Computed tomography in the diagnosis and treatment of surgical diseases of the liver

Surgical diseases of the liver were detected by computed tomography in 110 patients. The aimed percutaneous puncture of focal neoplasms of the liver followed by cytological examination of the aspiration material was performed in 34 patients. The elaboration of puncture techniques of treatment of hepatic cysts and abscesses as well as the preoperative decompression of bile ducts in patients with mechanical jaundice is in progress.     

Magnetic resonance imaging in marrow diseases

Magnetic resonance imaging is an exciting and promising diagnostic tool. It employs a powerful magnet and radio frequency waves to produce details of the human body with no known risk to patients or staff. It produces superior soft-tissue contrast between muscle, fat, ligaments and tendons, nerves, and blood vessels. Magnetic resonance imaging has potential diagnostic value in avascular necroses of bone caused by trauma, Legg-Perthes diseases, sickle cell syndrome, and other conditions. It is useful in determining the extent of marrow lesions, including tumors and metabolic disturbances, muscle trauma and diseases, spinal cord and peripheral nerve lesions including compression neuropathies, and perhaps in preoperative evaluation of the patient with intervertebral disc disease.     

Magnetic resonance tomography in spondylolysis and spondylolisthesis

40 patients with spondylolisthesis and/or spondylolysis were studied by magnetic resonance imaging (MR), 12 of whom with correlation to CT. CT proved to be more sensitive in detecting pars defects than MR. Sagittal MR, however, was more accurate in assessing spondylolisthesis than axial CT. At present, CT is superior to MR in demonstrating bony abnormalities. MR appears indicated in the patient undergoing spinal fusion in whom detection of intervertebral disc degeneration in the levels above or below intended fusion may lead to extension of fusion to the degenerated levels. Lack of ionizing radiation makes MR an ideal diagnostic method in evaluating spondylolisthesis in children and adolescents.     

Magnetic resonance in diagnosis of ureterocele

Ultrasonography is the main non-invasive technique for screening of ureterocele, but presents some difficulties for its diagnosis. Other supplementary diagnostic methods have the disadvantage of being invasive or using ionizing radiation. Magnetic resonance (MR) has a high sensitivity for diagnosing urinary tract malformations in adults and children. We report one case of ureterocele in a 1-year old child with the purpose of presenting its diagnosis through MR.     

Modern radiologic imaging in the diagnosis of abdominal diseases. Magnetic resonance imaging and spectroscopy

The diagnostic value of magnet resonance imaging for the diagnosis of pathological abdominal conditions has been limited sofar because of artefacts due to movement susceptibility. The current indications comprise: liver: differential diagnosis of metastases, cysts and hemangiomas, identification of small metastases, demonstration of malignant vascular invasion, evaluation of hemochromatosis; kidneys: evaluation of transplant rejection, analysis of complex cysts, demonstration of malignant tumoral invasion. The application of magnetic resonance will be greatly extended by the introduction of rapid image sequences and the application of specific contrast media.     

Significance of nuclear magnetic resonance tomography for the diagnosis of degenerative diseases of the lumbar spine

The authors report on the diagnosis value of magnetic resonance imaging (MRI) in diseases of the lumbar spine, assessed on the basis of 960 cases treated at Düsseldorf University Orthopedic clinic since 1982. Diseases can be differentiated by changes in shape (vertebral collapse due to tumors, spondylitides, disk prolapse etc.) as well as by structural and pathomorphologic changes (disk degeneration, upper plate reactions etc.). Seventy-four patients were examined for upper plate reactions, which were detected in particular with the partial saturation and the short-time inversion recovery sequences. On the basis of prospective studies the authors comment on the value of MRI as compared to computerized tomography for diagnosing disk prolapses and disk sequestra. It can be shown that the sensitivity and specificity of MRI are very good.     

Magnetic resonance imaging and surgical clips

Magnetic resonance imaging produces diagnostically useful images of soft-tissue structures within the body. Implanted magnetic materials degrade these images and are subject to magnetic forces from the imaging process. The authors evaluated 54 surgical clips (38 aneurysm and 16 hemostatic) for compatibility with magnetic resonance imaging. From their findings, they recommend that the use of ferromagnetic clips be discontinued and that until this is accomplished, a record of the type of clips used be noted so that the patient is not placed at risk by the use of magnetic resonance imaging or deprived of the diagnostic benefits associated with its use.     

Magnetic resonance imaging,computed tomography,and myelography in the diagnosis of recurrent lumbar disc herniation

Summary Thirteen patients with recurrent symptoms after lumbar discectomy were evaluated. All the patients were enrolled in the study on the basis of clinical symptoms and signs only. The patients were examined with MRI, CT, and myelography in order to compare a) the clinical findings with the imaging investigations, b) the predictive value of the different investigations, and c) the clinical and investigative results with the operative findings. All patients were operated upon according to the clinical findings, and the surgical results were used as the final diagnosis. In six patients a new disc herniation was detected. In the remaining cases surgery revealed either scar tissue or nothing to explain the recurrence of the symptoms. The three imaging modalities were analysed by receiver operating characteristic (ROC) curves. The areas under the ROC curves were 0.68 for MRI, 0.83 for CT, and 0.43 for myelography. The difference in areas between CT and myelography was significant (p<0.05). The results indicate that CT has the highest predictive value for demonstrating the recurrence of a lumbar disc herniation.     

Magnetic resonance tomography and arthrography of the hip joint

Plain film radiographs represent the imaging of choice for the initial evaluation of pathologies of the hip. However, many lesions of the joint itself and surrounding soft tissues are often not visualized by conventional radiographs. Magnetic resonance imaging (MRI) demonstrates most of these pathologies with high sensitivity and specificity. For further assessment of intra-articular lesions such as labral tears, hyaline cartilage lesions, rupture of the ligamentum teres, and loose bodies, direct MR arthrography after intra-articular administration of contrast medium may be indicated. This article summarizes the technical aspects and the most important indications for MRI and MR arthrography of the hip in correlation with typical imaging findings of the most frequent pathologies.     

Review article: Magnetic resonance imaging and computed tomography in the diagnosis of occult proximal femur fractures

Electronic databases of MEDLINE, EMBASE, CINAHL, and the Cochrane Library as well as the Google Scholar search engine were used. Studies written in the English language highlighting the use of magnetic resonance imaging (MRI) and computed tomography in diagnosing occult proximal femoral fractures despite negative or equivocal plain radiographs were included. Two reviewers independently extracted data from each article. Raw frequencies for each of the details investigated were calculated. 15 prospective and 7 retrospective studies from 1989 to 2009 were included in this systematic review. A total of 996 patients (mean age, 75 years; standard deviation, 5 years) with suspected occult proximal femur fractures underwent MRI for further assessment. 350 (35%) of the patients tested positive for proximal femoral fractures, of whom 295 (84%) underwent further treatment/surgical interventions. MRI also detected other fractures and soft-tissue injuries. MRI was superior to other imaging modalities in diagnosing occult proximal femoral fractures and should be performed within 24 hours of injury. Early diagnosis and management may avoid substantial displacement and complications, and improve overall mortality and morbidity.     

Ultrasonics in the surgical diagnosis of thyroid diseases

Echography enables a useful diagnostic distinction to be drawn between solid structures and cysts in the thyroid. Cold nodes measuring 1-5 cm in diameter, cysts (rarely malignant), and solid formations (more commonly malignant) can be differentiated to facilitate diagnosis, while changes in the size of a node can be followed without interrupting drug treatment to determine whether they are due to haemorrhage, resolution of a process, or an increase in node tissue. There is no risk to the patient and the cost of the examination is negligible. Its utility in the initial and subsequent investigation of such nodes is asserted.     

Magnetic resonance imaging in the diagnosis of childhood discitis

Diagnosis of disc space infection in childhood is often delayed and is usually made on the basis of multiple roentgenographic, laboratory, and nuclear imaging studies. Four cases of septic discitis in children are described. Special emphasis is placed on the diagnostic findings with magnetic resonance imaging. Magnetic resonance sensitivity for this entity and its role in comparison with other imaging modalities are discussed.     

Magnetic resonance imaging in the diagnosis of acute pancreatitis

Overall 52 patients with acute pancreatitis were examined with MRI and spiral CT. The examination was performed during 24 hours from admission time. Results of examination were assessed confidentially by 3 experts with 5-scores scale. Non-parametric chi-square criterion was used for significances detection. MRI demonstrated advantages over spiral CT in diagnosis of fat necrosis, sequestration and hemorrhages. MRI compares well with contrast CT in diagnosis of pancreonecrosis. MRI permits to diagnose destructive lesions in pancreas without contrast agent, and accordingly without additional effect on pancreas and kidneys. It is concluded that MRI is high informative method in diagnosis of acute pancreatitis and its complications.     

Role of computeric tomography and magnetic resonance imaging in diagnosis of inflammatory diseases of sacro-ileal joint

Sensitivity of computeric tomography (CT) and magnetic resonance imaging (MRI) for sacroileitis diagnosis was studied, optimal for MRI investigation was established. In 31 patients, owing obvious clinical signs of inflammatory sacroileitis (at average more than 5 mo duration of a low back pain) MRI of sacroiliac joint was conducted in a T1, T2 FS, 2D T2 FLASH regimes and after intravenous infusion of a contrast substance (gadolinium) - in a T1 FS regime, using system, owing a 1,5 T magnetic field intensity. The data obtained were compared with results of CT. Sacroileitis signs were revealed in 27 patients - according to CT data, and in 22 - MRI. CT have demonstrated as a more sensitive method of the bone erosion and sclerosis diagnosis, than MRI. MRI is more sensitive while revealing an active inflammatory process in the bone and joint space. While T1 FS application no additional information for sacroileitis diagnosis was obtained.