Simultaneous measurement of gallbladder emptying with cholescintigraphy and US during infusion of physiologic doses of cholecystokinin: a comparison

Both ultrasonography (US) and cholescintigraphy are used to study gallbladder dynamics. The present study was undertaken to determine whether the two methods provide the same or different information relating to gallbladder emptying. Emptying was simultaneously studied with both methods during infusion of graded physiologic doses of cholecystokinin (CCK) in six healthy subjects. Infusion of stepwise increasing doses of CCK, ranging from 0.03 to 0.5 Ivy dog units per kilogram of body weight per hour (IDU/kg.h), induced significant dose-related increases in plasma CCK, decreases in gallbladder volume assessed with US, and gallbladder emptying assessed with cholescintigraphy. The threshold dose for inducing significant gallbladder emptying was 0.13 IDU/kg.h, as determined with both techniques, indicating similar detection limits. There was a highly significant correlation between decreases in gallbladder volume and decreases in radioactive counts over the gallbladder region, with a tendency toward greater gallbladder responses at sonography during the early phase of gallbladder contraction and toward greater responses at cholescintigraphy during the later phase of gallbladder contraction. It is concluded that these methods can be used interchangeably for the quantitation of gallbladder emptying.     

A survey of neonatal jaundice in association with household drugs and chemicals in Nigeria

A survey was conducted to determine the extent of exposure of women of child-bearing age and their families to household chemicals and medicaments, and the prevalence of neonatal jaundice in the exposed and unexposed families compared. Significant exposures to naphthalene, insecticides, mentholated balms, mentholated powders, and traditional herbs occurred in 45-87% of the families studied. The overall incidence of jaundice did not differ significantly in neonates from households with or without positive history of drugs/chemical exposures. Severe neonatal jaundice, as judged by the need for exchange blood transfusion or death of the infant, was however, significantly more frequent among neonates from families with positive history of naphthalene exposure than in those with negative history. Some household chemicals and medicaments may be important in the pathogenesis of neonatal jaundice in our environment, and health education aimed at eliminating exposure neonates and pregnant women to such agents is urgently necessary.     

Interobserver variation in the interpretation of abdominal radiographs

A total of 140 sets of abdominal radiographs were reviewed independently by four qualified diagnostic radiologists. The degree of interobserver agreement was determined by calculating kappa values for 19 commonly used radiographic signs and diagnoses. There was fair to excellent interobserver agreement for 11 signs and diagnoses and poor agreement for the remaining eight. The signs and diagnoses for which agreement is poor cannot be considered reliable and include particularly large bowel obstruction and nonspecific gas pattern.     

Effect of intersection spacing on MR image contrast and study time

The effects of section separation on image contrast and calculated T1 relaxation times were investigated in healthy volunteers and a phantom using an early commercial version magnetic resonance imaging system. The effects are explained qualitatively on the basis of side lobes of excitation occurring outside the selected section resulting in reduction of the time permitted for T1 relaxation. The options for dealing with imperfect section selection, including separation of the sections (i.e., leaving gaps) and nonsequential excitation, are illustrated and the trade-offs involved in each explained.     

Perforation of the inferior vena cava with aortic and vertebral penetration by a suprarenal Greenfield filter

Various complications have been reported after insertion of the Greenfield filter. This report describes an unusual complication after suprarenal placement of this filter: spreading of the filter struts, with perforation of the inferior vena cava, and penetration of the aorta and a vertebral body, followed by fracture of one of the struts.     

Intradural lipoma in a child.

We report the case of a 5-year-old Nigerian boy in whom conus medullaris and cauda enquina compression was due to an intradural lipoma, a rare tumour of the spinal canal in the tropics. The literature on the subject is briefly reviewed and the differential diagnoses are discussed. The occurrence of the lesion in this child, without other features of spinal dysraphism, is noteworthy.     

High-resolution MR imaging with local coils

We propose the following rules to govern the choice of local coils by the practicing radiologist: 1. Smaller coils permit smaller FOVs and better resolution. The coil should be as small as possible. 2. Match the ROS of the coil to the FOV, which will be determined by the anatomic region of interest. 3. For the case of a choice between surface coils or between a surface and a whole- or partial-volume coil, the anatomic region should lie on the high side of the crossover point. For the case of a choice among whole-volume coils, the smallest coil that surrounds the region of interest should be chosen. 4. Considerations in regard to the anatomic shape or the need to vary the position of the structure may alter the choice of coil from that obtained by S/N considerations alone.     

White-matter lesions in MR imaging of clinically healthy brains of elderly subjects: possible pathologic basis

Patchy white-matter lesions occur in the magnetic resonance (MR) imaging brain studies of 20%-30% of neurologically healthy elderly subjects. To determine the frequency of histologically verifiable white-matter lesions at autopsy in such subjects the authors examined serial, microscopic, whole brain sections from 15 clinically healthy subjects aged 52-72 years. Small white-matter lesions were found in 12. In these 12, zones of atrophic perivascular demyelination were present in eight brains. These are not the familiar thrombotic, embolic, or ischemic vascular lesions that produce acute necrosis. This mild vascular insufficiency produces atrophy, which has been recognized in the pathology literature but whose clinical significance remains unknown. Other lesions seen were small vascular malformations in the centrum ovale in four brains, diverticula of the lateral ventricle extending into the white matter in three, and an isolated central white-matter infarction in one. All of these lesions are probably the basis of the patchy white-matter lesions seen on MR imaging studies in the neurologically healthy elderly population.