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Biomedical subjects

Franz J Wippold

Publications and source records attributed to Franz J Wippold.

15 recordsLinked to original sources
PubMed2006

Contrast enhancement of central nervous system lesions: multicenter intraindividual crossover comparative study of two MR contrast agents.

PURPOSE: To prospectively compare gadobenate dimeglumine with gadopentetate dimeglumine (0.1 mmol per kilogram body weight) for enhanced magnetic resonance (MR) imaging of central nervous system (CNS) lesions. MATERIALS AND METHODS: This study was HIPAA-compliant at U.S. centers and was conducted at all centers according to the Good Clinical Practice standard. Institutional review board and regulatory approval were granted; written informed consent was obtained. Seventy-nine men and 78 women (mean age, 50.5 years +/- 14.4 [standard deviation]) were randomized to group A (n = 78) or B (n = 79). Patients underwent two temporally separated 1.5-T MR imaging examinations. In randomized order, gadobenate followed by gadopentetate was administered in group A; order of administration was reversed in group B. Contrast agent administration (volume, speed of injection), imaging parameters before and after injection, and time between injections and postinjection acquisitions were identical for both examinations. Three blinded neuroradiologists evaluated images by using objective image interpretation criteria for diagnostic information end points (lesion border delineation, definition of disease extent, visualization of internal morphologic features of the lesion, enhancement of the lesion) and quantitative parameters (percentage of lesion enhancement, contrast-to-noise ratio [CNR]). Overall diagnostic preference in terms of lesion conspicuity, detectability, and diagnostic confidence was assessed. Between-group comparisons were performed with Wilcoxon signed rank test. RESULTS: Readers 1, 2, and 3 demonstrated overall preference for gadobenate in 75, 89, and 103 patients, compared with that for gadopentetate in seven, 10, and six patients, respectively (P < .0001). Significant (P < .0001) preference for gadobenate was demonstrated for diagnostic information end points, percentage of lesion enhancement, and CNR. Superiority of gadobenate was significant (P < .001) in patients with intraaxial and extraaxial lesions. CONCLUSION: Gadobenate compared with gadopentetate at an equivalent dose provides significantly better enhancement and diagnostic information for CNS MR imaging.

Central Nervous System Diseases↗
PubMed2005

Desmoplastic fibroma of the mandible in an infant.

We report the CT and MR imaging findings of a case of a desmoplastic fibroma of the mandible in a 6-month-old girl who presented with a rapidly enlarging facial mass and who represents one of the youngest reported children with this rare tumor. Although imaging is non-specific and these lesions are best distinguished histologically, the desmoplastic fibroma should be considered when there is an occurrence of any bubbly or cystic expansile mandibular lesion presenting in childhood.

Diagnosis, Differential↗
PubMed2005

Primary hypothyroidism in a 12-year-old girl with a suprasellar pituitary mass: rapid regression after thyroid replacement therapy: case report.

The authors report on a 12-year-old girl with a suprasellar mass and primary hypothyroidism in whom the lesion promptly regressed following initiation of thyroid replacement therapy. Based on this experience, it is suggested that secondary pituitary hyperplasia be included in the differential diagnostic considerations of a suprasellar lesion in a child and that resolution of the hyperplasia may occur in a matter of weeks rather than months as previously reported.

Child↗
PubMed2004

Tortuous vertebral artery injury complicating anterior cervical spinal fusion in a symptomatic rheumatoid cervical spine.

STUDY DESIGN: A case report of a 60-year-old patient with rheumatoid arthritis who sustained injury of a tortuous vertebral artery after anterior cervical spinal fusion is reported. The literature relevant to this topic is reviewed. OBJECTIVE: To report the surgical injury of a tortuous vertebral artery resulting from rheumatoid arthritis and to stress the value of cross-sectional imaging in identifying this anomaly before surgery in these patients. BACKGROUND DATA: Rheumatoid arthritis causes well-known bony complications such as atlantoaxial and subaxial subluxation and spinal stenosis with spinal cord compression. Less emphasized is vertebral artery loop formation and vascular compression. Anomalous vertebral artery position could jeopardize otherwise successful anterior diskectomy and corpectomy in these patients. METHODS: A 60-year-old man with rheumatoid arthritis sustained a vertebral artery injury during anterior corpectomy, which resulted in cerebral and cerebellar infarction. RESULTS: Computed tomography and magnetic resonance imaging and angiography confirmed the medially deviated vertebral artery. A computed tomography scan confirmed the cerebral infarction that resulted from dissection and injury of the artery at the time of surgery. CONCLUSION: The patient with rheumatoid arthritis of the cervical spine could have associated tortuosity of the vertebral artery, mandating a thorough awareness of vascular anatomy before surgical decompression. Cross-sectional imaging effectively locates the position of the vertebral arteries and should be carefully studied before anterior cervical spinal fusion in these patients.

Cervical Vertebrae↗
PubMed2003

MR imaging features of craniodiaphyseal dysplasia.

We report the magnetic resonance (MR) imaging findings in a 4-year-old girl with characteristic radiographic and computed tomography (CT) features of craniodiaphyseal dysplasia. MR imaging exquisitely depicted cranial nerve compression, small foramen magnum, hydrocephalus, and other intracranial complications of this syndrome. A syrinx of the cervical spinal cord was demonstrated. We suggest that MR imaging become a routine component of the evaluation of these patients.

Brain↗
PubMed2003

West Nile virus: case report with MR imaging findings.

We report a case of serologically proved West Nile virus encephalitis. Striking bilateral hyperintensities were noted in the basal ganglia and thalami on T2-weighted and fluid-attenuated inversion recovery MR images, similar to previous accounts of the imaging findings in cases of Japanese encephalitis. Recognition of the MR imaging appearance of this entity is important because of the expanding epidemic.

Female↗
PubMed2002

Determination and delineation of nodal target volumes for head-and-neck cancer based on patterns of failure in patients receiving definitive and postoperative IMRT.

PURPOSE: We present the guidelines for target volume determination and delineation of head-and-neck lymph nodes based on the analysis of the patterns of nodal failure in patients treated with intensity-modulated radiotherapy (IMRT). METHODS AND MATERIALS: Data pertaining to the natural course of nodal metastasis for each head-and-neck cancer subsite were reviewed. A system was established to provide guidance for nodal target volume determination and delineation. Following these guidelines, 126 patients (52 definitive, 74 postoperative) were treated between February 1997 and December 2000 with IMRT for head-and-neck cancer. The median follow-up was 26 months (range 12-55), and the patterns of nodal failure were analyzed. RESULTS: These guidelines define the nodal target volume based on the location of the primary tumor and the probability of microscopic metastasis to the ipsilateral and contralateral (Level I-V) nodal regions. Following these guidelines, persistent or recurrent nodal disease was found in 6 (12%) of 52 patients receiving definitive IMRT, and 7 (9%) of 74 patients receiving postoperative IMRT had failure in the nodal region. CONCLUSION: On the basis of our clinical experience in implementing inverse-planning IMRT for head-and-neck cancer, we present guidelines using a simplified, but clinically relevant, method for nodal target volume determination and delineation. The intention was to provide a foundation that enables different institutions to exchange clinical experiences in head-and-neck IMRT. These guidelines will be subject to future refinement when the clinical experience in head-and-neck IMRT advances.

Follow-Up Studies↗
PubMed2002

Cochlear implantation in children with CHARGE association.

OBJECTIVE: To explore the anomalies of the temporal bone found on radiologic examination, technical challenges in cochlear implantation, and audiologic benefit derived from cochlear implantation in a series of children with CHARGE association. DESIGN: Case series report. SETTING: Tertiary referral children's hospital pediatric cochlear implant program. PATIENTS: Six children with CHARGE association and sensorineural hearing loss. INTERVENTION: All patients were evaluated and followed up by the cochlear implant team. Cochlear implantation was attempted in all 6 children. MAIN OUTCOME MEASURES: Computed tomographic scans and cochlear implantation operative records were reviewed, and their findings were correlated. Audiometric and speech perception data before and after cochlear implantation were compared. RESULTS: Five children with CHARGE association received implants. A sixth child did not because of an aberrant course to the facial nerve. The 5 children receiving implants obtained varying degrees of measurable benefit from their implants. All 6 children had temporal bone abnormalities seen on their computed tomographic scans and documented at the time of surgery. CONCLUSIONS: Variations in the temporal bone anatomy of patients with CHARGE association can lead to increased technical challenges and risk to the facial nerve during cochlear implantation. Individual outcomes after implantation may vary; our patients receiving implants obtained benefit. Parents should be counseled thoroughly and have appropriate expectations before proceeding with implantation.

Abnormalities, Multiple↗
PubMed2002

Diffusion-weighted MR imaging in the preoperative assessment of brain abscesses.

BACKGROUND: Diffusion-weighted MR imaging (DWI) has recently shown promise in differentiating ring-enhancing lesions such as brain abscess and malignant neoplasm. The ability of DWI to strongly suggest brain abscess enables a neurosurgeon to alter stereotactic planning to optimize diagnosis. We report our experience with DWI in 5 patients with lesions on MR imaging and review the literature to assess the usefulness of this technique in the preoperative evaluation of cerebral abscess. METHODS: The MR images of 5 patients presenting with ring-enhancing lesions that ultimately proved to be brain abscesses were retrospectively reviewed. In addition to standard MR sequences, trace DWI and apparent diffusion coefficient (ADC) calculations were performed on all patients. Additionally, 15 recently published articles or references in press concerning DWI in cerebral abscesses were reviewed. RESULTS: All lesions were markedly hyperintense on DWI and had diminished ADC. Thirty-eight of 39 previously reported abscesses were hyperintense on DWI with reduced ADC. Of 165 nonpyogenic lesions with DWI findings, 87 were hypointense or isointense, 78 lesions had variable hyperintensities, and few manifested the degree of hyperintensity observed with abscesses. Most of these included chordomas and epidermoids, which are not likely to be confused with abscesses. CONCLUSIONS: Restricted water diffusion, as indicated by hyperintensity on DWI and low ADC, in ring-enhancing lesions assists in differentiating brain abscess from necrotic tumor. This information facilitates stereotactic surgical planning: abscesses should be preferentially centrally aspirated, whereas necrotic brain tumors should have diagnostic tissue biopsied from cavity walls. Although not definitive for brain abscess, restricted water diffusion is an important MR imaging sign and is useful in neurosurgical treatment strategies for ring-enhancing lesions.

Adult↗
PubMed2002

Imaging the treated oral cavity and oropharynx.

Cross-sectional imaging has become essential in the evaluation of the treated oral cavity and oropharynx. The purpose of this paper is to review the imaging guidelines for the evaluation of this region and to detail the typical changes encountered on imaging following surgical and radiation treatment for cancer.

Anatomy, Cross-Sectional↗
PubMed2002

Rhinocerebral mucormycosis in the era of lipid-based amphotericin B: case report and literature review.

Rhinocerebral mucormycosis (RCM) is an invasive fungal infection that necessitates, in most cases, aggressive surgical debridement and high cumulative, often nephrotoxic doses of amphotericin B. A 50-year-old woman with RCM was treated successfully with amphotericin B lipid complex as primary therapy. The patient previously had displayed progressive intracranial involvement and rising serum creatinine levels while receiving the conventional (nonlipid) form of amphotericin B. A literature review identified only a few cases where systemic antifungal therapy was administered, with minimal or no surgery. Our case further supports that amphotericin B lipid complex can be used as primary therapy in selected patients with RCM, without the need for surgical exenteration.

Amphotericin B↗
PubMedDate not supplied

Fast magnetic resonance imaging in steady-state precession (true FISP) in the prenatal diagnosis of a congenital brain teratoma.

Teratomas are the most common congenital intracranial tumor. Although fetal magnetic resonance (MR) imaging is becoming more popular for prenatal diagnosis, only 2 cases of congenital intracranial teratoma have been reported, and these cases relied on half-Fourier single-shot turbo spin echo (HASTE) imaging. We report the first known case of congenital intracranial teratoma diagnosed by means of a fast imaging in steady-state precession (true FISP) MR sequence. True FISP can be obtained in almost 20 seconds and provides superior contrast resolution compared with HASTE.

Adult↗