Depiction of normal gastrointestinal anatomy with MDCT: comparison of low- and high-attenuation oral contrast media

PURPOSE: To compare low- and high-attenuation oral contrast media for depiction of normal gastrointestinal anatomy with multidetector-row computed tomography (MDCT). MATERIALS AND METHODS: A prospective, randomized study of 90 consecutive patients without known or suspected gastrointestinal disease was conducted after the approval of our Institutional Review Board. All patients underwent IV contrast-enhanced abdominal and pelvic CT scans after oral administration of 900 ml of either low- or high-attenuation barium sulphate suspension. Using a five-point scale, two radiologists independently graded distention and wall visualization of stomach, duodenum, jejunum, and ileum. The degree of distention and wall visualization was compared using Mann-Whitney U-test. RESULTS: Duodenal, jejunal and ileal distention (p<0.05, <0.001, <0.001, respectively) and wall visualization (p<0.05, <0.01, <0.05, respectively) scores with low-attenuation contrast medium were significantly higher than those with high-attenuation barium sulphate preparation, for reader 1. Duodenal and jejunal wall visualization scores with low-attenuation contrast medium (p<0.05, <0.01, respectively) were significantly higher than those with high-attenuation contrast medium, for reader 2. Interobserver agreement was fair to good for both distention (kappa-range: 0.41-0.74) and wall visualization (kappa-range: 0.48-0.71). CONCLUSION: MDCT with low-attenuation contrast medium provides distention and wall visualization of the GI tract that is equal or better than high-attenuation contrast medium.     

乳腺肿块的高频彩超诊断与病理对照分析

 目的 探讨高频彩超在鉴别乳腺良、恶性肿块中的价值.方法 对经病理证实的乳腺良、恶性肿块86例的高频彩超进行回顾性分析.结果 高频彩超检查乳腺肿块86例,良性61例,超声检出57例,恶性肿块25例,超声检出23例.以RI =0.7为标准,诊断乳腺癌的敏感性0.92,特异性0.966,准确性0.930.彩色多普勒的阻力指数(RI)、脉动指数(PI)在良、恶性肿块中均有统计学差异(P＜0.01).彩超根据肿块彩色血流丰富程度分4级,良性肿块0、Ⅰ级为主,恶性肿块Ⅱ、Ⅲ级为主,二者有统计学差异(P＜0.01).结论 高频彩超对乳腺性肿块的检出率高,应用二维声像图特点与彩色多普勒分析,综合判断,可明显提高对乳腺良、恶性肿块的诊断水平.     

Accuracy and reproducibility of simple cross-sectional linear and area measurements of brain structures and their comparison with volume measurements

Volumetric measurement of brain structure on brain images is regarded as a gold standard, yet is very time consuming. We wondered whether simple linear and area measurements might be as accurate and reproducible. Two observers independently measured the cross-sectional area of the corpus callosum, lentiform and caudate nuclei, thalamus, amygdalas, hippocampi, lateral and third ventricles, and the width of the sylvian and frontal interhemispheric fissures and brain stem on brain MRI of 55 patients using a program written in-house; one observer also measured the volumes of the basal ganglia, amygdalo-hippocampal complex and ventricular system using Analyze, and performed qualitative assessment of four regions (lateral and third ventricles, cortex, and medial temporal lobe) using the Lieberman score. All measures were performed blinded to all other information. Test objects of known size were also imaged with MRI and measured by the two observers using the in-house program. The true sizes of the test objects were measured using engineering calipers by two observers blind to the MRI results. Differences between the two observers using the same measurement method, and one observer using different methods, were calculated. The simple linear and cross-sectional area measurements were rapid (20 min versus 5 h for volumetric); were highly accurate for test-object measurement versus true size; had excellent intraobserver reliability; and, for most brain structures, the simple measures correlated highly significantly with volumetric measures. The simple measures were in general highly reproducible, the difference (as a percentage of the area or width of a region) between the two raters being around 10 %, range 0.1 %– 14.1 %, (similar to inter-rater variability in previous studies of volume measurements). The simple linear and area measures are reproducible and correlate well with the measured volumes, and there is a considerable time saving with the former. In circumstances where a large volume of work precludes detailed volume measurement, simple methods are reliable and can be used instead. Received: 28 January 2000 Accepted: 6 July 2000     

Ultrasonography in primary hepatic tumors: potentialities, limits and comparison with arteriography (author's transl)

The echotomographic patterns in 22 patients with hepatic neoplasms are reported and discussed. Ultrasonography has a high sensitivity in detecting the solid echopattern of the tumour and its origin from liver parenchyma; gray-scale B-scan and a meticulous technique are very helpful for this purpose. Echotomography plays an important part in the diagnostic evaluation of this pathology, to better select the patients for more invasive techniques, after the screening procedures, as scintigraphy.     

Sports-related injuries in children. A study of their characteristics, frequency, and severity, with comparison to other types of accidental injuries

In 1981 to 1982, within a 1 year period, details were recorded of children aged 0 to 15 years and 3 months, who were treated for accidental injury in a French health care district; 789 sports-related accidents were registered, representing 11% of all accidents. Sports areas were the leading sites of accident among children over age 12. Out-of-school sports accidents were more frequent among boys, but boys and girls had similar injury rates in school physical education. Compared to home, school, and road accidents, sports accidents had the highest rate of upper limb injury. The fracture rate was 22% and the hospitalization rate 11%. In most cases children were injured without any participation of other players or sports equipment. Sports-related injuries were usually benign, but several hospital admissions for the same accident were required in 20% of the admitted children (significantly higher than in home, school, and road accidents), and the time elapsed between the accident and the end of the last stay in hospital was significantly greater than in other kinds of accidents. This might be explained by a higher rate of epiphyseal fractures (10%) and internal fixation (17%). Musculoskeletal sequelae were observed in 12% of inpatient children.     

T1 hyperintensity of bladder urine at prostate MRI: frequency and comparison with urinalysis findings

Objective

The purpose of this study was to assess the possible clinical significance of bladder urine T1 hyperintensity based upon comparison with urinalysis findings, using a cohort of patients who underwent prostate MRI and urinalysis at a similar point in time during preoperative work-up.

Methods

We identified 56 patients who underwent prostatectomy at our institution who obtained prostate MRI and urinalysis within 1 day of each other preoperatively. A control group of 160 consecutive adult men who underwent pelvic MRI during the same time period for other indications was also identified. Two radiologists independently and in consensus reviewed the T1-weighted images to assess the frequency of bladder urine T1 hyperintensity in both groups. The urinalyses in the 56 men undergoing prostatectomy were reviewed, with the results compared between patients with and without bladder urine T1 hyperintensity.

Results

Four (7.1%) of 56 men with prostate cancer exhibited T1 hyperintense bladder urine, compared with six (3.8%) of 160 patients exhibiting this finding in the control group (P=.288). Of the four prostate cancer patients with this finding, all exhibited a normal urinalysis. An abnormal urinalysis was identified for four of the prostate cancer patients, all of whom exhibited normal urine T1 signal intensity.

Conclusion

Bladder urine T1 hyperintensity may be seen occasionally in patients with prostate cancer but is not associated with abnormal urinalysis and therefore should not be regarded as a sign of acute urinary pathology.     

Value and limits of arthrography in the study of pathological mediopatellar plicae of the knee; a comparison with arthroscopy

The results from arthroscopy and arthrography were compared in a prospective study of the mediopatellar plicae in 100 knees with internal disorders. With reference to arthroscopy, the sensitivity and specificity of arthrography for the detection of mediopatellar plicae were, respectively, 83.6 and 88.8%. The arthrographic signs of pathological plicae were: a thick plica, thicker than the internal condylar cartilage (sensitivity: 72%; specificity: 84%) and an interposed plica (sensitivity: 85%; specificity: 81.8%). Statistically the arthrographic signs agreed with the arthroscopic signs. The two methods did not differ significantly in their contribution to the diagnosis of pathological plicae.     

Diagnostic performance of ethyl glucuronide in hair for the investigation of alcohol drinking behavior: a comparison with traditional biomarkers

Background  

Ethyl glucuronide (EtG) in hair has emerged as a useful biomarker for detecting alcohol abuse and monitoring abstinence. However, there is a need to establish a reliable cutoff value for the detection of chronic and excessive alcohol consumption.     

The biokinetics and radiotoxicology of curium: a comparison with americium

The human and animal data on the biokinetics of (242)Cm and (244)Cm are reviewed and shown to be very similar to those for (241)Am. Liver and skeleton are the main organs of deposition and the retention of curium in the skeleton is very prolonged in all the species examined. Retention of both curium and americium in the liver appears to be species-dependent, being relatively rapidly removed from the liver of rats, and probably humans, but being tenaciously retained in dogs and some other species. The radiotoxicity of curium is also reviewed and it is shown that, as with (241)Am, lung and bone tumour induction are the major hazards from inhaled and systemically deposited (244)Cm. The use of chelating agents for the treatment of accidental contamination of the human body with (242,244)Cm is also discussed.     

The frequency of intracranial arterial fenestrations: A study with 64-detector CT-angiography

Fenestration is a vascular variation that begins with a common origin, then splits into two parallel luminal channels and rejoins distally. Potential association between anomalies of cerebral circulation and increased occurrence of aneurysm makes intracranial arterial fenestrations important. The planning of intracranial arterial interventions may be complicated if a fenestration occurs proximal to the site of intended treatment. This study is planned to determine the frequency of fenestrations on CT angiography and to search whether there is relationship between aneurysms and fenestrations.CT angiographies of 395 consecutive patients, performed by 64-detector CT, were retrospectively reviewed for aneurysms and fenestrations. Overall fenestration frequency, fenestration frequency in patients with and without aneurysm, and aneurysm frequency in patients with and without fenestration were searched. Demographic characteristics of patients were also compared. Overall fenestration frequency was 12.9%. Vertebrobasilar system (5.56%) and anterior communicating region (5.32%) were the two most frequent sites of fenestration. The rate of fenestrations was not significantly different between patients who had and did not have aneurysms. Mean age was significantly higher, and females were predominant in patients with aneurysms. However our results did not show significant difference in age and sex of patients with fenestrations.The frequency of fenestrations in this study is higher than in previously published radiological studies, suggesting that fenestrations are relatively common. There is no significant relationship between the frequency of aneurysms and fenestrations.     

Radiology residency call in the northeastern United States: comparison of difficulty and frequency in programs of different size

RATIONALE AND OBJECTIVES: The purpose of this study was to develop objective measures of residency call frequency and difficulty, to establish mean values for the northeastern United States, and to test those values for correlation with program size. MATERIALS AND METHODS: A survey questionnaire was sent to 104 radiology residency programs in the northeastern United States. The programs were classified according to number of residents, as small (< 11 residents), medium-sized (11-20 residents), large (21-30 residents), or very large (> or = 31 residents). The call difficulty index was defined as the number of emergency examinations per resident per year. Call frequency indexes were defined as the numbers of evenings and of nights during the 4-year residency when residents were scheduled for call. RESULTS: The average call difficulty index and standard deviation for the respondent programs was 3,855 +/- 1,779. The average call frequency index and standard deviation for evenings was 140 +/- 53 and for nights was 120 +/- 59. A significant negative correlation was found between program size on one hand and call difficulty index (r = -0.36, P = .01), evening call frequency index (r = -0.29, P = .033), and night call frequency index (r = -0.51, P < .001) on the other. Residents in small programs could expect to be on call 192 evenings and 192 nights in the 4-year residency and to perform 4,866 emergency examinations per year, as opposed to the 110 evenings and 89 nights on call and the 3,213 emergency examinations that residents in very large programs could expect. In other words, the smaller the program, the more calls residents can expect to take, and the more emergency examinations they will interpret. CONCLUSION: The mean call difficulty and off-hours call frequency indexes established for residency programs of different size in the Northeast demonstrate increasing call difficulty and increasing off-hours call frequency with decreasing program size.     

Bone scans with one or two new abnormalities in cancer patients with no known metastases: frequency and serial scintigraphic behavior of benign and malignant lesions

Scintigraphic, radiologic, and clinical follow-up findings were reviewed in cases in which bone scans (n = 301) showed one or two new abnormalities in patients with malignancy but no known metastases. Metastatic disease was confirmed for 25 of 231 scans (11%) with one new abnormality and for 17 of 70 scans (24%) with two new abnormalities. The prevalence of metastases was 0.06 to 0.13 for lesions in all regions of the skeleton, except the sternum (three of six) and the pelvis (10 of 32). On follow-up scans, in the absence of an interval change in therapy, 19 of 21 metastases became more intense, whereas most benign abnormalities either remained unchanged (47%) or resolved (41%). Benign lesions in the ribs, extremities, and pelvis generally resolved within 12-24 months, while most benign skull and spine abnormalities were still apparent after 35-58 months of follow-up.     

臭氧联合胶原酶注射与单纯臭氧治疗腰椎间盘突出症的疗效观察

目的 观察臭氧联合胶原酶注射治疗腰椎间盘突出症(LDH)与单纯臭氧治疗椎间盘突出症的不同疗效.方法 在DSA导向下,正侧位透视后准确定位,采用9号穿刺针经皮穿刺向椎间盘内单纯注射臭氧或先后注射臭氧及胶原酶治疗76例腰椎间盘突出患者.结果 治疗后1、3和6个月进行随访.1个月后随访,臭氧联合胶原晦注射治疗组(A组,38例...     

Magnetic resonance angiography of extracranial carotid and vertebral arteries,including their origins: comparison with digital subtraction angiography

Summary Although carotid bifurcation stenoses are not the only lesions of the extracranial cerebral arteries, magnetic resonance angiographic (MRA) studies to date have concentrated on the carotid bifurcation. We compared digital subtraction angiography of the extracranial portions of the cerebral arteries with MRA using an ordinary body coil, the time-of-flight method, and multiple transverse slabs which covered the arteries down to the aortic arch. Twenty-two patients (15 with arteriosclerotic diseases, 4 with aortitis, and 3 with tumours) had MRA using a 1.5 T magnet system with a three-dimensional fast imaging with steady state precession (FISP) technique. Thirty-nine carotid and 39 vertebral arteries were assessed by three radiologists with regard to stenoses or occlusions, graded as normal, mild (<30%), moderate (30–60%) or severe (>60%) stenosis, or occluded. Grading corresponded well in 81%; stenoses appeared more marked on MRA in 14% and were seen less clearly on MRA in 5%. When 26 carotid bifurcations were assessed separately, grading corresponded well in 95%. MRA is the only method which can display the whole course of the extracranial carotid and vertebral arteries non-invasively and satisfactorily.