Differentiation of tumor from viable myocardium using cardiac tagging with MR imaging

We report the application of myocardial tagging by MR to define tissue planes and differentiate contractile from noncontractile tissue in a neonate with congenital cardiac rhabdomyoma. Using custom-written pulse programming software, six 2 mm thick radiofrequency (RF) slice-selective presaturation pulses (tags) were used to label the chest wall and myocardium in a star pattern in diastole, approximately 60 ms before the R-wave gating trigger. This method successfully delineated the myocardium from noncontractile tumor, providing information that influenced clinical management. This RF tagging technique allowed us to confirm the exact intramyocardial location of a congenital cardiac tumor.     

High resolution computed tomography of inflation-fixed lungs. Pathologic-radiologic correlation of centrilobular emphysema

Centrilobular emphysema (CLE) is a disease defined pathologically. Assessment of the accuracy of high resolution computed tomography (CT) in the diagnosis of centrilobular emphysema has been hampered by a lack of pathologic correlation. We applied high resolution computed tomography to 20 postmortem lung specimens fixed by a method that allows for direct one-to-one pathologic-radiologic correlation. The degree of centrilobular emphysema was assessed radiologically on a visual grading system based on nonperipheral low-attenuation areas. The lungs were then sectioned along the plane of the CT image, and the degree of centrilobular emphysema was graded pathologically by scoring against a panel of standards. A significant correlation (r = 0.91, p less than 0.005) was found between the pathologic grade and the in vitro CT score.     

Evaluation of the acceptability of intravaginal prasterone ovule administration using an applicator

The objective of the study is to evaluate the acceptability of the intravaginal administration of ovules/suppositories of DHEA (dehydroepiandrosterone, prasterone) for the treatment of vulvovaginal atrophy (VVA) in women with moderate to severe dyspareunia who were administered daily for 12 weeks intravaginal 0.50% (6.5 mg) DHEA or placebo. There were a total of 373 women in the per-protocol population who responded to the questionnaire for both treatment groups. While it was planned that the applicator would be evaluated as suitable if at least 80% of participants have a global score ≤?2 units, 99% and 100% of participants had a score ≤?2 units in the placebo and DHEA groups, respectively, for the global score (mean of 5 questions). When asked about like and dislike the technique of drug administration, 284 comments were positive, while 114 women gave no comment. About 92–94% of women indicated that they were very confident to be able use the applicator successfully in the future. The survey shows a high degree of satisfaction and of confidence to use the applicator successfully in the future.     

Morphologic basis of MR imaging of benign prostatic hyperplasia

Fifteen prostates were obtained from patients autopsied at The Johns Hopkins Hospital and imaged fresh in vitro by high resolution magnetic resonance (MR) imaging with a surface coil. Following scanning, the specimens were fixed and sectioned in the same plane as the MR images. The prostate sections, corresponding to the MR images, were examined grossly and histologically for prostate pathology. Tissue characteristics were quantified by morphometric techniques and correlated with MR image intensity. Five prostates were normal and showed two distinct anatomic zones, a central periurethral zone and a peripheral zone. These two zones corresponded to two zones identified on MR of the five normal prostates. In contrast, both the MR images and the pathologic and morphometric studies of nine of the 10 prostates with benign prostatic hyperplasia (BPH) showed three distinct zones: a central region of BPH, a surrounding fibrous capsule, and a peripheral zone. This study suggests that there is a morphologic basis for MR intensity in the prostate.     

"Small left colon" syndrome (two case reports)]

CASE REPORTS: Two newborns, one female and male were treated for neonatal bowel obstruction. A contrast enema led to the diagnosis of small left colon syndrome and treated those newborns successfully. CONCLUSION: Small left colon syndrome is a very rare cause of neonatal bowel obstruction. The diagnosis and treatment are assured by a simple contrast enema.     

Blood oxygenation dependence of t1 and t2 in the isolated,perfused rabbit heart at 4.7t

An MR line scan protocol has been used to measure relaxation parameters (T₁ and T₂) in isolated, blood perfused rabbit hearts at various blood oxygenations. Hearts were retro-gradely perfused at 37°C with a cardioplegic solution (modified St. Thomas' solution) containing sheep red blood cells and adenosine (1 mM) to maximally vasodilate the coronary vascular bed. Arresting the hearts eliminated motion complications and minimized arteriovenous oxygenation differences. The authors have found that under conditions of stable flow, there is a strong correlation between T₂ in myocardial septa and hemoglobin (Hb) saturation, while tissue T₁ is virtually independent of blood oxygenation. These effects are believed to be due to the paramagnetic agent deoxyhemoglobin.     

Diseases of the chest in AIDS: CT diagnosis

The advantages of computed tomography for the evaluation of various chest lesions commonly encountered in patients with AIDS are discussed. The significance of limited and extensive lymphadenopathy is considered and examples are presented. Also specifically illustrated are cases of opportunistic pneumocystis, cytomegalovirus, and nocardia pneumonitides and of candida esophagitis; septic emboli; empyema; premature bulla formation ranging from apical bullae to diffuse parenchymal destruction; Kaposi's sarcoma, and lymphoma. Examples of the value of CT in resolving obscure clinical chest problems in AIDS patients are also illustrated.