MS. This prospective study compares results of brain magnetic resonance imaging (MRI), cerebrospinal fluid (CSF) examinations and HLA-Dw2 phenotyping in 60 consecutive patients with ON. At a median of 17 days after the onset of ON, 69% had oligoclonal IgG bands, and at a median on 79 days after onset, 53% had multiple (≥ 3) white matter lesions on MRI. Subgroup analyses revealed that MRI abnormalities and oligoclonal IgG bands were equally common in patients examined early or late after the onset of ON. Strong correlations were found between the presence of MRI abnormalities and oligoclonal IgG bands. The HLA-Dw2 phenotype was significantly increased in ON patients compared with controls, but also significantly different from a group of MS patients from the same geographical area. A significant relation was found between Dw2 phenotype and oligoclonal IgG bands. During a mean follow-up time of about 2 years, the diagnosis in 17 of the patients changed to clinically definite MS. Initially, 16 of them had oligoclonal IgG bands and 12 had three or more MRI lesions. Both MRI and CSF studies are important diagnostic tools in the work-up of ON patients.
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  • 84
    ISSN: 1432-1459
    Keywords: Prosopagnosia ; Visual memory ; Right occipitotemporal lesion ; Magnetic resonance imaging ; Positron emission tomography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A patient is presented who developed prosopagnosia with a recent occipitotemporal infarct in the distribution of the right posterior cerebral artery. H ve topographical agnosia or object agnosia. He regained the ability to recognize faces of familiar persons, whereas he remained unable to identify faces of persons whom he met after the of persons whom he met after the disease onset. This case demonstrate that prosopagnosia may occur as a deficit of matching a perceived face to a memory store of the face, and that the failure to recognize unfamiliar faces may be due to the inability to form memory stores of new faces. These deficits can occur in association with a lesion confined to the right occipitotemporal region.
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  • 85
    ISSN: 1432-1459
    Keywords: Carpal tunnel syndrome ; Magnetic resonance imaging ; Therapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We examined 62 patients (72 hands) with carpal tunnel syndrome (CTS) by magnetic resonance imaging (MRI) of the carpal tunnel and latency measurements of the median nerve. In 32 of 72 hands a probable causative lesion of the CTS was identified by MRI, for example tenosynovitis, a cyst-like structure, or an aberrant muscle. The MRI findings were confirmed by surgery in 16 of 24 hands, slightly corrected in 5, and not substantiated in 3. In 65 of 72 hands, MRI disclosed pathology of the median nerve, most prominently an enlargement of the nerve at the level of the os pisiforme, a finding not seen during surgery. Oedema of the nerve was found in 14 of 72 hands. The distal latencies were prolonged in 62 of 72 hands. The sensory latencies correlated significantly with the MRI-determined cross-sectional area of the nerve at the level of the distal radius. The lack of other correlations suggests that partly independent features of the nerve lesion are demonstrated in each method or that the sensitivity and specificity of both methods are limited. Further experience with MRI in CTS is desirable. At present, the practical use of MRI in CTS should be restricted to special diagnostic problems such as carpal tunnel syndromes which do not respond adequately to conservative or surgical treatment.
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  • 86
    ISSN: 1432-2161
    Keywords: Sarcoidosis ; Mnscle ; Scintigraphy ; Magnetic resonance imaging ; Computed tomography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Scintigraphy using gallium-67 (67Ga) citrate and penvaralent technetium-99m dimercaptosuccinic acid {[99mTc(V)]DMSA} and other radiological examinations were performed in three patients with solitary muscular sarcoidosis who had tumor-like muscular lesions. Although distinction from other invasive soft tissue tumors was difficult using plain and enhanced computed tomography and magnetic resonance imaging, marked uptake of67Ga and moderate uptake of [99mTc(V)]DMSA were shown at the sites of granulomatous inflammatory lesions of sarcoidosis. Both67Ga and [99mTc(V)]DMSA scintigraphy could be of value in the diagnosis and detection of distribution of granulomas of sarcoidosis in the soft tissue and in determining the appropriate region for biopsy.
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  • 87
    ISSN: 1432-2161
    Keywords: Magnetic resonance imaging ; Fatty tumors ; Childhood
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract This study correlates the magnetic resonance imaging characteristics with the pathologic findings in rare benign fatty soft tissue tumors in four children. A review of the literature is presented. Two cases of infiltrating lipoma displayed bright signal on both T1- and T2-weighted images, similar to that observed in subcutaneous fat. Histological study revealed extensive muscle infiltration by mature fat, with some areas of total fatty replacement. The case of facial lipomatosis revealed an extensive process of fatty invasion of adjacent soft tissue and osseous deformity by mass effect of the tumor. This lesion was bright on T1- and T2-weighted images. Histopathologic examination showed widespread invasion of squamous mucosa and skeletal muscle. The single case of lipoblastoma involved the presacral region and right buttock. This lesion, although bright on both T1 and T2 weighting, was relatively hypointense to subcutaneous fat on T1. Microscopic examination revealed a well-encapsulated fatty mass made up of cells ranging from lipoblasts to mature lipocytes. In childhood, when fatty lesions are almost always benign, a morphologic characterization by magnetic resonance may be sufficient basis on which to make critical therapeutic judgements.
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  • 88
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    Skeletal radiology 23 (1994), S. 547-549 
    ISSN: 1432-2161
    Keywords: Hemochromatosis ; Knee arthropathy ; Magnetic resonance imaging ; Plain film radiography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract This study was undertaken to compare plain film radiography and magnetic resonance imaging in the assessment of hemochromatosis arthropathy of the knees of ten patients with a biopsy-proven diagnosis. Both modalities enabled visualisation of bony degenerative changes; magnetic resonance imaging enabled additional visualization of deformity of both cartilage and menisci. Magnetic resonance imaging failed reliably to confirm the presence of intra-articular iron in the patients studied. No correlation was observed between synovial fluid magnetic resonance signal values, corresponding serum ferritin levels, or the severity of the observed degenerative changes.
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  • 89
    ISSN: 1433-0350
    Keywords: Radiosurgery ; Magnetic resonance imaging ; Isodose distribution ; Computerized systems
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In stereotactic radiosurgery, thin external beams of ionizing radiation concentrated in a single dose onto a sharply defined target are employed to treat lesions within the brain, avoiding doses which may produce unwanted damage to the surrounding healthy tissue. The dynamic irradiation technique used with the linear accelerator employs variable arcs of irradiation rotating around the isocenter of the target. The technique of stereotactic magnetic resonance (MR) guided radiosurgery is supported by a dedicated computerized system for treatment planning simulation. The system, based on a personal computer, allows the acquisition, reconstruction, and visualization of the target volume from MR images, and permits calculation and visualization of a threedimensional dose distribution directly superimposed upon MR images of the lesion. The desired goal of destroying neoplastic tissue without damaging cerebral parenchyma is of particular importance in children. Consequently, adapting the three-dimensional isodose profiles to the morphology of the lesion to be treated is crucial. From this, the importance of the computer simulation is evident, as it permits one to go deeply into the study of isodose distribution, changing beam collimation, and the number and amplitude of arcs of irradiation.
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  • 90
    Electronic Resource
    Electronic Resource
    Springer
    Child's nervous system 10 (1994), S. 275-278 
    ISSN: 1433-0350
    Keywords: Mutism ; Posterior fossa ; Children ; Computed tomography ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract An 8-year-old girl developed mutism after removal of a vermian medulloblastoma. The mutism was not accompanied by long tract signs or cranial nerve palsy. The girl started to regain her speech 2 weeks postoperatively, showing marked improvement 2 months after the operation, after passing through a dysarthric phase. Magnetic resonance imaging showed only normal postoperative changes without abnormalities of dentate nuclei or supranuclear region. Nineteen similar cases of transient mutism following cerebellar operations have been reported in the literature, most of them with a delayed postoperative onset. In all patients the recovery of speech started to appear 4 days to 4 months postoperatively, and all patients passed through a monotonous, dysarthric phase. The absence of long tract or other brain stem signs, together with the presence of dysarthria during the recovery of speech, suggested a cerebellar cause of the transient mutism. Various hypotheses advanced to explain the pathogenesis of this speech disorder are analyzed.
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  • 91
    ISSN: 1433-0350
    Keywords: Desmoplastic infantile ganglioglioma ; Magnetic resonance imaging ; Immunocytochemistry
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The clinical course and radiological and histological findings in a 30-month-old boy suffering from desmoplastic infantile ganglioglioma are reported. The child's development was normal until a series of complex partial seizures occurred at the age of 7 months. Cranial computed tomography and magnetic resonance imaging revealed a cystic mass with intensive ring-shaped contrast enhancement in the right temporal fossa without shift of intracranial structures. Histologically, the firm, grayish tumor showed an enormous amount of connective tissue, cystic areas, and some mitoses. Glial and neuronal cell lines were identified by immunocytochemical methods. Eighteen months after surgery the boy had developed well without any neurological dysfunction; no radiation or chemotherapy was given. For the first time a synopsis of radiological findings in this rare brain tumor is correlated with the results of multiple histological and immunocytochemical studies. Despite some malignant characteristics, the prognosis of this dysontogenetic brain tumor is good.
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  • 92
    ISSN: 1433-0350
    Keywords: Neurofibromatosis ; Magnetic resonance imaging ; Optic glioma ; Visual function ; Visual evoked potentials
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Twenty-five asymptomatic patients with neurofibromatosis type 1 (NF 1), aged 6–21 years, underwent the following examinations: intracranial magnetic resonance testing (MRI), visual acuity testing, ophthalmoscopy, and visual field and pattern reversal visual evoked potentials (VEPs). MRI showed enlargement of one or both optic nerves in six children, with bilateral involvement in three. VEPs were normal in all these patients; two of them had abnormalities on other visual examinations, although there were no subjective visual disturbances. These results show that VEPs cannot be considered as a screening test for optic pathway lesions in children with NF 1, as previously stated, and that other types of visual function examination may be more sensitive. These data may contribute to the establishment of more precise guidelines for the evaluation and treatment of children with NF 1.
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  • 93
    ISSN: 1432-2161
    Keywords: Rotator cuff ; Shoulder ; Magnetic resonance imaging ; Partial tear ; Gradient echo
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Most magnetic resonance (MR) studies evaluating the rotator cuff for tears have used T2-weighted imaging in the coronal oblique and sagittal oblique planes, T2*-weighted gradient echo imaging, however, has advantages over spin echo imaging, including contiguous slices without cross-talk, high contrast around the cuff, and intrinsically shorter imaging times which can be used to increase the number of signals averaged and thus improve the signal-to-noise ratio. We reviewed the shoulder MR scans of 87 consecutive patients who underwent both a MR scan and a shoulder arthroscopy during which the size of tears, if present, was graded. The reviewers were blinded as to the history and arthroscopic results. The MR scans included oblique coronal T2*-weighted gradient echo and oblique sagittal T2-weighted spin echo images. MR cuff grades were correlated with arthroscopic findings. For complete tears, the sensitivity of MR was 0.91 and the specificity 0.95. For partial tears, the sensitivity was 0.74 and the specificity 0.87. This accuracy is similar to two-plane T2-weighted imaging as previously reported in the literature. There was a statistically significant correlation (p 〈 0.0005) between the cuff grade as determined by MR and the arthroscopic findings.
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  • 94
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    Skeletal radiology 23 (1994), S. 19-22 
    ISSN: 1432-2161
    Keywords: Magnetic resonance imaging ; Fracture ; Occult fracture ; Femur ; Osteoporosis ; Osteopenia ; Radionuclide bone scanning ; Bone scintigraphy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The evaluation of the painful hip in the elderly osteoporotic patient with normal plain radiographs can be difficult. We studied 15 osteopenic patients with normal plain radiographs and suspected hip fractures with magnetic resonance (MR) imaging and found MR to be an excellent aid in detecting occult fractures. A clear fracture was seen in 10 of the 15 patients, who then underwent surgical repair based on the MR study. The remaining patients had no MR-demonstrable fracture and were successfully treated nonoperatively. Some believe that a negative bone scan in this population of patients should be repeated within 3 days prior to a definitive “no fracture” decision being made. Unfortunately, bone scanning lacks spatial resolution, and increased osteoblastic activity may be caused by other pathologic processes besides fracture. Two of the 15 patients had MR-demonstrated bone infarcts near the fracture. One patient also had femoral head osteonecrosis on the side of the fracture. One patient with metastatic prostatic carcinoma had a hip fracture and one patient with metastatic breast carcinoma had no fracture. Not only is MR imaging an excellent technique for delineating occult fractures, but due to its spatial resolution, associated bone disorders adjacent to fractures can be detected in most instances. From a cost perspective, rapid diagnosis and early treatment of an occult femoral fracture is advisable. A reduced hospital stay pending diagnosis and the early institution of definitive therapy also decrease the chance that a simple non-displaced fracture will displace and require more complex management with resultant increased morbidity and cost. We propose that, especially in elderly, osteopenic patients with normal plain radiographs and a high index of suspicion for hip fracture, MR can serve as the sole additional imaging study in most instances.
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  • 95
    ISSN: 1432-2161
    Keywords: Soft tissue tumors ; Magnetic resonance imaging ; Hemangioma ; Fluid-fluid levels
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Five cases of cavernous hemangioma with fluid-fluid levels on magnetic resonance imaging and/or computed tomography are reported. The signal characteristics were those of blood and histological analysis of the fluid-fluid levels showed that they were blood-filled cavities in the tumor. Although this finding itself is not specific, it may help in confirming the diagnosis of cavernous hemangioma.
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  • 96
    ISSN: 1432-2161
    Keywords: Knee joint ; Menisci, tibial ; Ligaments, articular ; Anterior cruciate ligament ; Joint instability ; Magnetic resonance imaging ; Sagittal ; Coronal
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Sagittal images usually receive the most scrutiny in the magnetic resonance evaluation of meniscal and anterior cruciate ligament tears. We assessed the relative contribution of the coronal view. All knee magnetic resonance examinations performed over a 2-year period that had surgical confirmation were reviewed with respect to the presence of meniscal and anterior cruciate ligament tears. The appearance of an attenuated but uninterrupted anterior cruciate ligament was also evaluated. The coronal and sagittal plane images were evaluated separately. The study included 68 medial menisci, 67 lateral menisci, and 71 anterior cruciate ligaments. The coronal view is especially useful in the evaluation of the lateral meniscus. An anterior cruciate ligament that appears attennated but uninterrupted should be considered intact. The anterior cruciate ligament may be evaluated on the coronal view. The coronal view should be regarded as similar to the lateral chest radiograph, which supplements, but does not replace, the frontal chest radiograph.
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  • 97
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    Knee surgery, sports traumatology, arthroscopy 2 (1994), S. 147-149 
    ISSN: 1433-7347
    Keywords: Occult bone injury ; Knee injury ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine , Sports Science
    Notes: Abstract Knee injury evaluation with magnetic resonance imaging (MRI) has enabled a high percentage of associated diagnoses of occult bone injuries. An experimental occult bone injury was produced in the rabbit knee with a controlled impact in the range of approximately half the fracture force. An MR image of the occult bone imjury was obtained after killing the animals at 1, 3 and 9 weeks after impact. Histological study of the area under optical microscopy showed a benign, self-resolving injury paltern in the subchondral cancellous bone. The samples were compared with 11 human biopsy samples obtained during knee surgery. The same benign pattern was observed except for one case. The healing response of this injury at the subfracture level appears rather benign, and a permanent scar will probably not develop.
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  • 98
    ISSN: 1432-1459
    Keywords: Multiple sclerosis ; Evoked potentials ; Cerebrospinal fluid oligoclonal banding ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The sensitivities and predictive values of visual, somatosensory, and brain auditory evoked potentials (EPs), cerebrospinal fluid oligoclonal banding (CSF-OB) and magnetic resonance imaging (MRI) were evaluated for the early diagnosis of clinically definite multiple sclerosis (CDMS). Paraclinical evidence of asymptomatic lesions allows a diagnosis of CDMS. Eighty-two patients in whom MS was suspected but diagnosis of CDMS was not possible entered the study prospectively. Paraclinical examinations were performed at entry. Patients were examined and underwent EPs every 6 months, and MRI yearly. After a mean follow-up of 2.9 years, 28 patients (34%) had developed CDMS (McDonald-Halliday criteria). The initial MRI was strongly suggestive of MS in 19 of these (68%), while 27 (96%) had at least one MS-like abnormality in the initial MRI. CSF-OB and EPs had lower sensitivities. CDMS developed during follow-up in 19 of the 36 patients (53%) who had an initial MRI strongly suggestive of MS but in only 1 of the 25 who had normal MRI when first studied. These results support previous conclusions that MRI is the most sensitive test for detecting white matter asymptomatic lesions, and the most predictive for the diagnosis of CDMS.
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  • 99
    ISSN: 1432-1459
    Keywords: Neuro-Behcet's disease ; Magnetic resonance imaging ; Brain-stem auditory evoked potentials
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We studied central nervous system lesions in patients with neuro-Behcet's disease using magnetic resonance imaging (MRI) of the brain and recording of brain-stem auditory evoked potentials (BAEPs). MRI revealed abnormal findings in seven of eight patients. MRI studies demonstrated extensive regions with high intensity signal in the brain stem and/or basal ganglia on T2-weighted images obtained during the acute stage of the disease in three patients. One of these patients had a strongly gadolinum-enhanced round lesion in the lower pons. In four of the other five patients with chronic disease, brain-stem atrophy was observed on T1-weighted images. Atrophic changes were more severe in the brain stem than in the cerebellum. Abnormal BAEPs were observed in three patients and consisted of prolongation of interpeak latency of waves III-V and defects of wave III or V. Abnormal BAEPs were recorded in patients with severe inflammatory changes or progression of atrophic changes in the brain stem. Our findings show that MRI and BAEPs are useful in detecting the presence and assessing the degree of neurological involvement in patients with neuro-Behcet's disease.
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  • 100
    ISSN: 1619-7089
    Keywords: Magnetic resonance imaging ; Metaiodobenzylguanidine scintigraphy ; Paragangliomas ; Phaeochromocytomas
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Paragangliomas are tumours arising from paraganglionic tissue dispersed from the base of the skull to the pelvic diaphragm. These tumours produce symptoms by secreting catecholamines (functioning tumours) or by local tumour expansion. They can be part of several hereditary disorders. The introduction of magnetic resonance (MR) imaging and metaiodobenzylguanidine (MIBG) scintigraphy has provided new insights into paragangliomas and has tremendously changed the topographic diagnosis of paragangliomas. Both techniques have proven to be adequate in localising paragangliomas. In this report, the performance of these two non-invasive imaging methods in the examination of paragangliomas is compared and the merits and deficits of the two techniques are discussed. Both techniques produce comparable results in the detection of functioning paragangliomas. MR imaging, however, also demonstrates tumours that do not take up MIBG. MR imaging does not involve the use of ionising radiation and is not hampered by medication. Moreover, MR imaging has a higher spatial resolution. Because of these merits it is concluded that for demonstration of paragangliomas, wholebody MR imaging is the preferred and initial method of investigation. MIBG scintigraphy, on the other hand, continues to be a reliable method for non-invasive detection of functioning paragangliomas. At present it is clearly faster in whole-body imaging than MRI and it is definitely patient-friendly (no claustrophobia). It could be reserved for cases where a strong suspicion of a functioning paraganglioma persists, despite normal MR imaging findings, and for cases where doubt exists about the functional activity of one or more multicentric tumours. MIBG scintigraphy must be used in the evaluation of patients referred for iodine-131 MIBG treatment.
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