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Biomedical subjects

E Justich

Publications and source records attributed to E Justich.

At least 19 recordsLinked to original sources

A new surgical but less invasive treatment of central brain tumours Preliminary report.

Our goal was always to reduce the risks of anaesthesia and surgery to a minimum. Therefore we introduced the interstitial thermotherapy of central brain tumours. The center of the tumour is calculated with the help of computer tomography, then we reach the target stereotactically. The last step includes the insertion of a Nd:YAG laser fiber and the denaturation of the tumour under real time magnetic resonance control. The whole procedure is carried out in local anaesthesia. Methods and first clinical results are demonstrated.

Adult↗

Mitochondrial encephalomyopathy--two years follow-up by MRI.

A case of mitochondrial encephalomyopathy (MEM) followed-up by MRI for 2 1/2 y is presented. MRI showed gross, diffusely distributed white matter lesions in both hemispheres predominantly in frontal, parietal, temporal and occipital locations a marked ventriculomegaly indicative of cerebral atrophy. Except a slight increase of the cerebral atrophy there were no changes in the follow-up examinations. There are no specific MRI findings in MEM, the diagnosis is established by the synopsis of MRI, laboratory data and muscle biopsy.

Atrophy↗

[Staging of cervix cancer using MRT].

In a prospective study the results of FIGO staging and MR staging in uterine cervical carcinoma were compared with the findings of stepwise serial examination of en-bloc-resected specimens in 28 patients. Overall accuracy of MR staging was 59% compared to 41% in FIGO staging. Sensitivity in assessing parametrial tumour extension was 85% in MRI and 64% in clinical examination. Specificity was 74% in MRI and 69% in physical examination. Accuracy in parametrial tumour extension was 67 per cent in FIGO-Classification and 80 per cent in MRI.

Adult↗

Multiple sclerosis in childhood: contribution of serial MRI to earlier diagnosis.

The authors report six children (five girls, one boy) aged 11 to 13 years, of whom four had clinically definite multiple sclerosis (MS) and two had laboratory-supported definite MS. All had brain white matter abnormalities indicative of MS. In three cases, positive findings on the first MRI contributed significantly to their early diagnosis. Follow-up MRI studies over an average period of five months detected morphological changes in three of the children, although there was no concomitant clinical evidence. This raises the question of whether changes in clinically 'silent' lesions on follow-up MRI are antecedents of the essential MS criterion of dissemination over time, which could lead to earlier diagnosis of childhood MS. With cranial computerized tomography (CT) during the first clinical attack, a large focus with a lamellar structure mimicked a brain tumour in two patients. As CT also misses additional small lesions, it should no longer be used as the primary diagnostic method.

Adolescent↗

[MR study of bone marrow changes of the spine following radiotherapy].

MR examinations of bone marrow variations in the spine after radiotherapy were performed on 24 patients in the thoracic and lumbar vertebral column. The actinically affected bone marrow showed a characteristic increase of signal intensity in T1-weighted sequences in the sagittal plane, due to conversion of red marrow to fatty marrow. The dose in the well-defined radiation areas was between 28 and 70 Gray (Gy). The lowest dose, applied to the bone-marrow bordering on the defined radiation areas, where we still could find an increase of signal intensity, was below 2.6 to 5 Gy. MR imaging was performed between 6 and 9 month after radiotherapy.

Adult↗

Magnetic resonance imaging in children with acute hip pain.

45 children presenting with acute hip pain were prospectively evaluated with conventional radiography, radioisotope bone scan, and magnetic resonance imaging (MRI). The final diagnoses were transient synovitis (n = 17), septic arthritis (n = 2), Legg-Calve-Perthes disease (LCPD, n = 13), epiphyseal dysplasia (n = 2), other conditions (n = 4), and normal findings (n = 7). In the work-up MRI provided more morphologic information than other techniques and enlarged the diagnostic possibilities. It was the only imaging technique able to give an early indication of bone marrow involvement in systemic diseases. For the early diagnosis of LCPD, MRI was as sensitive as isotope bone scan and more precise than conventional radiography. In the follow-up of LCPD patients MRI was not able to indicate the start of revascularisation of the necrotic area, which bone scans showed reliably in six patients: but MRI provided excellent evaluation of the position, form and size of the femoral head and the surrounding soft tissues.

Acute Disease↗

Magnetic resonance imaging in cervical cancer: a basis for objective classification.

Conventional clinical staging of cervical cancer is subjective because it is based on palpatory findings and inadequate because it cannot assess the single most important prognostic factor--tumor size. To determine the exactitude of in vivo MRI measurements of tumor volume, 22 patients with invasive cervical cancer were studied before surgery. The volumes obtained by MRI correlated well (r = 0.983) with those obtained by histomorphometric analysis of the surgical specimens, but only weakly with clinical stage. MRI may provide a basis for precise classification of cervical cancer and for objective comparison of surgery and radiotherapy.

Female↗

MR findings in methotrexate-induced CNS abnormalities.

MR of the brain was performed in eight patients (mean age, 14.9 years) with osteogenic sarcoma during or after IV treatment with high-dose methotrexate. MR detected brain abnormalities in four patients, three of whom had concomitant neurologic dysfunction. Pathologic findings demonstrated on MR were (1) chronic brain edema, demonstrable over a period of 3-14 months (proved by autopsy in one patient); (2) multifocal white matter necrosis; and (3) deep brain atrophy. MR appears to be valuable in the detection of abnormalities induced by treatment with high-dose methotrexate.

Adolescent↗

Magnetic resonance imaging in clinical cervical cancer: pretherapeutic tumour volumetry.

MRI can define the spread, size, and volume of clinical cervical cancers. Appropriate pulse sequences and slice thicknesses are necessary. Twenty-five patients underwent MRI tumour volumetry before radical hysterectomy. The volume obtained by MRI was compared with that obtained from the histological giant sections; the volumes agreed at a statistically significant correlation coefficient of 0.983. The volumes obtained by MRI of 13 unfixed surgical specimens correlated with their histological volumes with a statistically significant coefficient of 0.894. Tumour volumes were compared with the respective clinical stages. Clinical stage did not correlate with tumour volume. Three very large tumours were in clinical Stage Ib. Tumour size is a major prognostic factor, can be measured easily, and, as the basis for classification, is superior to FIGO staging. MRI can measure tumour volume before treatment.

Female↗

Nuclear magnetic resonance image white matter lesions and risk factors for stroke in normal individuals.

The incidence, average number, and localization of lesions of the white matter detected by the T2-weighted nuclear magnetic resonance images among volunteers without cerebrovascular symptoms have been correlated with the number of risk factors for stroke. Accepted risk factors were arterial hypertension, diabetes mellitus, smoking, hypercholesterolemia, and cardiac disease. The 42 subjects examined were divided into Group A (0-1 risk factor, mean age 59.36 +/- 5.73 years), Group B (2 risk factors, mean age 61.54 +/- 8.33 years), and Group C (greater than or equal to 3 risk factors, mean age 62.57 +/- 9.83 years). Multiple risk factors among the age-matched groups was accompanied by a highly significant increase (p less than 0.001, Group A versus Group B; p less than 0.01, Group A versus Group C) of the incidence of white matter lesions. The average number of white matter lesions was increased (p less than 0.001) when Group A was compared with Groups B and C. Ninety-two percent of the white matter lesions were localized in watershed zones. Only 11 of the 155 abnormalities of the white matter detected by nuclear magnetic resonance imaging could be detected by computed tomography. White matter lesions in T2-weighted images appear to be an early stage of cerebrovascular disease.

Brain↗

The diagnostic value of renal cortex-to-medulla contrast on magnetic resonance images.

The diagnostic value of magnetic resonance contrast between the renal cortex and renal medulla as an indicator of renal disease was retrospectively studied in 38 patients (ten patients with a variety of diseases affecting the renal parenchyma, nine with renal obstruction, four with diffusely infiltrating renal-cell carcinoma, one with renal hematoma, nine with normally functioning renal allograft, and five with renal allograft failure). Twelve normal volunteers served as controls. On spin-echo (SE) images (TR 0.5 sec, TE 28 msec), the cortex-to-medulla contrast was present in the kidneys of all the normal volunteers (19% contrast +/- 2% S.D.) and in all the normally functioning allografts (17% contrast +/- 2% S.D.). Decrease or absence of cortex-to-medulla contrast (SE image with TR 0.5 sec and TE 28 msec) was found to be a sensitive but nonspecific sign of renal disease. It occurred in renal diseases of various causes and was produced by different pathophysiologic mechanisms such as edema, scarring, and tissue replacement by neoplasm or hematoma. Of the calculated T1 and T2 relaxation times and spin density of the cortex and the medulla, the T1 changes most consistently reflected renal disease.

Adolescent↗

Complications of renal tumor embolization.

In 121 renal tumor embolizations with four different embolic agents (Gelfoam, Ivalon, ethanol, coils) the mean complication rate was 9.9%, with a mortality of 3.3%. Because of the large embolized tumor mass and the severely impaired health of patients, the complication rate in palliative embolizations was about four times as high as in preoperative procedures. Complications most commonly encountered were renal failure and unintentional embolization of nontarget organs.

Adult↗

[Reduction of the rate of cerebral angiography complications by a standardized study method].

The complications from cerebral angiography encountered in 1034 patients between 1977 and 1982 are described. A standardised technique of cerebral transfemoral catheter angiography is outlined, which helps to reduce the number of complications. The role of the disease for which the examination is done, and the effect of the new contrast media on the risk of the examination, are discussed. Patients with a compromised blood-brain barrier and manifest reduction in cerebral blood flow run a greater risk than patients with other abnormalities. Low osmolar contrast media are better tolerated subjectively. Theoretically, their use would be expected to lead to a reduction in complications but, so far, it has not been possible to confirm this.

Adult↗

Infected aortoiliofemoral grafts: magnetic resonance imaging.

Three patients with proved infected aortoiliofemoral grafts were examined by magnetic resonance (MR) imaging using a spin echo technique. MR clearly identified the perigraft abscess, the involvement of adjacent structures, and the longitudinal extent of the process in all patients. The MR findings were: Abscesses create a high signal intensity, somewhat less than fat. The perigraft abscess has a great contrast with the signal void of flowing blood in the graft. Inflammatory changes cause an inhomogeneous intermediate signal, slightly more intense than muscle. Both abscesses and edematous areas increase their signal intensity with long repetition rates and long echo delays. Areas of gas appear black. They cannot be distinguished from calcified plaques. Additional information is gained about the graft patency. Although the specificity has to be proved, MR imaging is sensitive in the detection of infected grafts and for defining the longitudinal extent of the perigraft abscess.

Aged↗