Needle biopsy of renal allografts: comparison of two techniques

Two techniques for renal allograft biopsy were retrospectively evaluated to compare relative safety and efficacy. After ultrasound (US) localization of the kidney and biopsy with a hand-held 14-gauge cutting needle, an adequate specimen was obtained in 74 of 77 cases (96%). Major complications occurred in six of these 77 cases (8%). One hundred four biopsies were performed by using a smaller 18-gauge cutting needle with a spring-loaded biopsy "gun" and real-time US guidance. With this newer technique, specimens adequate for diagnosis were obtained in 99 biopsies (95%). There was a single major complication with this technique (1%). The 18-gauge needle with real-time US guidance yields comparably adequate specimens with a lower frequency of complications.     

Reduction of peristaltic artifacts on magnetic resonance imaging of the abdomen: a comparative evaluation of three drugs

Background: Peristaltic motion is an omnipresent source of degradation in abdominal magnetic resonance (MR) imaging by blurring images and producing ghost artifacts that can mask or mimic lesions. The objective of this study was to select an effective and easy-to-administer drug to provide consistent reduction of peristaltic motion artifacts on MR images. Methods: One hundred forty-eight adult patients with MR examinations of the abdomen were enrolled in a prospective, single-blind comparative study. Four groups were defined: (a) no-drug control group (n = 35), (b) 1 mg of intravenous (IV) glucagon (n = 19), (c) 20 mg of IV butylscopolamine (n = 28), and (d) 20 mg of oral dicyclomine (n = 66). All patients received high-density barium sulphate as a negative oral contrast medium. Quantitative image analysis was performed with operator-defined region-of-interest measurements of signal intensity. Gastrointestinal noise was measured outside the patient at the posterior part of the left hemiabdomen along the phase-encoding direction on a short inversion time inversion recovery (STIR) sequence. Results: Treatment groups showed reduced gastrointestinal noise (p < 0.01). When compared with the control group, IV butylscopolamine (p < 0.05) and oral dicyclomine (p < 0.05) significantly reduced gastrointestinal noise, whereas glucagon did not. Conclusion: Anticholinergic drugs significantly reduced the intensity of ghost artifacts on MR imaging of the abdomen. Twenty milligrams of oral dicyclomine is an effective and safe alternative to more expensive and parenterally administered drugs such as glucagon and butylscopolamine. Received: 22 November 1994/Accepted after revision: 14 March 1995     

Posttransplantation cyclosporine-induced lymphoproliferative disorders: clinical and radiologic manifestations

Fifteen allograft transplant recipients acquired lymphoproliferative disorders after immunosuppressive therapy with cyclosporine and steroids. Many of these lymphoproliferative disorders regressed or disappeared completely after reduction of cyclosporine dose. This disease has several aspects that distinguish it from usual posttransplantation lymphomas that occur with regimens that do not contain cyclosporine. The time course from transplantation to onset of lymphoma is relatively short, with an average of approximately 8 months. Organs show a wide spectrum of abnormalities typical of other immunosuppression-associated lymphomas, but there is unique sparing of the central nervous system. The tumor is also unique in that it responds to a decrease in the cyclosporine dose.