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1.
Magnetic resonance urography: initial experience of a low-dose Gd-DTPA-enhanced technique 总被引:2,自引:0,他引:2
Contrast-enhanced magnetic resonance urography (MRU) is a promising tool in the evaluation of the renal collecting system,
but it can be limited by T2* effects resulting from hyperconcentrated gadolinium chelates. The aim of this study was to evaluate a low-dose dimeglumine
gadopentetate (Gd-DTPA) MRU technique consisting of a dynamic fast low-angle-shot (FLASH) 2D sequence and a static fast imaging
in steady state precession (FISP) 3D sequence for depicting the kidneys and urinary tract. The Gd-DTPA dose (0.01 mmol/kg)
was established experimentally in a healthy volunteer study. Ninety-one patients presenting with various renal disorders were
examined with a low-dose Gd-DTPA MRU and a T2-weighted turbo spin echo (TSE) MRU technique on a 1.5-T system. Image quality
and diagnostic value were considered at least satisfactory in 98.9 % of the FLASH 2D studies, 83.5 % of the FISP 3D studies
and 78.5 % of the TSE T2-weighted studies. Typical enhancement patterns were established for the renal cell carcinoma and
transitional cell carcinoma. The major limitations were motion artefacts and insufficient hydration of the patients. Low-dose
Gd-DTPA MRU appears to be a useful technique in the evaluation of the kidneys and urinary tract, especially in cases of renal
tumours.
Received: 26 February 1998; Revised: 25 January 1999; Accepted: 14 June 1999 相似文献
2.
Congenital abnormality of the aortic arch is a diagnosis made most of the time incidentally in childhood, unless dysphagia
or respiratory disorders occur before. A case of a complex aortic arch anomaly with an aneurysm of the right subclavian artery
presenting as an isolated Horner's syndrome in an adult is reported herein. Magnetic resonance imaging led to this very unusual
diagnosis.
Received: 17 March 1999; Revised: 15 July 1999; Accepted: 13 August 1999 相似文献
3.
Compressive vertebral haemangiomas (VHs) are rare. Correct preoperative diagnosis is useful both for operative planning (since
compressive VHs are extremely vascular lesions) and to allow preoperative embolisation. Numerous radiological signs for VHs
have been described, but compressive VHs frequently have atypical features. In particular, magnetic resonance features are
not well established. We present imaging features in three cases of compressive VH and review the imaging findings in an additional
106 previously published cases. Findings were typical in 52 of 80 plain film (65 %), 33 of 41 computed tomography (80 %) and
13 of 25 magnetic resonance examinations (52 %). The prevalence of previously described imaging features is reported. Awareness
of the range of magnetic resonance features is important since this is frequently the initial investigation in patients presenting
with symptoms of neural compression. Since computed tomography is typical in 80 % of cases, this is a useful confirmatory
test if magnetic resonance features are suspicious but not diagnostic of compressive VH.
Received: 6 August 1999; Revised: 4 November 1999; Accepted: 4 November 1999 相似文献
4.
Coronary arteries 总被引:5,自引:0,他引:5
Coronary angiography (CA) is presently considered the gold standard for the assessment of the coronary arteries. However,
the presence of ionizing radiation, its invasiveness and the small associated risk of morbidity prompted long ago the development
of more patient-friendly imaging modalities. A promising technique, magnetic resonance imaging (MRI), has been regarded as
the major modality in the coming decade. Although still in its infancy qualitatively, its flexibility and non-invasiveness
opens the door for a comprehensive evaluation of the heart and the coronary arteries in one single sitting with high anatomical
definition and excellent soft tissue contrast capabilities, double-oblique tomographic sections and the possibility to quantify
an innumerable number of cardiovascular physiological parameters. Numerous ideas have been assessed, comprising breath-hold
and free-breathing two-dimensional and three-dimensional measurements. New ongoing trials with intravascular contrast agents
may provide for all these techniques the long-awaited essential boost for reliable magnetic resonance coronary angiography
(MRCA). Introduction of parallel MRI acquisition techniques, such as simultaneous acquisition of spatial harmonics (SMASH)
and sensitivity encoding (SENSE) may provide the speed enhancement required to shorten imaging time for all techniques explored
to date. 相似文献
5.
Imaging in ureteral complications of renal transplantation: value of static fluid MR urography 总被引:3,自引:0,他引:3
Schubert RA Göckeritz S Mentzel HJ Rzanny R Schubert J Kaiser WA 《European radiology》2000,10(7):1152-1157
Ureteral obstruction is an infrequent complication after renal transplantation that may cause rapid loss of transplant function.
We tested static fluid MR urography for determining the cause of graft hydronephrosis. Magnetic resonance urography was performed
in nine transplants with dilated collecting systems on ultrasound. A heavily T2-weighted 3D turbo spin-echo sequence on a
1.5-T scanner was used and maximum intensity projections were obtained. The patients also underwent excretory urography (n = 1), renal scintigraphy (n = 1), antegrade pyelography (n = 3), voiding cystourethrography (n = 4), and non-enhanced CT (n = 2). Six patients had pathologic conditions including ureteral stricture, compression by lymphoceles, implantation stenosis,
vesicoureteral reflux, and late-occurring transitional cell carcinoma at the implantation site. Static MRU was able to diagnose
or exclude a dilation of the graft collecting system. It visualized the course of the ureters and localized the obstruction
site in four of five obstructed transplants. In one case the ureter was obscured by lymphoceles, which were demonstrated by
hydrographic MRU as well. The definite cause for obstruction was provided in only 2 of 5 cases. Dilation due to vesicoureteral
reflux could not be differentiated. The current multimodality approach to renal transplant imaging already provides comprehensive
assessment of graft hydronephrosis. Static MRU may be useful in some cases since complications associated with intravenous
iodinated contrast or antegrade pyelography can be avoided. Its main drawback, the lack of functional information, may be
overcome by combining it with contrast-enhanced MRU.
Received: 18 February 1999; Revised: 23 July 1999; Accepted: 18 November 1999 相似文献
6.
Vanrietvelde F Lemmerling M Mespreuve M Crevits L De Reuck J Kunnen M 《European radiology》2000,10(4):576-578
The clinical, biochemical and magnetic resonance imaging findings of two patients with cerebrotendinous xanthomatosis are
reported. This is a rare hereditary disease. Early recognition of this entity is important in view of the existing treatment
possibilities. Magnetic resonance imaging findings typically include a bilateral and almost symmetrical increase of the signal
intensity on the T2-weighted images in the cerebellar and periventricular cerebral white matter, the basal ganglia, the dentate
nuclei and the brainstem as well as cerebellar and cerebral atrophy.
Received: 18 January 1999; Revised: 3 June 1999; Accepted: 7 June 1999 相似文献
7.
Magnetic resonance imaging in the assessment of urologic disease: an all-in-one approach 总被引:9,自引:0,他引:9
Verswijvel GA Oyen RH Van Poppel HP Goethuys H Maes B Vaninbrouckx J Bosmans H Marchal G 《European radiology》2000,10(10):1614-1619
The aim of this study was to evaluate an “all-in-one” MR procedure to examine the kidneys, the renal vascular supply and
renal perfusion, and the urinary tract. In 64 patients (58 with urologic disease and 6 healthy volunteers), MR was performed
including: (a) T1- and T2-weighted imaging; (b) 3D contrast-enhanced MR angiography (MRA), including the renal arteries, renal
veins, as well as renal perfusion; and (c) 3D contrast-enhanced MR urography (MRU) in the coronal and sagittal plane. For
the latter, low- and high-resolution images were compared. Prior to gadolinium injection, 0.1 mg/kg body weight of furosemide
was administered intravenously. The results were compared with correlative imaging modalities (ultrasonography, intravenous
urography, CT), ureterorenoscopy and/or surgical–pathologic findings. Visualization of the renal parenchyma, the vascular
supply, and the collecting system was adequate in all cases, both in nondilated and in dilated systems and irrespective of
the renal function. One infiltrating urothelial cancer was missed; there was one false-positive urothelial malignancy. Different
MR techniques can be combined to establish an all-in-one imaging modality in the assessment of diseases which affect the kidneys
and urinary tracts. Continuous refinement of the applied MR techniques and further improvements in spatial resolution is needed
to expand the actual imaging possibilities and to create new tracts and challenges in the MR evaluation of urologic disease.
Received: 27 September 1999; Revised: 20 January 2000; Accepted: 22 May 2000 相似文献
8.
Vázquez-Barquero A Abascal F García-Valtuille R Pinto JI Figols FJ Cerezal L 《European radiology》2000,10(10):1602-1605
An uncommon case of chronic nontraumatic spinal epidural hematoma of the lumbar spine in a 75-year-old woman is reported.
The patient presented with a 7-month history of low back pain and bilateral sciatica. Magnetic resonance imaging enabled a
correct preoperative diagnosis revealing a nodular, well-circumscribed epidural mass with peripheral enhancement and signal
intensities consistent with chronic hematoma, which extended from L2 to L3. Laminectomy of L2–L3 was performed and the hematoma
was totally resected. Histological examination of the surgical specimen demonstrated a chronic encapsulated hematoma. No evidence
of vascular malformation was found. The patient recovered fully after surgical treatment.
Received: 23 August 1999; Revised: 13 January 2000; Accepted: 4 February 2000 相似文献
9.
Tumors of the cardiac valves: imaging findings in magnetic resonance imaging, electron beam computed tomography, and echocardiography 总被引:2,自引:0,他引:2
Wintersperger BJ Becker CR Gulbins H Knez A Bruening R Heuck A Reiser MF 《European radiology》2000,10(3):443-449
We describe the findings from various cross-sectional imaging modalities in patients with cardiac valve adherent masses.
The techniques are discussed, and imaging findings are compared with the results of cardiac surgery. All three patients had
neurological symptoms and/or cardiac murmurs. Transthoracic and/or transesophageal echocardiography revealed the cardiac mass
in all three. For differentiation of thrombus and cardiac neoplasm magnetic resonance imaging (MRI) was also performed in
all three patients and electron-beam computed tomography (EBCT) in two. Fast segmented cine gradient-echo MRI techniques provided
mass depiction in all patients, while T1-weighted spin-echo imaging failed in mass detection in one patient. None of the patients
showed evidence of valve regurgitation or stenosis in flow sensitive cine MRI. EBCT excluded mass calcifications in both patients
and reliably demonstrated the valve attached lesions. Although echocardiography is the modality of choice in evaluating cardiac
masses and especially valve attached masses, MRI and EBCT provide additional information about tissue characteristics and
allows an excellent overview of the cardiac and paracardiac morphology. Fast segmented cine gradient-echo MRI is especially
able to depict even small tumors attached to rapidly moving cardiac valves, and valve competence can be easily assessed within
the same examination.
Received: 17 December 1998; Revision received: 1 June 1999; Accepted: 10 August 1999 相似文献
10.
Detection of severe acute pancreatitis by contrast-enhanced magnetic resonance imaging 总被引:3,自引:0,他引:3
Piironen A Kivisaari R Kemppainen E Laippala P Koivisto AM Poutanen VP Kivisaari L 《European radiology》2000,10(2):354-361
The aim of the study was to assess the ability of MRI to differentiate between the two forms of severity of acute pancreatitis
(AP), which is important for the detection of patients who require intensive monitoring and therapy. The second objective
was to evaluate whether the distinction would be possible regardless of the MRI equipment. Magnetic resonance imaging was
performed before and after intravenous administration of a gadolinium (Gd) chelate at 1.0 T using the breath-hold multislice
rapid gradient-echo turbo fast low-angle shot (FLASH) sequence in 14 patients, and at 1.5 T with the 2D FLASH(50) sequence
with fat saturation in 18 patients with acute pancreatitis early in the course of the disease. The patients were classified
according to the Atlanta classification system as having the mild (MAP) or severe (SAP) form of the disease. At 1.0 T with
use of a body coil, contrast-enhanced MRI failed to distinguish mild from severe pancreatitis. At 1.5 T with a phased-array
body coil, the signal intensities of the patients with SAP were statistically significantly lower than those of the MAP group.
Our initial clinical experience suggests that MRI with a sufficient magnetic field gradient strength may be useful for separating
the two forms of acute pancreatitis in their early phases.
Received: 19 January 1999; Revised: 28 May 1999; Accepted: 22 July 1999 相似文献
11.
Sener RN 《European radiology》2000,10(9):1452-1455
A patient is reported with diffuse leukoencephalopathy associated with cystic degeneration of the white matter of the brain
(van der Knaap syndrome). The changes were studied by fluid attenuated inversion recovery (FLAIR), and diffusion-weighted
MR imaging. The FLAIR sequence revealed suppressed signal of the cysts, and widespread high-signal white matter changes associated
with thinned cortices. On diffusion-weighted MR imaging, apparent diffusion coefficient (ADC) values ranged from 3.0 × 10–3 to 2.7 × 10–3 mm2/s in the temporal cysts, similar to that of CSF. The ADC values within the parenchyma ranged between 2 × 10–3 and 2.1 × 10–3 mm2/s, a value falling between normal parenchyma and cerebrospinal fluid, compared with a control group of three healthy subjects.
The changes were also evaluated by proton MR spectroscopy, and were compared with a control group of 12 cases. Magnetic resonance
spectroscopy revealed apparently increased NAA/Cr ratios in most parts of the brain. The NAA/Cho ratios were either high or
low, and the Cho/Cr ratios were increased or normal in different regions.
Received: 27 October 1999; Revised: 9 December 1999; Accepted: 20 December 1999 相似文献
12.
The aim of this study was to determine the accuracy in quantifying right and left ventricular volumes using a 1.0-T system
and commercially available, standard equipment. For exact comparison of MRI measurements and real volumes we used an animal
heart model ex vivo. Eight pig hearts were explanted and prepared by removal of the atria. Aorta and pulmonary truncus were
cannulated. Definable volumes were injected into the ventricles. Magnetic resonance imaging was performed at 1.0 T (Gyroscan
T10 NT, Philips, Eindhoven, The Netherlands); sequence: fast field echo–echo planar (multishot EPI); body coil; MR software:
Cardiac Application Package (Philips). Statistical analysis correlated the real volumes and MR measurements separately for
both ventricles and two investigators (SAS, ANOVA). For both ventricles and both investigators the correlation between real
volumes and MR measurements was greater than 0.99. There was no significant systematic false estimation for both ventricles.
Magnetic resonance imaging at 1.0 T using standard hardware and software equipment enables the quantification of right and
left ventricular volumes with high approximation to the real volumes in vitro. There is a clear restriction in translating
these data into a clinical application because under experimental conditions no motion-induced artifacts existed.
Received: 22 July 1999; Accepted: 27 August 1999 相似文献
13.
We report on a 46-year-old patient in whom an intracranial dural arteriovenous (AV) fistula, supplied by a branch of the
ascending pharyngeal artery, drained into spinal veins and produced rapidly progressive symptoms of myelopathy and brainstem
dysfunction including respiratory insufficiency. Magnetic resonance imaging studies demonstrated brainstem oedema and dilated
veins of the brainstem and spinal cord. Endovascular embolization of the fistula led to good neurological recovery, although
the patient had been paraplegic for 24 h prior to embolization. This case demonstrates the MRI characteristics of an intracranial
dural AV fistula with spinal drainage and illustrates the importance of early diagnosis and treatment. Even paraplegia may
be reversible, if angiography is performed and the fistula treated before ischaemic and gliotic changes become irreversible.
Received: 25 May 1999; Revised: 25 January 2000; Accepted: 15 February 2000 相似文献
14.
Petit P Vivarrat-Perrin L Champsaur P Juhan V Chagnaud C Vidal V Gaubert JY Bartoli JM Dessi P Zanaret M Moulin G 《European radiology》2000,10(7):1184-1189
The aim of this study was to describe cross-sectional imaging features of recurrent papilloma of the nasal fossa and paranasal
sinuses and to evaluate the role of MR and CT in the postoperative follow-up of this lesion. Magnetic resonance imaging and
CT of ten patients who presented recurrence of inverted papilloma were reviewed and correlated to initial imaging, endoscopy,
and surgical reports. Imaging patterns of recurrent inverted papilloma are identical to those of initial tumors and recurrence
location is closely related to the site of the former lesion. Magnetic resonance is more efficient than CT for the diagnosis
and evaluation of extensions. Magnetic resonance supplies the deficiencies of endoscopy in case of extensions to the frontal
sinus or the lateral recess of the antrum, especially if mucosal hyperplasia or sinusitis is associated. Magnetic resonance
imaging is the first imaging modality to perform in the follow-up after removal of inverted papilloma.
Received: 28 April 1999; Revised: 18 November 1999; Accepted: 19 November 1999 相似文献
15.
MR imaging of pituitary hyperplasia in a child with growth arrest and primary hypothyroidism 总被引:5,自引:0,他引:5
Papakonstantinou O Bitsori M Mamoulakis D Bakantaki A Papadaki E Gourtsoyiannis N 《European radiology》2000,10(3):516-518
Magnetic resonance imaging of pituitary hyperplasia has been rarely described in children with primary hypothyroidism. We
report a case of pituitary hyperplasia in a child presented with significant growth arrest and laboratory evidence of hypothyroidism.
Magnetic resonance imaging revealed symmetrical pituitary enlargement simulating macroadenoma. After thyroid hormone replacement
therapy, the child's height increased and pituitary enlargement regressed to normal. Awareness of MRI appearance of pituitary
hyperplasia in children with laboratory evidence of hypothyroidism might avoid misdiagnosis for pituitary tumor, which may
also manifest as growth disorder, obviating unnecessary surgery.
Received: 4 March 1999; Revision received: 4 June 1999; Accepted: 7 June 1999 相似文献
16.
The role of MR imaging in invasive cervical carcinoma 总被引:6,自引:0,他引:6
In this article the role of MR imaging in the management of cervical cancer is reviewed and illustrated. The appearance of
the normal uterine cervix and of cervical carcinoma is shown. Important factors for optimal MR imaging of cervical carcinoma
are reviewed. The value of MR imaging in the staging of cervical carcinoma is illustrated by showing parametrial invasion
and lymph node involvement. Finally, the value of MR imaging staging is compared with clinical staging, CT staging, and surgical
findings. The role of new imaging techniques, such as fast dynamic enhanced MR imaging, is described.
Received: 12 April 1999; Revised: 13 July 1999; Accepted: 14 July 1999 相似文献
17.
Renal artery blood flow: quantification with breath-hold or respiratory triggered phase-contrast MR imaging 总被引:3,自引:0,他引:3
The aim of this study was to evaluate the validity and reproducibility of breath-hold and respiratory triggered phase-contrast
(PC) MR imaging techniques in the measurement of renal artery blood flow. In 12 healthy subjects cardiac-gated PC flow measurements
were obtained in the renal arteries using a breath-hold and a respiratory-triggered technique. The flow measurements were
repeated in each renal artery separately. Comparison between the sum of flow measurements in the renal arteries and the difference
in aortic flow measurements above and below the renal arteries served as an internal control. The flow measurements showed
a good reproducibility both with the breath-hold (r = 0.92, p < 0.0001) and with the respiratory-triggered (r = 0.91, p < 0.0001) technique. The validity of both methods was good and there was no statistically significant difference. Reproducible
quantitative measurements of renal artery blood flow are possible with respiratory controlled, cardiac-gated, PC MR imaging.
Received: 12 February 1999; Revised: 8 February 2000; Accepted: 9 February 2000 相似文献
18.
MR imaging of lumbar facet joint synovial cysts 总被引:5,自引:0,他引:5
The increasing application of magnetic resonance (MR) imaging of the spine has raised the awareness of lumbar facet synovial
cysts (LFSC). This well recognised, yet uncommon condition, presents with low back pain and radiculopathy due to the presence
of an extradural mass. The commonest affected level is L4/5 with a mild degenerative spondylolisthesis a frequent associated
finding. MR imaging is the technique of choice to detect and diagnose a LFSC. This pictorial essay, drawing on experience
of 43 cases seen in 40 patients, illustrates the spectrum of appearances that can be encountered and suggest differing causes
for the variable signal characteristics exhibited. Computed tomography (CT) can be of value in some cases to aid interpretation
of the MR images. In addition, CT facet arthrography by injection of air or iodinated non-ionic contrast medium may be used
to confirm the diagnosis in doubtful cases as well as noting whether the patients presenting symptoms can be provoked. A comprehensive
review of the existing literature is presented.
Received: 22 September 1998; Revised: 29 June 1999; Accepted: 30 June 1999 相似文献
19.
A case of isolated bilateral xanthogranulomatous perinephritis, which presented as a symmetrical irregular perirenal rim
of soft tissue, is reported. Differential diagnosis and image features on ultrasound, computed tomography, and magnetic resonance
are discussed.
Received: 20 May 1999; Revised: 20 July 1999; Accepted: 22 July 1999 相似文献
20.
Lycklama à Nijeholt GJ Uitdehaag BM Bergers E Castelijns JA Polman CH Barkhof F 《European radiology》2000,10(2):368-376
We examined the value of spinal cord magnetic resonance imaging (MRI) in the diagnostic work-up of multiple sclerosis (MS).
Forty patients suspected of having MS were examined within 24 months after the start of symptoms. Disability was assessed,
and symptoms were categorized as either brain or spinal cord. Work-up further included cerebrospinal fluid analysis and standard
proton-density, T2-, and T1-weighted gadolinium-enhanced brain and spinal cord MRI. Patients were categorized as either clinically
definite MS (n = 13), laboratory-supported definite MS (n = 14), or clinically probable MS (n = 4); four patients had clinically probable MS, and in nine MS was suspected. Spinal cord abnormalities were found in 35
of 40 patients (87.5 %), consisting of focal lesions in 31, only diffuse abnormalities in two, and both in two. Asymptomatic
spinal cord lesions occurred in six patients. All patients with diffuse spinal cord abnormality had clear spinal cord symptoms
and a primary progressive disease course. In clinically definite MS, the inclusion of spinal imaging increased the sensitivity
of MRI to 100 %. Seven patients without a definite diagnosis had clinically isolated syndromes involving the spinal cord.
Brain MRI was inconclusive, while all had focal spinal cord lesions which explained symptoms and ruled out other causes. Two
other patients had atypical brain abnormalities suggesting ischemic/vascular disease. No spinal cord abnormalities were found,
and during follow-up MS was ruled out. Spinal cord abnormalities are common in suspected MS, and may occur asymptomatic. Although
diagnostic classification is seldom changed, spinal cord imaging increases diagnostic sensitivity of MRI in patients with
suspected MS. In addition, patients with primary progressive MS may possibly be earlier diagnosed. Finally, differentiation
with atypical lesions may be improved.
Received: 21 April 1999; Revised: 3 August 1999; Accepted: 7 August 1999 相似文献