Microcirculation and microvasculature in breast tumors: pharmacokinetic analysis of dynamic MR image series.

The purpose of this study was to quantify microcirculation and microvasculature in breast lesions by pharmacokinetic analysis of Gd-DTPA-enhanced MRI series. Strongly T1-weighted MR images were acquired in 18 patients with breast lesions using a saturation-recovery-TurboFLASH sequence. Concentration-time courses were determined for blood, pectoral muscle, and breast masses and subsequently analyzed by a two-compartment model to estimate plasma flow and the capillary transfer coefficient per unit of plasma volume (F/VP, KPS/VP) as well as fractional volumes of the plasma and interstitial space (fP, fI). Tissue parameters determined for pectoral muscle (fP = 0.04 +/- 0.01, fI = 0.09 +/- 0.01, F/VP = 2.4 +/- 1.3 min(-1), and KPS/VP = 1.2 +/- 0.5 min(-1)) and 10 histologically proven carcinomas (fP = 0.20 +/- 0.07, fI = 0.34 +/- 0.16, F/VP = 2.4 +/- 0.7 min(-1), and KPS/VP = 0.86 +/- 0.62 min(-1)) agreed reasonable well with literature data. Best separation between malignant and benign lesions was obtained by the ratio KPS/F (0.35 +/- 0.17 vs. 1.23 +/- 0.65). The functional imaging technique presented appears promising to quantitatively characterize tumor pathophysiology. Its impact on diagnosis and therapy management of breast tumors, however, has to be evaluated in larger patient studies.     

Posterolateral aspect and stability of the knee joint. I. Anatomy and function of the popliteus muscle-tendon unit: an anatomical and biomechanical study

This study examined ten human adult cadaveric knees to dissect the popliteus muscle-tendon unit (PMTU), including its numerous attachments to other posterior and posterolateral structures, and to determine the effect of tensioning the PMTU on the internal and external rotation, total rotational arcs, and neutral tibial rotation in full extension and 30 degrees, 60 degrees, and 90 degrees of knee flexion. The junction between the popliteus tendon and the fibular head commonly described as the popliteofibular ligament became lax in internal and tense in external tibial rotation. The internal and external rotational arcs increased gradually between extension and 90 degrees of flexion. Tensioning the PMTU resulted in a statistically highly significant internal tibial rotation with decreased internal and increased rotational arcs. The anatomical findings and functional data indicate that the PMTU is an important structure maintaining dorsolateral stability, stabilizing the lateral meniscus, and balancing the neutral tibial rotation.     

Sonography of the tongue and floor of mouth. Part I: Anatomy

Normal structures of the tongue and floor of the mouth were studied using anatomic sections cut with a stainless steel band saw. The sections were performed on the same planes as used in US and CT scanning. The ultrasound studies were carried out with 20 young and healthy volunteers. CT images were obtained from head-neck preparations that were subsequently used for anatomic sectioning. On comparing these sections to US and CT images, normal structures including intrinsic and extrinsic tongue muscles, vessels and salivary glands were identified. Knowledge of the anatomic landmarks is mandatory for optimal US image reading.     

Follow-up of musculoskeletal tumors I. Local recurrence

The prognosis for a patient with a musculoskeletal sarcoma has improved considerably over the past two decades largely due to the use of adjuvant chemotherapy. Surgical techniques have become more sophisticated with limb salvage, the preferred management in the majority of cases. Imaging plays an important role in the assessment of suspected local recurrence of tumor. This pictorial essay reviews the different imaging options and highlights various pitfalls in the detection and diagnosis of recurrence. The role of magnetic resonance imaging in this respect is stressed. Received 7 July 1997; Revision received 9 December 1997; Accepted 15 December 1997     

Staging of bladder tumors by transrectal ultrasonotomography and U.I. Octoson

The staging of bladder tumors was performed in 100 cases by transrectal ultrasonotomography and in 44 cases by U.I. Octoson. Complete agreement between histology and ultrasound was obtained in 80% of the cases by the former method and in 73% by the latter method for tumors arising from the corpus of the bladder. However, agreement was obtained in only 38% of the cases by the former method and in 59% by the latter method for tumors arising from the apex and fundus of the bladder. The possibility of improving the agreement for tumors in the apex and fundus by introducing real-time transrectal linear scanning is suggested.     

Computed tomography of the carotid space and related cervical spaces. Part I: Anatomy

The carotid space, parapharyngeal space, and paraspinal space are described. The carotid space is shown on computed tomography (CT) to be posterior to the parapharyngeal space and separated from it by the styloid apparatus. The paraspinal space is posterior to the carotid space and separated from it by the longus and anterior scalene muscles.     

Automated thermoluminescence reader. I. Technical construction and function.

An automated TLD reader has been developed and constructed. The dosimeter material consisting of LiF is permanently enclosed in thin-walled teflon tubes. Dosimeters are identified by numbers, which simplifies individual calibration. A calibration radiation source consisting of a cylinder (90Sr-90Y) is used for the calibrations. The function of the reader and the calibration radiation source is described, and the method of measurement briefly reported.     

The optic pathways: a magnetic resonance study at 1.5 tesla. I. Anatomy

The authors retrospectively examined one hundred and twenty-nine patients who had undergone MR examination of the sellar, parasellar and orbital regions, to evaluate MR capabilities in demonstrating the optic pathways and their relationship to the most important anatomical structures nearby. T1-weighted images allowed a very good evaluation not only of the optic pathways as a whole, but also of the intracanalicular and intracranial segments of the optic nerve; the optic tracts and geniculate bodies were also clearly demonstrated. Optic radiations were clearly visible on both T1- and T2-weighted images. The orbital portion of the optic nerve could be evaluated with T1-weighted images, which showed its external profile. However, only multi-echo T2-weighted images allowed the nerve to be differentiated from perineural spaces, filled with cerebrospinal fluid, thus giving a true cisternographic effect.     

Effect of irradiation of oral, pharyngeal and laryngeal tumors on thyroid function

The irradiation of cervical lymphatics in case of oral and pharyngeal carcinomas as well as the irradiation of the operated area in case of laryngeal carcinomas leads to an exposition of the thyroid gland which may result in a dysfunction of this organ. An evaluation of our patients suffering from these tumors and treated during 1984 and 1985 showed a latent hypothyreosis in 46.7% of the patients treated only by cervical irradiation and in 20.7% of the cases treated by radiotherapy of the tumoral focus and additional irradiation of the cervical lymphatics (p less than 0.1). Clinical symptoms were scarcely evident in both groups. For struma prophylaxis, thyreosubstitution with L-thyroxine is recommended.     

Anatomy of a contract.

Medical planners are constantly searching for new initiatives to solve the health care provider shortage. One of the most widely used methods to meet this need is contracting. This article focuses on the essential steps necessary to develop a successful contract using the Direct Health Care Provider Program. It also outlines the differences between personal services and non-personal services contracts.     

Multimodality Imaging Review of Anorectal and Perirectal Diseases With Histological,Endoscopic, and Operative Correlation,Part I: Anatomy and Neoplasms

A broad spectrum of pathology affects the rectum, anus, and perineum and understanding of its relevant anatomy is important in accurate reporting, particularly in rectal cancer. In this pictorial essay, correlative imaging, endoscopic, pathologic, and operative images are presented to illustrate normal anorectal anatomy and neoplastic conditions that affect the anus and rectum. A particular case-based focus is given to rectal adenocarcinoma with pelvic MR and surgical histopathology. Additionally, carcinoid tumor, gastrointestinal stromal tumor, condylomata acuminata, squamous cell carcinoma, melanoma, and metastatic disease about the rectum and anus are reviewed.