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81.
Goichi Yotsumoto Koki Tanaka Naoki Ishizaki Akira Ikoma Sumihiro Kawashima Akira Taira 《Surgery today》1997,27(7):657-660
We report herein a case of spontaneous subcapsular hepatic hemorrhage which occurred in a 33-year-old woman 1 day after she
had been delivered of her second child by cesarean section following an uneventful pregnancy. She complained of right upper
quadrant pain on the 1st postoperative day, and computed tomography (CT) showed subcapsular low-density masses in both liver
lobes, while extravasation was demonstrated by CO2 intraarterial digital subtraction angiography (IADSA). The hemorrhage was successfully controlled by transcatheter arterial
embolization (TAE). However, on the 3rd day after TAE, an exploratory laparotomy was performed to establish an exact diagnosis
to explain the persistent abdominal pain and abnormal liver function tests. Subcapsular hematomas in both lobes were confirmed
and no visible laceration was present. The patient recovered gradually by spontaneous absorption of the hematomas and was
discharged on the 22nd postoperative day. Spontaneous hepatic hemorrhage associated with pregnancy is a very rare complication,
and establishing a correct diagnosis and initiating appropriate therapy are essential for this life-threatening disease. 相似文献
82.
Ischemic necrosis of the entire femoral head and rapidly destructive hip disease: potential causative relationship 总被引:6,自引:0,他引:6
Kyung Nam Ryu Eui Jong Kim Myung Chul Yoo Yong Koo Park David J. Sartoris Donald Resnick 《Skeletal radiology》1997,26(3):143-149
Objective. Rapidly destructive hip disease (RDHD) is an uncommon disorder of the hip that has been considered a disease of unknown cause
and distinct from ischemic necrosis of the femoral head. The objective of this study was to investigate ischemic necrosis
of the femoral head as one potential cause of RDHD. Design and patients. In 600 patients who underwent MR imaging of the hip, 20 cases of ischemic necrosis involving the entire femoral head in 18
patients (3%) were retrospectively studied with routine radiography and MR imaging. All patients had surgically confirmed
ischemic necrosis of the femoral head. Results and conclusions. All patients showed rapid destruction of the femoral head on routine radiography and MR imaging as compared with the gradual
onset of clinical symptoms. Plain radiographs showed several bone fragments at the inferomedial aspect of the femoral head
(75%), acetabular erosions (55%), eccentric depression at the lateral articular surface of the femoral head conforming to
the adjacent acetabulum (35%), and mild osteoarthritis (15%). Bone sclerosis was often present at sites of impaction between
the femoral head and the acetabulum. MR imaging showed marked distention of the joint capsule in all cases. In 14 of 20 cases,
the contents of the joint space showed predominantly low or intermediate signal intensity on T1- and T2-weighted images. Ischemic
necrosis involving the entire femoral head may represent one of the causes of RDHD. 相似文献
83.
Yasuyuki Yamashita Katsuhiko Mitsuzaki Yi Tang Tomohiro Namimoto Mutsumasa Takahashi 《Journal of magnetic resonance imaging : JMRI》1997,7(4):623-628
MR angiography (MRA) was performed in 50 consecutive subjects (mean age, 59 years), who had been referred for abdominal MRA, on a 1.5-T superconductive unit that used a body phased-array coil. Three breath-hold three-dimensional sequences were evaluated both in phantom and clinical studies: (a) standard fast three-dimensional gradient-echo sequence (TR = 15, TE = 6; imaging time, 32 seconds), (b) ultrafast three-dimensional gradient-echo sequence (TR = 8.2, TE = 3; imaging time, 18 seconds), and (c) ultrafast magnetization-prepared (MP) rapid acquisition gradient echo (RAGE) (TR = 5.8, TE = 2.9, inversion time [TI] = 20; imaging time, 15 seconds). The initial 30 patients were randomized into three groups by three separate sequences. For the remaining 20 patients, ultrafast-gradient-echo and ultrafast MP-RAGE sequences were performed. Conventional angiography was performed on 36 patients. Signal measurements of the phantom and clinical images of the aorta, visceral branches of the aorta, iliac arteries, inferior vena cavae, and portal veins were performed. The overall image quality and background fatty tissue contrast of the vessels were rated subjectively. Comparison of images between MRA and conventional angiography also was performed. The contrast between the vessels and background fatty tissue was significantly higher in the ultrafast MP-RAGE sequence in both quantitative and qualitative analysis, and image-quality ultrafast MP-RAGE was superior to the other two sequences (P < .01). The aorta and iliac arteries could be visualized in all pulse sequences, and abnormalities of these vessels were diagnosed correctly. The renal artery was visualized more clearly with the two ultrafast sequences. 相似文献
84.
Daniel W. Walsh Vincent B. Ho Michael F. Haggerty 《Journal of magnetic resonance imaging : JMRI》1997,7(2):312-315
Mycotic aneurysms of the abdominal aorta are potentially fatal but uncommon. We report the MRI and MRA features of an abdominal aortic mycotic aneurysm in a patient who presented with nonspecific low back pain. By delineating the saccular nature of the aneurysm and identifying the coexistence of vertebral enhancement, MRI was crucial for the final diagnosis. A potential pitfall of contrast-enhanced MRA is also demonstrated. 相似文献
85.
Val M. Runge John E. Kirsch Cecil Woolfolk Mitchell A. Brack Robert A. Garneau 《Journal of magnetic resonance imaging : JMRI》1994,4(3):343-350
A necrotic liver abscess model was studied with magnetic resonance (MR) imaging at 1.5 T before and after intravenous administration of gadoteridol at doses of 0.1, 0.25, and 0.5 mmol/kg in 24 rabbits. Enhancement characteristics and lesion delineation were assessed with both breath-hold and non-breath-hold imaging techniques. Lesion delineation, as assessed both by signal intensity measurements and evaluations by two image readers blinded to imaging technique, was greatest on high-dose (0.5 mmol/kg) breath-hold images. Lesion rim enhancement was seen consistently only on postcontrast images obtained at a dose of 0.5 mmol/kg and progressed with time after injection of contrast material. 相似文献
86.
P. B. Dimakakos M. Papasavval T. Stefanopoulos D. Mourikis G. Kostopanagiotou A. Doufas 《European journal of plastic surgery》1997,20(3):132-135
Fourteen pigs with an average weight of 17 kg were used in this study. Under general anesthesia and magnification 1–3 ccm/kg of carbon dioxide were administered in the lymph vessels of the front and rear legs. Imaging of the peripheral lymph vessels, lymph nodes and the thoracic duct was achieved with digital subtraction angiography. The quality of lymphangiography was satisfactory and comparable with that of the standard non-ionic contrast agent. It is anticipated that further technical evolution will permit the application of CO2/DSA lymphangiography to man. Carbon dioxide is non-nephrotoxic and is non-allergic; it is inexpensive, can be administered in unlimited quantity and is quickly eliminated via the pulmonary system. 相似文献
87.
Peter Reimer Sanjay Saini Ken K. Kwong Mark S. Cohen Ralph Weissleder Thomas J. Brady 《Journal of magnetic resonance imaging : JMRI》1994,4(3):331-335
To develop guidelines for clinical magnetic resonance imaging of the liver, the authors undertook an animal study to investigate the effect of dose and pulse sequence on liver signal intensity in gadopentetate dimeglumine—enhanced echo-planar imaging. Serial imaging of the liver was performed in anesthetized rats after intravenous administration of five different doses (0.01, 0.05, 0.1, 0.2, and 0.5 mmol/kg) of contrast agent, with six different pulse sequences. The results show that gadopentetate dimeglumine—enhanced echo-planar images obtained during the perfusion phase can yield either positive (due to increased T1 relaxation rates) or negative (due to susceptibility-induced increased T2 relaxation rates) liver enhancement depending on choice of pulse sequence and dose. At the current clinically recommended dose of 0.1 mmol/kg, maximal liver signal enhancement was seen with a T1-weighted inversion-recovery sequence, while maximal liver signal diminution was seen with a T2*-weighted gradient-echo sequence. The authors conclude that gadopentetate dimeglumine—enhanced echo-planar imaging can provide T1, T2, and T2* contrast that may be exploited for both lesion detection and lesion characterization. 相似文献
88.
Michael P. Recht Josef Kramer Cheryl A. Petersilge Joseph Yu Mini Pathria Debra Trudell David J. Sartoris Donald Resnick 《Journal of magnetic resonance imaging : JMRI》1994,4(2):173-177
Although magnetic resonance (MR) images of the glenohumeral joint frequently demonstrate intraarticular fluid, no specific criteria have, to the authors' knowledge, been published that allow accurate assessment of the amount of fluid present. Also, despite the increasing use of MR arthrography of the shoulder, the optimal amount of intra-articular fluid that should be used with this technique has not been determined. The authors progressively distended the glenohumeral joint in six cadaveric shoulder specimens with a dilute gadopentetate dimeglumine solution and obtained MR images after injection of 2, 5, 10, 15, and 20 mL of the solution. The pattern of fluid distribution was evaluated, and these results were then used to estimate the amount of fluid that was present in the glenohumeral joint on MR images of 20 shoulders obtained in 12 asymptomatic volunteers. In 14 of these shoulders, intraarticular fluid was present; however, in none was more than 2 mL evident. Results of the cadaveric study also indicated that 15 mL of intraarticular fluid appears to be the optimal amount for MR arthrography. 相似文献
89.
目的:分析立体定向X-刀放射治疗颅内肿瘤后的近期疗效,并进行阶段性工作总结。材料和方法:53例不同类型脑瘤患者,以CT、MR、DSA图像资料作为定位依据,用德国Brain LAB治疗计划系统设计三维优化方案,西门子MD-2型直线加速器旋转照射。结果:53例患者经X-刀治疗后,近期均取得了满意效果,诸如以卡氏评分法评价,临床症状有所改善;以CT增强扫描复查观察,肿瘤大小趋于缩小或消失。结论:立体定向放射治疗后的追踪观察表明,只要严格掌握适应症,精确定位,精确计划,精心治疗,X-刀是一种安全、有效、无痛苦的治疗脑肿瘤的方法。它可起到改善临床症状,提高患者生活质量,延长生存期限的作用。 相似文献
90.
We report a newly developed MR simulation system for intracavitary brachytherapy for cervical cancer and subsequent treatment results. MR simulation was performed on six patients. The spatial relationship of the tumor to the bladder, rectum, bowel, applicators, etc. was depicted well. Doses to the tumor and surrounding normal tissues were read from isodose curves superimposed on the T2-weighted sagittal image. This system promises to be useful in customizing the dose distribution. 相似文献