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1.
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
2.
MR imaging findings in granular cell tumor of the neurohypophysis: a difficult preoperative diagnosis 总被引:1,自引:0,他引:1
Granular cell tumor is a rare neoplasm arising within the neurohypophysis. We describe the MR imaging findings in two symptomatic
patients. In one patient with history of panhypopituitarism, MR images showed a large sellar and suprasellar mass. The other
patient presented with acute loss of vision in her left eye, and MR images showed a suprasellar mass with compression of the
optic chiasm.
Received: 18 November 1999; Revised: 5 April 2000; Accepted: 10 April 2000 相似文献
3.
Two cases of xanthogranulomatous pyelonephritis (XGP) are presented with emphasis on MR appearances. One case is the diffuse
type of XGP secondary to chronic obstruction caused by transitional cell carcinoma of the renal pelvis. The other case is
the focal or “tumefactive” type of XGP which mimics renal cell carcinoma.
Received: 15 February 1999; Revised: 14 June 1999; Accepted: 8 July 1999 相似文献
4.
A 21-year-old woman with tuberous sclerosis presented with abdominal distension and flank pain. Imaging studies, including
CT and MR imaging, revealed bilateral renal mass lesions, containing fat and suggesting the diagnosis of tuberous sclerosis.
However the imaging characteristics of one of these lesions differed from the others with no radiologically detectable fat
tissue in this solid lesion suggesting renal cell carcinoma. Histopathological examination of this lesion in the left kidney
revealed an angiomyolipoma with minimal fat tissue. The radiological diagnosis of angiomyolipomas with minimal fat tissue
remains difficult and the differential diagnosis is discussed.
Received: 5 October 1998; Revised: 22 December 1998; Accepted: 7 June 1999 相似文献
5.
Ide C De Coene B Mailleux P Baudrez V Ossemann M Trigaux JP 《European radiology》2000,10(12):1865-1870
We present the characteristic imaging findings of hypoplasia of the internal carotid artery (ICA) in two cases, one accompanied
by an intracranial aneurysm. Finding of a diffuse luminal narrowing of the ICA on MR angiography or digital subtraction angiography
(DSA) could wrongly evoke severe acquired diseases such as dissection or atherosclerosis. Absence of associated wall thickening
and flow disturbances on color Doppler sonography (CDS) should suggest carotid hypoplasia. Confirmation of the diagnosis is
obtained by CT of the skull showing a small carotid canal. Non-invasive procedures are sufficient to differentiate this rare
congenital anomaly from acquired string signs.
Received: 25 October 1999; Revised: 27 January 2000; Accepted: 30 March 2000 相似文献
6.
Schneider G Uder M Altmeyer K Bonkhoff H Gruber M Kramann B 《European radiology》2000,10(9):1395-1400
We report a case of littoral cell angioma (LCA) of the spleen, a recently described splenic pathology, which imaging characteristics
and pathologic morphology have been discussed only by a few authors. The imaging findings in unenhanced and contrast-enhanced
MRI and CT as well as histologic specimen are presented. Diagnosis was made after elective splenectomy. Differential diagnosis
of splenic tumors as well as the imaging findings in this particular case are discussed.
Received: 7 July 1999; Revised: 18 January 2000; Accepted: 19 January 2000 相似文献
7.
Tetsumura A Yoshino N Amagasa T Nagumo K Okada N Sasaki T 《Dento maxillo facial radiology》2001,30(1):14-21
OBJECTIVES: To determine in vitro the potential of high-resolution MRI for evaluating the depth of tumor invasion of the tongue. METHODS: Twenty-one resected specimens of squamous cell carcinoma of the tongue were examined on a 1.5T MRI system with a 4 cm surface coil using four different sequences; T1W SE, T2W SE, 3D-FISP and 3D-CISS. The thickness of normal epithelium, tumor depth and width were measured on both MR images and histopathological sections. RESULTS: The mucosal epithelium, lamina propria and muscles of the tongue were clearly identifiable on MRI. All 21 carcinomas, including three early invasive carcinomas, were clearly demonstrated. A high correlation was found between the values measured by MRI and histopathology for thickness of mucosal epithelium and both depth and width of tumors. There was a good agreement between the T2W SE and the other imaging sequences for measurements of both depth and width of tumors. CONCLUSION: High-resolution MR imaging appears reliable for the in vitro evaluation of depth of tumor invasion in carcinoma of the tongue. 相似文献
8.
Multifocal nodular fatty infiltration of the liver mimicking metastatic disease on CT: imaging findings and diagnosis using MR imaging 总被引:1,自引:0,他引:1
Kröncke TJ Taupitz M Kivelitz D Scheer I Daberkow U Rudolph B Hamm B 《European radiology》2000,10(7):1095-1100
The aim of this study was to describe the MR appearance of multifocal nodular fatty infiltration of the liver (MNFIL) using
T1-weighted in-phase (IP) and opposed-phase (OP) gradient-echo as well as T2-weighted turbo-spin-echo sequences with fat suppression
(FSTSE) and without (HASTE). Magnetic resonance imaging examinations at 1.5 T using T1-weighted IP and OP-GRE with fast low
angle shot (FLASH) technique, and T2-weighted FSTSE, T2-weighted HASTE of 137 patients undergoing evaluation for focal liver
lesions were reviewed. Five patients were identified in whom CT indicated metastatic disease; however, no liver malignancy
was finally proven. Diagnosis was confirmed by biopsy (n = 3), additional wedge resection (n = 1) or follow-up MRI 6–12 months later (n = 5). Regarding the identified five patients, the number of focal liver lesions was 2 (n = 2) and more than 20 (n = 3). The MR imaging characteristics were as follows: OP-image: markedly hypointense (n = 5); IP image: isointense (n = 2) or slightly hyperintense (n = 3); T2-weighted FSTSE-image: isointense (n = 5); T2-weighted HASTE image isointense (n = 1); slightly hyperintense (n = 4). On OP images all lesions were sharply demarcated and of almost spherical configuration (n = 5). Further evaluation by histology or follow-up MR imaging did not give evidence of malignancy in any case. Histology
revealed fatty infiltration of the liver parenchyma in three patients. Magnetic resonance follow-up showed complete resolution
in two patients and no change in three patients. Multifocal nodular fatty infiltration can simulate metastatic disease on
both CT and MR imaging. The combination of in-phase (IP) and opposed-phase (OP) gradient-echo imaging can reliably differentiate
MNFIL from metastatic disease.
Received: 15 September 1999 Revised: 3 February 2000; Accepted: 7 February 2000 相似文献
9.
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
10.
Value of fluid-attenuated inversion recovery sequences in early MRI of the brain in neonates with a perinatal hypoxic-ischemic encephalopathy 总被引:3,自引:0,他引:3
The aim of our study was to assess the usefulness of fluid-attenuated inversion recovery (FLAIR) sequences in comparison
with conventional spin-echo and inversion MR imaging in neonates for evaluation of myelination and for detection of hypoxic-ischemic
brain injury. We reviewed early MR scans of 18 neonates with suspected hypoxic-ischemic brain damage. Myelination could be
evaluated with confidence using conventional MR imaging in all but 2 infants; however, the presence of myelin was very difficult
to assess on FLAIR images. Overall, 53 lesions or groups of lesions were identified. The FLAIR technique was more sensitive
in 11 of the lesions; especially (pre)cystic lesions could be identified much better and more cysts were found. Conventional
MR imaging failed to identify 2 of the lesions and was more sensitive in 14 of the lesions; especially punctate hemorrhages
and lesions in basal ganglia or thalami could be better determined. The FLAIR technique missed 3 of these lesions. In the
remaining 28 lesions conventional MR and FLAIR images were equally diagnostic. The FLAIR technique and conventional MR imaging
are complementary in detecting early sequelae of hypoxic-ischemic brain injury in neonates. The FLAIR technique is not suitable
for assessing myelination of the neonatal brain; therefore, FLAIR cannot replace conventional MR imaging.
Received: 11 January 2000; Revised: 10 April 2000; Accepted: 10 April 2000 相似文献
11.
The aim of this study was to determine whether rapidly acquired MRI sequences, taking less than 5 min imaging time, can accurately
characterise renal masses. All patients found to have a renal space-occupying lesion on CT or ultrasound were asked to participate
in a prospective study using rapidly acquired MRI. The MRI technique was performed on a GE Signa (General Electric, Milwaukee,
Wis.) 1.5 T magnet using breath-hold coronal and axial T1 GRASS (fast spoiled gradient-recalled acquisition into steady state,
FSPGR/30/90) and axial T2 fast spin-echo sequences. The results were analysed by two radiologists unaware of the CT or ultrasound
findings. The CT/US was independently viewed by a third radiologist. Lesions were characterised as simple cysts, indeterminate
or solid. The MR and CT/US results were correlated and the sensitivity and specificity of MR for the characterisation of simple
cysts and solid renal masses calculated. A total of 144 lesions (68 patients; 29 women 39 men, age range 32–78 years, average
age 60 years) were studied: 111 simple cysts; 3 hyperdense cysts; 26 renal cell carcinomas; and 4 indeterminate lesions on
CT/US. There was agreement between the CT/US and MRI in 82 % of cases. All renal cell carcinomas were correctly characterised
on MRI. Of simple cysts, 79 % were correctly identified using this technique. Breath-hold MRI performed in less than 5 min
can accurately characterise the majority of renal masses. It is 100 % sensitive in the characterisation of renal carcinoma,
and it correctly identified approximately 80 % of simple cysts. If used at the time a renal mass is detected on MRI, it would
reduce the need for further investigation of the majority of incidentally detected lesions which are simple cysts.
Received: 15 December 1998; Revised: 10 May 1999; Accepted: 2 July 1999 相似文献
12.
MRI in the diagnosis of small bowel disease: use of positive and negative oral contrast media in combination with enteroclysis 总被引:12,自引:0,他引:12
Rieber A Aschoff A Nüssle K Wruk D Tomczak R Reinshagen M Adler G Brambs HJ 《European radiology》2000,10(9):1377-1382
The aim of the study was to evaluate the additional findings of MRI following small bowel enteroclysis and to compare the
efficacy of negative and positive intraluminal contrast agents. Fifty patients with inflammatory or tumorous small bowel disease
were investigated by small bowel enteroclysis and consecutive MRI using breathhold protocol (T1-weighted fast low-angle shot,
T2-weighted turbo spin echo). Patients were randomly assigned to either receiving a positive oral (Magnevist, Schering, Berlin,
Germany) or a negative oral MR contrast media (Abdoscan, Nycomed, Oslo, Norway). The pattern of contrast distribution, the
contrast effect, presence of artifacts, as well as bowel wall and extraluminal changes, were determined and compared between
the contrast type using Fischer's exact test. Sensitivity, specificity, and diagnostic accuracy for MRI and enteroclysis were
calculated. Twenty-seven patients had clinically proven Crohn's disease and two patients surgically proven small bowel tumours.
Magnetic resonance imaging had important additional findings as abscesses and fistulae in 20 patients. Surgically compared
sensitivities were 100 and 0 % for MRI and enteroclysis, for the detection of abscesses, and 83.3 and 17 % for the diagnosis
of fistulae, respectively. Bowel wall thickening was more reliably detected with use of positive oral contrast media without
intravenous enhancement (p < 0.001), whereas postcontrast negative oral contrast media allow for a superior detection (p < 0.001). T2-weighted sequences were necessary with use of negative oral contrast media, because loop abscesses may be masked.
Magnetic resonance imaging should be performed in all patients with suspicion of extraintestinal complications, because the
complications are more reliably detected by MRI. Negative oral contrast media show advantages with the use of intravenous
contrast but can mask loop abscesses using only T1-weighted imaging.
Received: 5 March 1999; Revised: 21 September 1999; Accepted: 3 February 2000 相似文献
13.
The aim of this study was to investigate the usefulness of contrast-enhanced harmonic power Doppler ultrasound (US) for the
detection of residual viable hepatocellular carcinoma (HCC) after treatment with transcatheter arterial chemoembolization
(TACE). Forty-seven patients with 68 HCC lesions 1.8–9.5 cm in diameter (mean ± SD 4.3 ± 1.7 cm) underwent contrast-enhanced
power Doppler US, in the harmonic mode, before and after treatment with TACE. Unenhanced spiral CT and contrast-enhanced dynamic
MR imaging were also performed to help establish the outcome of therapy. Before treatment, intratumoral blood flow signals
were detected at contrast-enhanced harmonic power Doppler US in 65 (95 %) of 68 lesions. After TACE, flow signals were no
longer detectable in 22 of these 65 lesions, which showed complete response at spiral CT and dynamic MR imaging. In 38 (88
%) of the 43 lesions with partial response, intratumoral flow signals were still identified at contrast-enhanced harmonic
power Doppler US. Twenty-eight of these 38 lesions underwent additional treatment with percutaneous ethanol injection (PEI)
using contrast-enhanced harmonic power Doppler US guidance. Complete response was seen after PEI in 23 of 28 lesions. Contrast-enhanced
harmonic power Doppler US proved useful for assessing the therapeutic effect of TACE on HCC and for guiding additional treatment
with PEI in cases of partial response.
Received: 25 January 2000; Revised: 21 April 2000; Accepted: 25 April 2000 相似文献
14.
D. Kihiczak R. A. Novelline J. N. Lawrason T. Ptak J. T. Rhea R. Sacknoff 《Emergency radiology》2001,8(5):276-278
Magnetic resonance (MR) imaging is not routinely used to exclude ligamentous and other soft tissue injury in the unconscious
trauma patient. In order to determine the frequency and types of soft tissue injuries detected by MR imaging but not by computed
tomography (CT), we performed a retrospective investigation comparing the MR findings in 59 trauma patients, either alert
or unconscious, who previously had undergone a negative clearance multislice CT study of the cervical spine. Six patients
had abnormalities not identified on the CT studies, including four cases of ligamentous injury. 相似文献
15.
Weishaupt D Hetzer FH Ruehm SG Patak MA Schmidt M Debatin JF 《European radiology》2000,10(12):1958-1964
The aim of this study was to compare the performance of 3D MRI in conjunction with an intravascular contrast agent to spiral
contrast-enhanced CT, regarding the detection of abdominal parenchymal injuries as well as peritoneal hemorrhage in an animal
model. Liver and kidney injuries were created surgically in six female pigs under general anesthesia. All pigs underwent contrast-enhanced
spiral CT and 3D MR imaging following administration of an intravascular contrast agent (NC100150 Injection). Two readers
rated their confidence independently on MR and CT data sets using a five-point scale for the presence of organ injury and
hemoperitoneum. Autopsy findings served as standard of reference. Sensitivity and specificity for MR in detecting hepatic
and renal injuries as well as hemoperitoneum was 100 %. Computed tomography was less accurate with sensitivity and specificity
values of 90 and 94 %, respectively. Receiver operating characteristics (ROC) analysis revealed a higher confidence when interpretation
was based on MR images. In an animal model 3D MR imaging in conjunction with an intravascular contrast agent proved highly
accurate in detecting and localizing parenchymal injuries to the upper abdomen as well as in detecting intraperitoneal blood
collections.
Received: 4 November 1999, Revised: 5 May 2000, Accepted: 9 May 2000 相似文献
16.
MRI of the shoulder 总被引:2,自引:0,他引:2
Vahlensieck M 《European radiology》2000,10(2):242-249
Shoulder imaging is one of the major applications in musculoskeletal MRI. In order to analyze the images it is important
to keep informed about anatomical and pathological findings and publications. In this article MRI technique, anatomy and pathology
is reviewed. Technical considerations about MR sequences and examination strategy are only shortly discussed with emphasis
on turbo spin echo and short T1 inversion recovery imaging. Basic anatomy as well as recent findings, including macroscopic
aspects of the supraspinatus fat pad, composition of the supraspinatus muscle belly, and variability of the glenohumeral ligaments
or coracoid ligament, are presented. Basic pathological conditions are described in detail, e. g. instability particularly
problems in differentiating the various subtypes of labral pathology. Rotator cuff diseases are elucidated with emphasis on
some rarer entities such as subscapularis calcifying tendinitis, coracoid impingement, chronic bursitis producing the double-line
sign, prominent coraco-acromial ligament and the impingement due to an inflamed os acromiale. 相似文献
17.
目的:评价舌和口底鳞状细胞癌(SCC)和脉管畸形的MR扩散加权成像(MR-DWI)特点。方法:对治疗前行常规MRI和MR-DWI检查的65例舌和口底SCC和11例脉管畸形(均经手术病理证实)进行回顾性分析。MR-DWI上,分别于b值为500 s/mm2和1000 s/mm2时获取其ADC均值,并进行t检验统计处理和分析。结果:b值分别为500 s/mm2和1000 s/mm2时,SCC的ADC均值分别为1.23×10^-3mm^2/s和0.904×10^-3mm^2/s;脉管畸形的ADC均值分别为1.79×10-3mm^2/s和1.17×10-3mm^2/s。统计分析显示两组b值情况下的ADC均值在SCC和脉管畸形之间差异均有统计学意义(P〈0.01)。结论:舌和口底SCC和脉管畸形之间具有不同MR-DWI特点,两者之间的差异能为临床鉴别诊断提供有益信息。 相似文献
18.
S. Takashima M. Ueda A. Shibata F. Takayama M. Momose K. Yamashita 《Acta radiologica (Stockholm, Sweden : 1987)》2001,42(4):376-382
Purpose: To study MR findings for clues to the diagnosis of lingual thyroid.Material and Methods: MR findings and clinical and scintigraphic data of 5 cases of lingual thyroid were reviewed and the MR findings were compared to those of 16 cases of other submucosal lesions in the base of the tongue.Results: Four of the 5 patients with lingual thyroid were women and all had hypothyroidism. MR imaging depicted lingual thyroid in the midline in the base of the tongue (n=5) and additional ectopic thyroid glands in the floor of the mouth (n=2) or between the right and left sternohyoid muscles (n=1). Ectopic thyroid glands appeared isointense or hyperintense relative to muscle tissue on T1-weighted images and showed slight or fair contrast enhancement. All glands had low to intermediate T2 signal, which was also seen in 1 case of non-Hodgkin's lymphoma and 1 case of adenoid cystic carcinoma. All ectopic thyroid glands had well-defined margins, whereas malignant tumors tended to have ill-defined margins and to invade the surrounding structures. All but the 5 cases of lingual thyroid had an MR-demonstrable thyroid gland in the normal cervical position.Conclusion: A well-defined mass of low-intermediate T2 signal in the midline base of the tongue, neither with invasive tendency nor with a cervical thyroid gland in the normal site on MR imaging, may strongly indicate lingual thyroid. 相似文献
19.
García Figueiras R Sousa Escandón A García Figueiras A González Rodríguez AA Pazos González G Armesto Fernández M Lapeña Villarroya JA Pérez Valcárcel J Rey Sanjurjo JL 《European radiology》2000,10(10):1639-1643
Retrovesical masses in men not related to prostatic carcinoma or hyperplasia is an uncommon pathology. Rare masses or unusual
manifestations of those common diseases are a diagnostic dilemma. We review our experience in three unusual retrovesical masses
in men: carcinosarcoma filling a giant bladder diverticulum; cystic prostatic carcinoma; and acquired cystic dilatation of
the seminal vesicle associated with a prostatic carcinoma that obstructed and invaded the vesicle. We report the imaging findings
and review the literature. In our experience, the imaging findings are usually not specific for doing a precise diagnosis
and biopsy procedures are necessary.
Received: 18 October 1999; Revised: 13 March 2000; Accepted: 16 March 2000 相似文献
20.
Gleno-humeral instabilities 总被引:4,自引:1,他引:3
The purpose of this review is to highlight the most efficient imaging exploratory techniques depicting shoulder instability,
to describe its various forms and to point out the findings which can simulate instability. In anterior recurrent dislocation,
surgery is indicated and the procedure essentially depends on the importance of glenoid rim lesions. In this case, a standard
X-ray evaluation is usually sufficient. The CT arthrography or MRI techniques give more specific details as to the severity
of the lesions, particularly soft tissues alterations; however, these data do not alter standard therapeutic protocol. In
fixed posterior dislocations, CT scan represents the most pertinent technique to evaluate the size of the humeral head defect
and to determine the therapeutic follow-up. In subtle forms of instability, diagnosis or instability direction are not clearly
assessed clinically and standard X-ray evaluation is usually unremarkable. In this case, further exploration, such as CT arthrography,
MR imaging or MR arthrography, are recommended to confirm the diagnosis of instability and to evaluate its direction. The
technique of choice is undoubtedly MR arthrography. Atraumatic voluntary painless subluxations associated with hyperlaxity
of the shoulder do not require any specific exploratory method because the findings are generally limited to a capacious axillary
pouch.
Received: 28 September 1998; Revised: 21 January 1999; Accepted: 22 March 1999 相似文献