[Non-invasive coronary arteriography in magnetic resonance scanning].
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Contraindications↗
Biomedical subjects
E Lundorf
Publications and source records attributed to E Lundorf.
[MR-cholangiography in patients suspected with choledochus calculi].
To test a new non-invasive imaging method, magnetic resonance cholangiography (MRCP), we compared MRCP with intraoperative cholangiography (IOC) or endoscopic retrograde cholangiography (ERC). In 55 patients with 11 common bile duct stones MRCP identified all 11 stones and incorrectly found stones in seven additional patients. Predictive value of positive test was 61%, predictive value of negative test was 100%. As a consequence of MRCP, ERC or IOC can be avoided in 67% of the patients.
Adult↗
[Magnetic resonance imaging of patients with perianal fistulas].
Magnetic resonance imaging (MRI) of the anal canal was retrospectively evaluated during a three year period in 67 patients with suspected perianal fistulae. In six cases the surgeon, who knew the results of the MRI, found a fistula not seen on MRI while MRI showed a fistula in one patient which could not be found at surgery. We recommend MRI in cases where an experienced surgeon has difficulties mapping the fistula tract.
Adolescent↗
Incidence and growth pattern of vestibular schwannomas in a Danish county, 1977-98.
During a period of 21 years 162 acoustic neuromas or vestibular schwannomas (VS) were diagnosed in the county of Aarhus. During this period the incidence increased gradually, probably due to improvement of the quality of computed tomography imaging (CTI), and more widely available access to magnetic resonance imaging (MRI). Sixty-four patients were followed up by repeated CTI or MRI, whereas the remaining patients were referred for immediate operation. Six of the observed patients had their tumours removed after demonstration of continuous tumour growth. The observation of 64 tumours over periods between 5 months and 15 years provided useful information on the natural history of sporadic VS. Our results showed that 14 VS (22%) regressed, 35 VS (55%) did not grow or had only minimal growth (growth rate up to 1 mm/year), whereas 15 VS (23%) grew > 1 mm/year. All VS with positive growth had regular growth patterns.
Adult↗
Investigations into the natural history of vestibular schwannomas.
In the period from 1977 to 1996 143 vestibular schwannomas were diagnosed in 138 patients in the County of Aarhus, Denmark. The natural history of vestibular schwannomas was observed in 50 patients with 52 tumours who did not undergo immediate surgical removal of their tumour due to small tumour size, advanced age, poor general health and the patients' refusal of surgery. The management included serial CT- or MR-imaging and complete otoneurological evaluation. The imaging interval was between 6 months and 2 years and depended on the recorded growth rate. Thirty-three (64%) of the tumours showed continuous growth with a mean growth rate of 1.6 mm/year. In 11 (21%) of the tumours the size was unchanged and eight (15%) remitted. The last group consisted mainly of the largest tumours. Among the tumours with positive growth, 15 (45%) had a growth rate of 1 mm/year or less. Generally, our findings showed that approximately two-thirds of all the tumours did not grow, were getting smaller or had a growth rate sufficiently small to be simply watched. Additionally, our results suggest that some symptomatic tumours will grow to a certain point whereupon stagnation or remission occurs.
Denmark↗
Clinical magnetic resonance imaging and arthroscopic findings in knees: a comparative prospective study of meniscus anterior cruciate ligament and cartilage lesions.
We compared the diagnostic and predictive value of magnetic resonance imaging (MRI) and clinical findings with arthroscopy in 61 knees in a prospective study. In meniscal tears, the accuracy and positive predictive value of MRI was found to be nearly twice that of clinical examination. The sensitivity, specificity, and negative predictive value of MRI were comparable to the figures found in other studies. We recommend MRI as a clarifying diagnostic tool when a clinical examination indicates a lesion of the meniscus. In our study, the clinical relevance of MRI in anterior cruciate ligament lesions and especially in cartilage lesions was more doubtful. The combination of clinical and MRI findings would reduce the number of blank arthroscopies to 5%. MRI is a valuable diagnostic tool in planning the type of anesthesia and treatment, and could significantly reduce the need for a second arthroscopy.
Adult↗
Magnetic resonance imaging of spinal cord infarction after infrarenal vascular surgery.
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Aged↗
[Intracranial lipomas].
Intracranial lipomas are rare lesions that should be regarded as congenital malformations. They are usually asymptomatic and incidental findings during neuroradiological investigations. Other brain malformations are often seen in association with intracranial lipomas. The most common is hypoplasia of the corpus callosum. An attempt at surgical removal is not advisable. Lipomas are strongly adherent to the surroundings and typically enclose both vessels and nerves. Magnetic resonance imaging is capable of differentiating lipomas from dermoid cysts and teratomas, making this the diagnostic method of choice.
Adult↗
The size of acoustic neuromas: CT and MRI.
The growth rate of acoustic neuromas is very variable: some tumours grow rapidly, some do not grow and some even get smaller. When making treatment decisions, it may be important to have an idea of the growth rate of the individual tumour, and this is only possible when there are comparable examinations. We performed both CT and MRI on 15 patients. Two radiologists estimated the size of their acoustic neuromas. There was a significant difference between the two examiners' calculations of tumour volumes on CT and between the first examiner's CT and MRI volume calculations. No difference was found between the two MRI volume estimations or the second examiner's estimation of volumes on CT and MRI. Measurements of the maximal tumour diameter along the pyramid showed good concordance. We conclude that measurement the size of acoustic neuromas is reproducible with MRI and the measurement of the maximal tumour diameter is in practice a better parameter for comparison than calculation of real volume.
Adult↗
Tumour oxygenation assessed by polarographic needle electrodes and bioenergetic status measured by 31P magnetic resonance spectroscopy in human soft tissue tumours.
The purpose of this study was to evaluate the feasibility of polarographic oxygen electrode measurements and phosphorus magnetic resonance spectroscopy (31P-MRS) in extravisceral soft tissue tumours, designated to receive preoperative radiotherapy. Pretreatment tumour oxygenation was determined in 41 cases and 31P-MRS was amenable to lesions in 34 patients. Biopsies were characterized histopathologically as 25 primary soft tissue sarcomas (STS), 2 recurrent STS, 9 benign and 5 other malignancies. Evaluation of phosphorus (31P) spectra was possible in 11 cases. The oxygenation status of normal tissue was higher than that of tumours, whereas no difference was found between oxygenation status of benign lesions and that of STS. There was substantial variation between tumours in the median pO2 and the bioenergetic status (beta-NTP/Pi). No correlation was found between tumour pO2 and volume (n = 25). Moreover, there was no correlation between beta-NTP/Pi and the median tumour pO2, the fraction of pO2 values < or =2.5 mmHg or tumour volume (n = 10), respectively. In conclusion, oxygen electrode assessment was found to be a clinically applicable and feasible technique for measuring tumour oxygenation status, whereas the success of 31P-MRS in human neoplasms was limited by a very poor resolution in the phosphorus signal that allowed analysis of 31P spectra in 11 tumours out of 34 cases.
Adult↗
[Can magnetic resonance imaging differentiate between benign and malignant conditions in patients with skeletal or soft tissue tumors?].
The records of 437 patients referred preoperatively for magnetic resonance imaging (MRI) due to clinical or radiological suspicion of a bone or soft-tissue malignancy were examined retrospectively in order to evaluate how good MRI is at distinguishing malignant from benign lesions. The MR-examination tends to overestimate malignancy. In all cases, the preoperative MR-examination correctly identified all malignant tumours as malignant, but also estimated a number of benign lesions as malignant. Sensitivity, specificity and predictive value was 100%, 71.2% and 76.4% respectively. In case of bursa/ganglion and pseudotumour, MR was able to correctly identify these lesions as benign. MR could not differentiate between the different types of sarcomas.
Diagnosis, Differential↗
Hemifacial spasm: magnetic resonance angiography.
Twenty-three consecutive patients with hemifacial spasm were studied. Magnetic resonance imaging angiography of the brain was performed in 20 patients and 15 controls. The angiograms were evaluated by two independent observers and blinded for side-location of the spasm. Contact between an artery from the vertebrobasilar circulation and the intracranial part of the facial nerve was observed ipsilaterally to the spasm in 17 patients (85%) and in two of 30 control half-brains (7%), respectively. Treatment is discussed. The study confirms that arterial relation to the facial nerve root is the most frequent cause of hemifacial spasm. Magnetic resonance imaging is recommended to exclude mass lesions in the posterior cranial fossa, and magnetic resonance angiography is recommended in preoperative evaluation and in research.
Adult↗
The pituitary gland in nocturnal enuresis: MR findings.
Nocturnal enuresis is considered a benign condition partially explained by a defect circadian rhythm of vasopressin. An organic cause may be responsible for an abnormal pituitary function, when enuresis persists into adulthood. In the present study the pituitary gland and surroundings of 8 adults suffering from primary monosymptomatic nocturnal enuresis were studied by magnetic resonance imaging. The pituitary gland appeared normal in all, except from a Rathke's cleft cyst observed in one patient. This cleft cyst was not considered to be clinically important. It was concluded, that severe nocturnal enuresis persisting into adulthood is not likely to be combined with detectable pathology on magnetic resonance imaging of the pituitary gland.
Adult↗
[Size of acoustic neurinomas assessed by CT and magnetic resonance scanning].
Some acoustic neuromas do not grow or grow very slowly. It is therefore of value to compare the results of measuring the size of acoustic neuromas by either CT or Magnetic Resonance Imaging (MRI) scanning with a view to being able to observe the growth rate of these tumours. Fifteen patients with acoustic neuromas had both CT- and MRI-scans performed. Two trained radiologists evaluated the size of the tumours in a blinded fashion. There was a significant difference between one observer's calculations from the CT- and the MRI-scans, and also a significant difference between the two observers' calculations from the CT-scans. No difference in calculating tumour size was found between the two observers' calculations from the MRI-scans. It is concluded that the size of acoustic neuromas i evaluated more equally by two observers using MRI-scans than when using CT-scans. By the use of repeated MRI-scanning it is possible to keep patients with acoustic nouromas under observation and avoid operation in those patients where the tumour does not grow.
Adult↗
[Hemifacial spasms--clinical picture, diagnosis and treatment].
A rectrospective study of 23 consecutive patients with hemifacial spasm is presented. Based on this experience, a practical approach to the diagnosis, investigation and treatment with injections of botulinum toxin is described. Magnetic resonance imaging angiography of the brain was performed in 20 patients an 15 controls. Contact between an artery from the vertebrobasilar circulation and the intracranial part of the facial nerve was observed ipsilaterally to the spasm in 17 patients (85%) and in two controls (7%). Treatment with botulinum toxin was performed in 16 patients with moderate to good improvement in the majority of the patients. MR-angiography is recommended in order to exclude infrequent etiologies and as preoperative evaluation. Botulinum toxin injection is recommended as the symptomatic treatment of choice. The possibility of curative surgical intervention by microvascular decompression of the facial nerve is discussed.
Adult↗
Imaging of chondrosarcoma with histopathological and prognostic correlation. An analysis of 49 cases mainly based on plain film radiography.
PURPOSE: To investigate the course of chondrosarcoma in relation to radiographic and histopathologic findings. MATERIAL AND METHODS: 49 consecutive patients seen during an 11-year-period were analysed, including re-evaluation of their radiographic and histopathologic material. RESULTS: Forty-two patients had radiographic changes typical for cartilaginous tumours, in 37 with malignant stigmata. Seven patients had malignant changes not typical for chondrosarcoma. By histopathologic grading 16 patients had grade I, 17 grade II and 16 grade III tumours. Six of the grade II-III tumours were histopathologic variants (mesenchymal, dedifferentiated or myxoid chondrosarcomas). Surgical removal of the tumour was performed in 42 patients, 41 of whom were followed up for 0.4-11.4 years (median 3.8 years). Local recurrence occurred in 7 patients, and 11 patients developed metastases. Ten patients, 4 with local recurrence and metastases, and 6 with metastases only were dead at the end of the follow-up. The actuarial 5-year overall survival rate was 64%. The occurrence of local recurrence, metastases and death was found to be related to the histopathologic grades II and III. Atypical radiographic features only occurred in grade II-III tumours and were related to metastases and death, but not to local recurrence. CONCLUSION: Atypical radiographic findings were related to high-grade malignancy and poor prognosis.
Adolescent↗
Intraarticular findings in the chronically painful shoulder. A study of 32 posttraumatic cases.
32 consecutive patients suffering from chronic shoulder pain for more than 6 months after a single, nondislocating shoulder trauma were examined clinically and by special radiographs, dynamic sonography, MRI and arthroscopy. Typical complaints were pain during loading, especially during over the head activities. Symptoms of a "dead arm" and instability were also present. Patients with previous dislocations, traumas or radiographic signs of degenerative shoulder lesions were excluded. The patients had a decreased active range of motion and positive signs of apprehension and impingement, but only 4 had clinical signs of shoulder instability. Diagnostic evaluation identified labral tears, partial and total rotator cuff lesions with subacromial impingement and tendinitis of the biceps tendon. Surgery was performed in 24 patients, using capsulolabral and rotator cuff reconstruction, arthroscopic labral resection and open subacromial decompression. In conclusion, patients with chronic posttraumatic shoulder pain have intraarticular injuries, especially tears of the glenoid labrum. History, clinical findings, radiography and sonography are seldom diagnostic. MRI is valuable, particularly for identification of labral pathology, but arthroscopy appears necessary for a preoperative assessment.
Adolescent↗
Comparison of the safety of standard and triple dose gadodiamide injection in MR imaging of the central nervous system. A double-blind study.
Gadodiamide injection was administered intravenously to 49 patients with known or suspected CNS lesions undergoing MR imaging. Two parallel groups were used to evaluate the efficacy and safety of single doses of 0.1 (25 patients) and 0.3 (24 patients) mmol/kg b.w. The principal measures of efficacy were diagnostic yield of MR and the overall contrast enhancement. Adverse events and serum bilirubin were the main safety parameters. Contrast enhancement of the lesion was observed for 16 patients in each dose group. Thirteen patients in the 0.1 and 17 in the 0.3 mmol/kg group had their diagnosis amended following the postcontrast image, but only one patient in each dose group had their management affected by new information from the postcontrast image. The overall diagnostic utility of gadodiamide injection was good, but there were no differences between the 2 doses studied in this respect. No injection-associated discomfort or other adverse events were reported. No clinically important changes in serum bilirubin, or other parameters of blood chemistry, or hematology were observed. Overall, the safety profile of gadodiamide injection 0.3 mmol/kg b.w. in this study was similar to that of 0.1 mmol/kg b.w.
Adult↗