Discoid menisci of the knee: MR imaging appearance

Discoid menisci of the knee are not uncommon, and the criteria for arthrographic diagnosis and the clinical symptoms are well known. Although enlarged menisci have been recognized at magnetic resonance (MR) imaging, there are no criteria for the MR imaging diagnosis. The authors describe 29 discoid menisci imaged by means of MR. A discoid meniscus was said to be present if three or more 5-mm-thick contiguous sagittal images demonstrated continuity of the meniscus between the anterior and posterior horns. High-resolution coronal images allowed more graphic depiction of the abnormally wide meniscus. In approximately one-third of the cases in which coronal images were obtained, the measurable height difference between the discoid and the opposite meniscus was greater than or equal to 2 mm. Arthroscopic correlation (obtained in 10 cases) revealed that six cases of discoid meniscus were diagnosed correctly with MR imaging, although one meniscus was considered discoid at MR imaging but was not considered discoid at arthroscopy. Of three discoid menisci seen to be torn at arthroscopy, two were seen to be torn at MR imaging.     

Blood MR signal suppression by preexcitation with inverting pulses

A cardiac-gated sequence has been developed for functional cardiac imaging. It uses a nonselective 180 degrees preinverting pulse before a spin-echo (SE) readout sequence with an echo time (TE) of 28 msec. In seven healthy volunteers this sequence provided superior wall-to-chamber contrast in end diastole and end systole when compared with the following sequences: SE, TE = 28 msec; SE, TE = 28 msec with dephasing gradients; and SE, TE = 28 msec with presaturation bands.     

Chronic wrist pain: evaluation with high-resolution MR imaging

The diagnostic performance of magnetic resonance (MR) imaging in the evaluation of the triangular fibrocartilage complex and the intrinsic and extrinsic ligaments of the wrist was assessed in 43 patients with chronic wrist pain. Forty-one patients underwent correlative arthrography. Twenty-three patients underwent arthroscopy or arthrotomy or both. The normal anatomy of the triangular fibrocartilage and the intrinsic and extrinsic ligaments could be demonstrated effectively with MR imaging. MR imaging was effective in the evaluation of triangular fibrocartilage tears with a sensitivity of 1.0, a specificity of 0.93, and an accuracy of 0.95 when compared with arthrography; 0.89, 0.92, and 0.90, respectively, when compared with arthroscopy and arthrotomy. MR imaging could also be used effectively to evaluate tears of the intercarpal ligaments, particularly the scapholunate ligament. Disruptions of the extrinsic ligaments, articular cartilage defects, and subluxations of the distal radioulnar joint were also well demonstrated. MR imaging is an effective procedure in assessing patients with chronic wrist pain.     

REPRODUCIBILITY OF CONVENTIONAL AND POWER SPECTRAL MEASUREMENTS OF CARDIOVASCULAR SYMPATHETIC ACTIVATION IN NORMAL SUBJECTS

1. Normal subjects (n = 5; age 20-42 years; mean resting blood pressure (± 1 s.d.) 116±21/61±11 mmHg) underwent cardiovascular reflex testing five times each. On every occasion systolic blood pressure (SBP) responses to sustained handgrip (GRIP) and cold pressure (COLD) tests were measured and continuous non-invasive SBP and heart period (RRINT) data were analysed in the frequency domain using fast Fourier transforms. Power spectral (PS) density estimates of high frequency/total power (HF%; a measure of vagal activity), low frequency/HF ratio (LF/HF; a measure mainly of cardiovascular sympathetic activity for heart period) and low frequency/total power (LF%; a proposed measure of sympathetic activity for SBP) at rest, during and 2min after the end of stimuli were calculated. 2. The data from the rest and recovery periods did not differ and showed that cardiovascular recovery to baseline measures following sympathetic stimulation occurred within 2 min. 3. There was a significant rise in SBP with GRIP and COLD. The LF/HF(RRINT) rose significantly with GRIP, but not with COLD. The LF%(SBP) did not change significantly with GRIP or COLD. 4. The SBP and PS analyses showed low intra-individual reproducibility of responses to reflex tests, with coefficients of variation for PS measures at rest of 25-41% and on sympathetic stimulation of up to 80%. 5. The high variability of these observations indicates that PS methods may not be suitable for the analysis of transient cardiovascular reflexes.     

Characteristics and expression of binding sites specific for ferritin H- chain on human cell lines

Purified recombinant human ferritin composed solely of H subunit was radiolabeled and incubated with proerythroleukemic K562 human cells. A specific binding was detected, and it could be displaced only by ferritins, natural or recombinant, containing large proportion of the H subunit. The specific ferritin H-chain binding was saturable, and cells showed 17,000 to 23,000 binding sites per cell. The affinity constant measured at 37 degrees C was of 3 x 10(8) M-1. Treatment with pronase eliminated the specific binding. The binding sites were expressed in a high number during the cellular exponential phase of growth and progressively decreased to disappear when cells reached the plateau phase. Treatment of the cells with desferrioxamine increased recombinant H-ferritin binding, while iron had little effect. K562 cells induced to differentiate by hemin failed to bind ferritin H. Ferritin H-chain binding capacity is present on various cell lines such as HL60, lung cancer, and hepatoma cells. Analysis of the binding sites by western blotting showed a peptide with apparent mol wt of about 100 kd.     

Common tumors of the parapharyngeal space: refined imaging diagnosis

Computed tomographic (CT) scans and magnetic resonance (MR) images in 103 patients with either a deep-lobe parotid tumor extending into the parapharyngeal space, a minor salivary gland tumor, a neuroma, or a paraganglioma were reviewed. The parotid or extraparotid nature of these masses was established by identifying a fat plane between the mass and the parotid gland. This was more reliably accomplished with MR imaging than with CT. Although dynamic CT allowed identification of the glomus tumors, MR imaging also permitted diagnosis of these lesions. The inherent CT and MR imaging characteristics of most of the neuromas and minor salivary gland tumors were indistinguishable. However, the neuromas tended to displace the internal carotid artery anteriorly, whereas the salivary lesions displaced this vessel posteriorly. This artery was better identified on MR images than on CT scans. Thus, these lesions, which are the four most common primary parapharyngeal space tumors, can be distinguished on MR images by evaluating not only their inherent signal characteristics but also the surrounding fat planes and any displacement of the internal carotid artery.     

Computed tomography in sciatica

Lumber facet arthropathy and a herniated disk are two major causes of low back pain and sciatica. The authors evaluated the importance of computed tomography (CT) in 243 patients with low back pain and/or sciatica. Lumbar facet abnormalities were found in 139 patients (57%), and a herniated disk was found in 48 patients (20%). CT findings correlated precisely with surgical observations in cases involving a herniated disk and correlated well with the results of an intra-articular facet block in a small series of patients. CT can effectively diagnose and differentiate between lumbar facet arthropathy and a herniated disk.