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Biomedical subjects

G Ranner

Publications and source records attributed to G Ranner.

At least 55 records · Page 3Linked to original sources
PubMed1994

Magnetic resonance assessment of age-related development of the sphenoid sinus.

Magnetic resonance images of the sphenoid sinus in 401 patients under 15 years old were reviewed to establish normal age-related standards. T1-weighted sagittal and T2-weighted axial scans were evaluated for bone marrow conversion, development of pneumatization, spatial enlargement and septation of the sphenoid sinus. The sphenoid sinus had a uniformly low signal intensity (red bone marrow) on T1-weighted images in all children less than 4 months old. Signal intensity changes from hypointense to hyperintense (bone marrow conversion) started at the age of 4 months. Onset of pneumatization was observed in 12% of the patients at age 13-15 months. By age 43-48 months, 85% of the patients showed pneumatization of the anterior part of the sphenoid bone. Pneumatization was complete in all patients older than 10 years. Enlargement of the sinus showed a characteristic profile in each dimension. Median septation was observed irregularly with age, with a maximum of 77%. Septum variants were noticed between 4.5% and 20%. Because paediatric sinus disease is a challenging problem in children, these results may be useful as baseline standards of normal age-related development of the sphenoid sinus during childhood.

Adolescent↗
PubMed1994

[Distinguishing of scar tissue from recurrent tumor after therapy of tumors of the female pelvis].

Patients treated for gynecological malignancies are followed up at short intervals during the first 3 years after treatment. Locoregional recurrence in the pelvis is often not detectable by palpation. Thus, efficient and sensitive follow-up of patients treated for gynecologic malignancies requires the use of imaging techniques. Computed tomography is well suited for the primary diagnoses of locoregional recurrences and lymph-node metastases after radical surgery. In addition to detailed anatomical information, magnetic resonance imaging (MRI) permits tissue characterization on the basis of signal intensity and thus differentiation between fibrosis and recurrence. After primary radiotherapy for cervical cancer, MRI follow-up can assess tumor response to treatment. Prognostic evaluation of the success or failure of treatment requires knowledge of the signal characteristics and volume of the primary tumor and of the interval since primary treatment. In our experience, conventional spin-echo sequences with heavy T2-weighting are best for distinguishing between fibrosis and recurrence.

Cicatrix↗
PubMed1994

[Radiologic diagnosis of Perthes disease].

In Legg-Calvé-Perthes disease (LCPD), magnetic resonance imaging (MRI) and conventional radiography in two planes are considered the most important methods of investigation for early diagnosis and for assessment of the course of the disease. MRI can reveal the early marrow oedema, thus allowing early differential diagnosis against diseases that are similar in clinical appearance (coxitis fugax, epiphyseal dysplasia). The extent of the necrotic area within the epiphysis, the most important indicator of the prognosis of the disease and thus for the therapeutic management, can be assessed earlier and more reliably with MRI than with other techniques. The loss of containment can be visualized by MRI, because depiction of the cartilaginous structures is possible earlier than with conventional radiography. Staging of LCPD is also possible with MRI, especially in stages I and II. Radiography shows the reossification and the osseous remodelling of the epiphysis better. A disadvantage of MRI seems to be the occasional need for sedation or anaesthesia of the child to avoid motion artefacts.

Diagnosis, Differential↗
PubMed1993

Undifferentiated (embryonal) sarcoma of the liver in childhood. Successful combined-modality therapy in four patients.

BACKGROUND: Undifferentiated (embryonal) sarcoma of the liver is a rare, highly malignant, mesenchymal tumor presenting predominantly in late childhood. Four girls, ages 6-13 years, who were treated with combined-modality regimens are reported. METHODS: In the first and second patients, hemihepatectomy resulted in complete removal of the tumor, and multiple-agent chemotherapy was administered postoperatively. In the third patient, only partial resection could be accomplished initially. By synchronous radiation therapy and chemotherapy, the tumor decreased to an extent that it could be resected completely and was totally devitalized on histologic examination. Postoperative chemotherapy was discontinued after 8 weeks. In the fourth patient, the tumor was not resectable at diagnostic biopsy. Polychemotherapy led to a significant reduction of the tumor size, and resection with clear margins could be performed subsequently. Because histologic necrosis amounted to about 95%, postoperative chemotherapy was also discontinued after 6 weeks. RESULTS: All four patients remain well without evidence of tumor recurrence after 79, 41, 36, and 22 months from diagnosis. CONCLUSIONS: The authors suggest that a multimodal therapeutic regimen should be used in patients with undifferentiated hepatic sarcoma.

Adolescent↗
PubMed1993

MR findings and treatment of four patients with cervical spinal cord injuries.

We report the value of magnetic resonance imaging (MRI) in the assessment of cervical spine injuries with neurological deficit and the implications such information might have in the management of acute spinal cord injuries. Four cases are presented that were neurologically classified according to the 5-step Frankel scale. Three patients presented with an intramedullary hemorrhage. One of these patients showed additional mild compression of the spinal cord due to a retropulsed bony fragment, and one an epidural hematoma without any evidence of spinal cord compression. The fourth patient had compression of the spinal cord secondary to bony fragments from a burst fracture. We carried out two decompressions of the spinal cord by removing the disc and bony fragments. In addition, we performed two interbody fusions. In one patient we applied a halo vest, and in one case surgical intervention was not necessary after MRI assessment.

Cervical Vertebrae↗
PubMed1993

Ultrasound and MRI findings in a case of childhood amyloid goiter.

Goiter secondary to amyloidosis is rare in clinical practice and only a few descriptions of its radiologic features have been reported. We present the ultrasound and MRI findings of thyroid amyloidosis in a 7-year-old Turkish boy with familial Mediterranean fever.

Amyloidosis↗
PubMed1993

Cervical cord compression in hereditary multiple exostoses.

A seven year old girl, known to have hereditary multiple exostoses, developed moderate gait disorders at the age of six years. Deterioration of myelopathy initiated the clinical investigation including spinal computed tomography (CT) and magnetic resonance imaging (MRI). These examinations demonstrated a coneshaped exostosis originating from the posterior arch of C2. The spinal canal was markedly narrowed with significant compression of the spinal cord at the C2 level. The girl underwent laminectomy of C2 with total removal of the exostosis. Postoperative deterioration of neurological symptoms correlated with a hypointense lesion on T1 weighted imaging in the cord at the same level, but no further cord compression on follow-up MRI. The spastic tetraparesis has improved considerably within 12 months thereafter.

Child↗
PubMed1992

Cervical cancer: serial MR imaging before and after primary radiation therapy--a 2-year follow-up study.

Serial magnetic resonance imaging studies were performed in 28 patients undergoing primary radiation therapy for invasive cervical cancer. T2-weighted spin-echo pulse sequences with long repetition times (2,500 msec) and echo times (30-100 msec) were used at a field strength of 1.5 T. Eighteen tumors responded promptly to radiation therapy with a volume reduction and significant decrease of signal intensity in the early posttreatment phase (1-3 months) and with total tumor regression at 1-6 months (immediate responders). At 6 months seven tumors were visible as residual tumors with declining signal intensity; all seven of these tumors had resolved at 9 months (delayed responders). Thus, a delayed response with residual tumor at 6 months was still compatible with subsequent clinical cure. The tumors showed progression and no marked change in signal intensity (nonresponders). Primary tumors with a volume of more than 50 cm3 were more likely to have no or delayed response. An early (2-3 months) and significant decrease in the signal intensity and volume of a tumor indicates a favorable response. Large primary tumors may show a delayed response.

Adenocarcinoma↗
PubMed1992

[The value of magnetic resonance tomography in diagnosis and follow-up of cervical spine injuries].

We report upon 12 cases of magnetic resonance imaging of cervical spinal cord injuries, in 8 cases done within 24 h after the injury. We found haemorrhages in the spinal cord in 3 cases, compression of the spinal cord in 3, swelling of the spinal cord in 2, and transsection of the spinal cord and hematoma in the epidural space in 1 case each. A normal MR image was seen in a patient with a complete transverse lesion of the spinal cord. The other 4 MR examinations were carried out between 2 weeks and 8 months after injury or operation. In 2 of these trauma victims interbody fusion of the cervical spine was performed, and the neurological deficit was subsequently worse in both. In 1 patient the course of a haemorrhage within the spinal cord was monitored by MR imaging: 1 image revealed the treatment of a burst fracture of C-7 with an interposed flap from the greater omentum.

Adult↗
PubMed1992

[The effect of high-dose peroral zidovudine treatment in a 4-year-old child with HIV encephalopathy].

We report a four-year-old boy with HIV encephalopathy after vertical HIV infection. On the first admission to our hospital he showed ataxia, loose of expressive language and interstitial pneumonia. After treatment of the pneumonia the patient was started on oral zidovudine with 6 x 6 mg/kg bw/day, because of persisting neurologic symptoms and deep white matter lesions in the MR tomogram of the brain. Two months later he showed an improvement of the gait and the reappearance of the expressive language. Seven months after the start with zidovudine the MR tomogram of the brain revealed the disappearance of white matter lesions with exception of little areas of demyelinisation. No side effects of treatment were observed. The only persisting pathological clinical signs were developmental delay of about a half year and moderately hyperactive tendon reflexes of the lower extremities. Our case suggests that even oral treatment with zidovudine can have a beneficial effect on the HIV encephalopathy in infants.

AIDS Dementia Complex↗
PubMed1992

[Radiologic diagnosis of cervical spine injuries].

This investigation was designed to evaluate the radiological methods used for diagnosis of cervical spine injuries. In the time from 1977 to 1990, a total of 102 patients with 113 fractures or fracture-dislocations of several segments of the cervical spine were diagnosed and treated in the University Surgical Clinic in Graz; 36 of these patients had lesions of the upper cervical spine and 66, lesions of the lower cervical spine. All trauma patients with disturbances of consciousness or neck discomfort reported on questioning or elicited by palpation underwent three-view radiographic screening for cervical spine injuries (lateral, AP and open-mouth views). This led us to suspect cervical spine injuries in all 102 patients. Computerized tomography was performed in 76 cases, which yielded additional information in 55 cases about the middle and posterior column and the adjacent vertebral bodies. In 13 cases conventional tomograms were important to confirm the diagnosis of dens fracture. Except for the diagnosis of hanged-man and dens fractures, computerized tomography is accepted as the second step for the evaluation of cervical spine injuries. We performed 8 investigations with magnetic resonance imaging in 7 patients, and noted spinal cord lesions of low signal intensity in 3 of these cases.

Cervical Vertebrae↗
PubMed1990

[Osteochondrosis deformans coxae juvenilis (Legg-Calvé-Perthes disease) in the MR tomogram: diagnosis and follow-up assessment correlated with x-rays and skeletal scintigraphy].

23 children with Legg-Perthes' disease (25 affected hips) were prospectively evaluated via MRI, bone scintigraphy and conventional radiography both at first presentation and during follow-ups. For the early diagnosis of LCPD MRI was similar as sensitive as isotope bone scan and more precise than conventional radiography. The extent of the necrotic area within the epiphysis could be better assessed by MRI than by conventional radiography. Providing a more detailed depiction of bone marrow and soft tissues MRI showed exactly the position and contour of the femoral head including the femoral and acetabular cartilage. The loss of containment of the femoral head could be diagnosed earlier by MRI than by conventional radiography. A system of staging of LCPD oriented towards the pathogenesis of the disease was possible with MRI in school age children, at least when comparing the tomograms with earlier studies. Scintigraphy was the most reliable imaging technique to determine the onset of revascularisation.

Child↗
PubMed1990

[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↗
PubMed1989

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↗
PubMed1989

Abdominal metastases of an ovarian cancer demonstrated on bone imaging.

Tc-99m HMDP uptake by abdominal metastases of an ovarian cancer was seen on a bone image. The findings were confirmed by computed tomography and by biopsy at surgery. The psammoma bodies throughout the tumor tissue appeared to be the substrate of this unusual extraosseous tracer uptake.

Abdominal Neoplasms↗
PubMed1989

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↗