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F J Wippold

Publications and source records attributed to F J Wippold.

53 records · Page 3Linked to original sources
PubMed1993

White matter lesions and cerebral atrophy on MR images in patients with and without AIDS dementia complex.

OBJECTIVE: The objective of this study was threefold: to determine if the frequency of deep white matter changes and cerebral atrophy seen on MR images is significantly different between patients with and without AIDS dementia complex, to determine if certain patterns of white matter changes are more closely associated with AIDS dementia complex, and to determine if focal lesions within the white matter of the splenium are more common in AIDS dementia complex. MATERIALS AND METHODS: Forty-five patients with AIDS were clinically examined for AIDS dementia complex. MR images from these patients were retrospectively reviewed without knowledge of the clinical results. The presence or absence of white matter abnormalities and cerebral atrophy was evaluated by using graded scales and correlated with the presence or absence of AIDS dementia complex. RESULTS: Ten patients met the criteria for AIDS dementia complex. Eight of 25 patients in whom MR images showed abnormal signal intensity in deep white matter had dementia compared with two of 20 in whom MR showed no changes in deep white matter. The presence of these deep white matter abnormalities was not significantly different between groups with and without dementia (p = .08), although higher grades of deep white matter abnormality were more likely to be associated with AIDS dementia complex. Nine of 19 patients in whom MR images showed atrophy had dementia compared with one of 26 in whom MR showed no atrophy. Atrophy was significantly associated with AIDS dementia complex (p = .001). Eight of 15 patients in whom MR images showed abnormal signal intensity within the white matter of the splenium had dementia compared with two of 30 in whom MR showed normal signal intensity in this area. The degree of abnormality in the splenium was weakly associated with AIDS dementia complex (Kendall's tau = .471, p = .001). CONCLUSION: MR findings of cerebral atrophy and abnormal signal intensity in the splenium are associated with AIDS dementia complex. The presence of generalized deep white matter abnormalities does not differ significantly between patients with and without dementia, although more severe grades of white matter abnormality are more likely to be seen in patients with AIDS dementia complex.

AIDS Dementia Complex↗
PubMed1991

Senile dementia and healthy aging: a longitudinal CT study.

Volumetric indexes of cerebral atrophy obtained by using computed tomography (CT) were measured longitudinally in patients with senile dementia of the Alzheimer type (SDAT) and in healthy elderly control subjects. Measurements were made three times over a 51-month period. Of the original 44 patients with SDAT, five were available for CT examination at the last time of assessment (51 months); in contrast, 41 of the original 58 control subjects were still available for study at 51 months. As a group, scans of SDAT subjects showed greater atrophy than those of control subjects in all volumetric indexes at each time of testing and demonstrated greater progression of atrophy during the study period. However, the overlap of indexes between the patients with SDAT and the control subjects indicates that CT data cannot be used alone to predict the presence or progression of dementia in individual cases.

Aged↗
PubMed1988

Radiologic evaluation of mass casualty victims: lessons from the Gander, Newfoundland, accident.

This study describes the use of radiologic methods in the identification of 256 bodies after the crash of an airliner in Gander, Newfoundland. Two hundred thirty-one (90%) of the victims were identified positively with dental and/or fingerprint comparisons. Radiologic data confirmed identification in 29 of these victims. Seventeen bodies without dental or fingerprint identification were presumptively identified with a variety of data, which included radiologic characteristics in four cases. Eight bodies were identified with an exclusion matrix. Radiologic input was critical in two of these. The procedures described provide practical information for radiologists in a mass casualty disaster investigation.

Accidents, Aviation↗
PubMed1987

Evaluation of MR in spinal dysraphism with lipoma: comparison with metrizamide computed tomography.

Magnetic resonance (MR) imaging and metrizamide computed tomography (CT) were performed on three patients with spinal dysraphism with lipoma. Sagittal MR images were superior to metrizamide CT reformatted sagittal images in demonstrating anatomic relationships of the spinal cord, filum terminale and lipoma. In the axial plane, CT proved superior to MR. In all cases, the T1 weighted images with exceptional spatial resolution and excellent fat discrimination were more helpful than T2 weighted images. Although both MR and CT are useful in the initial evaluation of these disorders, subsequent evaluation employing only MR is probably adequate. Promising developments in surface coil imaging may eventually replace CT.

Adolescent↗
PubMedDate not supplied

Pre- and postcontrast MR studies in tuberous sclerosis.

The MR findings in eight patients with intracranial manifestations of tuberous sclerosis are reported. There were subependymal lesions in seven patients and peripheral lesions (i.e., cortical and subcortical) in all patients. All lesions were supratentorial. We emphasize two findings that have not been previously stressed. The signal intensity patterns of the subependymal lesions varied from patient to patient, but in all patients receiving intravenous contrast medium, the majority of these lesions enhanced. Although this finding may signify early breakdown of the blood-brain barrier with potential for lesion growth, the high frequency of enhancement challenges earlier concepts of equating this phenomenon with existence of actively growing giant cell astrocytomas. The peripheral lesions were more numerous than subependymal lesions. These lesions were nearly always hyperintense in the proton density weighted and T2-weighted images. Most notable is the fact that, in half of the lesions, signal intensity was also elevated in the T1-weighted image, an observation that has not been emphasized in previous reports. Although not pathologically confirmed this signal pattern may represent early stages of calcification within these lesions. Finally, unlike subependymal lesions, none of the peripheral lesions showed contrast enhancement.

Adolescent↗
PubMedDate not supplied

MRI of esthesioneuroblastoma.

OBJECTIVE: Esthesioneuroblastomas are uncommon tumors originating in the olfactory epithelium of the superior nasal cavity. Accurate staging appropriately guides therapy and predicts survival. The MR appearance and pattern of contrast enhancement in these tumors have not been well described. The goals of this article were to analyze the MRI characteristics of esthesioneuroblastoma, including extent of tumor, differentiation from obstructive sinus disease, MR signal, and pattern of contrast enhancement. MATERIALS AND METHODS: The MR examinations of six patients with proven advanced esthesioneuroblastoma were reviewed. Standard SE T1- and T2-weighted axial images were obtained [550-600/15-25 and 2,000-2,760/80-90 (TR/TE), respectively], followed by postcontrast axial and coronal T1-weighted sequences in all patients. RESULTS: Five of the six tumors were centered in the superior nasal cavity and one was centered in the lateral ethmoid air cells. Five tumors extended intracranially. Postobstructive sinus disease was always encountered. As compared to gray matter, the signal on T1-weighted images was either hypo- or isointense. On T2-weighted images, the signal varied from iso- to hyperintensity. Contrast enhancement was intense and of variable uniformity. CONCLUSION: Magnetic resonance signal characteristics helped to distinguish obstructive sinus disease from tumor. The MR signal characteristics and pattern of contrast enhancement were nonspecific for esthesioneuroblastoma. Enhanced images, particularly in the coronal plane, were very helpful in identifying intracranial extension.

Adult↗
PubMedDate not supplied

Limited coronal CT: an alternative screening examination for sinonasal inflammatory disease.

Coronal CT is the definitive procedure for radiologic evaluation of sinonasal inflammatory disease, yet many clinicians rely on the less expensive plain film sinus series. We designed a limited four slice coronal CT and prospectively compared it with conventional coronal CT and plain film sinus series in 25 patients to determine whether a limited CT examination is a suitable alternative to these other radiologic procedures in screening for sinonasal inflammatory disease. The presence, amount, and location of mucous membrane disease, opacification, air fluid levels, retention cysts, erosions, and anomalies were recorded for each technique. The limited CT agreed with the complete CT in 82% of the 200 sinus compartments reviewed. Localized disease, usually mucosal thickening of 3 mm or less and missed on the limited CT, but detected on the complete CT, accounted for 22 of 36 errors of interpretation. Underestimation of mucosal disease, usually 2 mm or less, accounted for eight errors and misinterpretation of partial volume effect for three errors. Using complete CT a s the established standard, plain film missed 37 instances of disease detected on the limited CT; 73% involved an error of mucosal thickening 4 mm or greater. A limited coronal CT of the paranasal sinuses offers a potentially lower cost alternative to complete CT in screening for sinonasal inflammatory disease. It is more accurate than plain film series. Localized disease and osteomeatal disease is underestimated with the current protocol, and so a limited CT should not be used for evaluating potential cancer patients or for surgical planning.

Adult↗
PubMedDate not supplied

Neuropathology for the neuroradiologist: palisades and pseudopalisades.

Histologic patterns of cellular architecture often suggest a tissue diagnosis. One distinctive histologic pattern seen within some tumors of the nervous system is the palisade. The purpose of this report is to review the significance of palisades and pseudopalisades in the context of such tumors as schwannomas and glioblastomas.

Glioblastoma↗
PubMedDate not supplied

Significance of cerebellar tonsillar position on MR.

It has been noted that a low degree of ectopia of the cerebellar tonsils on MR is of questionable significance. We measured the position of the cerebellar tonsils with respect to the inferior aspect of the foramen magnum in 200 normal patients and in 25 patients with a firm diagnosis of Chiari I malformation. In the normal group, the mean position of the tonsils was 1 mm above the foramen magnum with a range from 8 mm above the foramen magnum to 5 mm below. In the patients with Chiari I malformations, the mean position was 13 mm below the foramen magnum with a range from 3 mm below the foramen magnum to 29 mm below. Fourteen percent of normal patients had tonsils extending slightly below the foramen magnum. If 2 mm below the foramen magnum is taken as the lowest extent for tonsils in a normal patient, our sensitivity in predicting symptomatic patients is 100% and our specificity is 98.5% (three false positives). If 3 mm below the foramen magnum is taken as the lowest normal tonsillar position, our sensitivity is 96% and our specificity is 99.5%. MR demonstration of less than 2 mm of tonsillar ectopia is probably of no clinical significance in the absence of syringomyelia.

Arnold-Chiari Malformation↗
PubMedDate not supplied

MR of postoperative syringomyelia.

Twenty-seven MR scans of 20 patients surgically treated for syringomyelia were reviewed. Thirteen patients had syringomyelia associated with the Chiari I malformation, four cases were posttraumatic, and three were idiopathic. The operations performed included syringosubarachnoid and syringoperitoneal shunts, myelotomies, and foramen magnum decompressions. Three of the foramen magnum decompressions had associated posterior fossa duroplasties, two had fourth-ventricle-to-subarachnoid shunts, and two had plugging at the obex. On 20 scans of patients in whom the syrinx cavity had been shunted, the shunt catheter was seen in 15 (75%). When adequately treated by shunting, syringes are completely collapsed and show no flow void. Nine patients were treated by foramen magnum decompression; all were well seen by MR. Three of these patients had a poor clinical result; these were the only patients in whom CSF was not seen between the foramen magnum and the neural structures of the posterior fossa on any images. The proposed mechanisms of syrinx formation and extension are discussed and related to the surgical procedures used to treat syringomyelia.

Adult↗
PubMedDate not supplied

Chondrosarcoma of the larynx: CT features.

PURPOSE: To define the typical CT features of chondrosarcoma of the larynx. PATIENTS AND METHODS: Results of CT studies, performed on 10 patients with pathologically proved chondrosarcoma of the larynx, were retrospectively reviewed and correlated with clinical presentation. RESULTS: In all patients, the mass was detected on CT. The most frequent site of origin of the tumor was the cricoid cartilage (nine cases) followed by the thyroid cartilage (one case). Coarse or stippled calcification within the tumor was the most helpful radiologic finding and was seen in every case. In eight patients, the tumor had both an endolaryngeal and an extralaryngeal growth pattern, whereas in two patients the tumor was entirely endolaryngeal. Hoarseness, dyspnea, and dysphagia were the most common symptoms. In all patients presenting with dyspnea, the tumor exhibited endolaryngeal components. In patients presenting with hoarseness, three tumors had endolaryngeal and extralaryngeal components and two tumors were entirely endolaryngeal. CONCLUSION: Cross-sectional imaging afforded excellent evaluation of the airway as well as the extralaryngeal component of the tumor.

Aged↗