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Biomedical subjects

I Isherwood

Publications and source records attributed to I Isherwood.

At least 19 recordsLinked to original sources

Magnetization transfer contrast (MTC) imaging of skeletal muscle at 0.26 Tesla--changes in signal intensity following exercise.

Magnetization transfer contrast (MTC) imaging of skeletal muscle before and after exercise has been studied in normal volunteers at 0.26 Tesla. A saturation pulse was applied over a range of offset frequencies immediately before a gradient recall echo sequence. Substantial signal loss was observed in all muscles. After exercise, selective saturation resulted in a significant increase of contrast between active and less active muscle, a phenomenon attributable to an increase in extracellular water content. MTC imaging provides a more sensitive method to detect changes in water distribution in human skeletal muscle.

Adipose Tissue

How frequent is chronic lumbar arachnoiditis following intrathecal Myodil?

Chronic lumbar arachnoiditis has numerous causes, including the introduction of contrast media into the lumbar subarachnoid space. The oily contrast medium Myodil (iophendylate) is often cited but the true incidence of symptomatic lumbar arachnoiditis due solely to the presence of Myodil is unknown. A retrospective review of 98 patients in whom Myodil was introduced by ventriculography or cisternography, i.e. remote from the lumbar spine, revealed no cases of chronic lumbar arachnoiditis. All patients were monitored closely for periods ranging from 1 to 28 years. We conclude that, in these circumstances, it is rare for Myodil to produce symptomatic arachnoiditis.

Adult

Investigation of children with suspected spinal dysraphism by magnetic resonance imaging.

Findings on Magnetic Resonance Imaging (MRI) of 52 children with suspected spinal dysraphism have been reviewed. In 24, no significant spinal abnormality was demonstrated. Seven patients had scoliosis or vertebral segmentation anomalies without demonstrable abnormality of the underlying soft tissues and one had an isolated subcutaneous haemangioma. In 20 children with spinal dysraphism, a low tethered cord was the most frequent finding, occurring in 80%. Other manifestations included myelo- or meningocoele (60%), syringomyelia (30%), lipoma (25%), congenital tumour (20%), diastematomyelia (15%) and thickened filum terminale (5%). The relationship between the clinical reason for requesting MRI and the scan results are discussed.

Adolescent

The effects of sodium nitroprusside on Doppler signals from a soft tissue tumour.

In a previous study, we described the effects of systemic vasoconstriction on the Doppler signals from a soft tissue tumour (Taylor et al, 1989). Our conclusions were that vasoconstriction produced significant changes in the signals from normal vessels and enhanced the differences between normal and neoplastic vessel signals. The aim of this study was to determine whether converse changes were produced by vasodilatation.

Animals

Musculoskeletal haemangiomas: comparison of MRI with CT.

MRI and CT findings were reviewed from 11 patients with musculoskeletal haemangiomas. With MRI, morphological characteristics and extent of haemangiomas were optimally demonstrated on T2-weighted spin echo scans. High-resolution contrast-enhanced CT provided equivalent information regarding lesional characteristics and extent for small, localized haemangiomas. In CT evaluation of the extent of large haemangiomas, the radiation dose, transaxial scan plane, amount of intravenous contrast medium required and the necessity for correct timing of post-contrast scans became limiting factors. For such lesions, particularly those extending into the trunk, MRI supplemented by a plain radiograph is the optimum method of evaluation.

Adolescent

Magnetic resonance imaging of musculoaponeurotic fibromatosis.

Musculoaponeurotic fibromatosis can be mistaken for soft-tissue sarcoma both clinically and on X-ray computed tomography. Magnetic resonance imaging (MRI) in three patients with this condition enabled the correct diagnosis to be made prospectively in two. The appearance on MRI of a heterogeneous mass with well-defined, predominantly peripheral areas of very low signal intensity due to dense fibrous tissue and areas of medium to high signal intensity corresponding to a more cellular stroma should raise the the suspicion of musculoaponeurotic fibromatosis. Cellular areas within the tumour showed moderate enhancement after gadolinium diethylene triamine pentaacetic acid administration.

Adult

Accuracy in staging carcinoma of the bladder by magnetic resonance imaging.

Thirty-four patients with a presumptive diagnosis of carcinoma of the bladder diagnosed at EUA and cystoscopy have been staged by MRI and the findings correlated with pathology in 15 patients and clinical follow-up, including repeat cystoscopy, in the remainder. MRI is accurate in identifying tumours confined to the bladder wall or extending beyond the wall to involve perivesical fat or adjacent organs. Whilst it is not possible to distinguish between T1, T2 or early T3a tumours they can be distinguished from advanced T3a lesions and this may affect management. MRI is superior to clinical staging, particularly in detecting lymphadenopathy and provides information for optimal radiotherapy planning. The problem of distinguishing between the effects of radiotherapy and suspected recurrent tumour is discussed.

Aged

Diagnosis and assessment of mitral and aortic valve disease by cine-flow magnetic resonance imaging.

Seventy-six aortic and mitral valves, in 44 patients and 5 normal volunteers, were studied by Cine-Flow MRI (on a 0.26-T superconducting magnet system), utilizing compound oblique imaging planes and a Field Echo Even Rephasing sequence. All patients had had cardiac catheterization and echocardiography. All patients with valvular stenosis and aortic sclerosis (n = 45) showed complete signal loss distal to the respective valve. Length of signal loss distal to the aortic valve in those in whom it was measured (n = 15) allowed differentiation of aortic stenosis (n = 9) from sclerosis (n = 6). This also permitted grading of stenosis with highly significant correlation (T = 0.86; P less than 0.002) with pressure gradient measurement. In mitral stenosis (n = 12) calculation of the area of signal loss distal to the mitral valve as a percentage of left ventricular cross-sectional area showed a highly significant correlation (T = 0.77; P = 0.001) with pressure gradient measurement. Clinically significant valvular regurgitation was graded by size and duration of signal loss proximal to the value with concordance with angiocardiography. It is concluded that Cine-Flow MRI has a clinical role in the diagnosis and assessment of valvular heart disease.

Adult

The effects of angiotensin II on Doppler signals from a soft-tissue tumour.

A 10 mHz continuous-wave Doppler system has been used to detect blood flow within a sarcoma implanted in a rabbit's ear. The effects of vasoconstriction produced by intravenous angiotensin II were studied. Criteria are described that enabled differentiation of the Doppler signals from the tumour from those of the adjacent central artery. The effect of vasoconstriction upon these criteria is also described.

Angiotensin II

Evaluation of computer advisor in the interpretation of CT images of the head.

This paper describes the evaluation of a computer advisor system (BRAINS), which was constructed to aid in the interpretation of CT images of the head. It was developed at the National Hospital for Nervous Diseases, Queen Square, London. The system was transferred, without difficulty, to an 'external', that is previously unassociated, site (the Department of Diagnostic Radiology, University of Manchester) for an external evaluation. Response of external users to the system was mixed. Many were unfamiliar with the concept of formal description of images and the evaluation demonstrated the need for a person to person training programme. Users who accessed the HELP facilities most frequently were the most successful in obtaining accurate descriptions and hence satisfactory diagnostic advice. An objective appraisal of user's success in describing images to obtain the correct diagnosis as first choice indicated that, in general, the system performed well.

Brain Diseases

Gadolinium-DTPA as a contrast agent in magnetic resonance imaging of the brain.

One hundred patients with CT-proven intracranial disease have been studied by magnetic resonance imaging (MRI) before and after intravenous injection with Gadolinium-DTPA (Gd-DTPA), in order to assess the role and clinical efficacy of Gd-DTPA. T2-weighted spin echo sequences, although sensitive to the detection of intracranial disease, in general fail to differentiate macroscopic tumor from oedema. Following Gd-DTPA, T1-weighted spin echo sequences in primary tumours demonstrated a variable degree of contrast enhancement unrelated to histological type. Small tumours, especially acoustic neuromas and meningiomas in the posterior fossa, were rendered more conspicuous. Optimum time for scanning was between five and 25 min following injection for all lesions except those adjacent to normal enhancing structures such as nasal/sinus mucosa and pituitary gland when delayed scans up to 45 min were necessary. No differences were observed between the 0.1 and 0.2 mmol/kg Gd-DTPA concentrations used and no complications attributable to Gd-DTPA were detected. Clinical advantages of Gd-DTPA include shorter scan times, macroscopic tumour/oedema separation and improved detection of certain tumours, particularly acoustic neuromas.

Adolescent

Plexiform trigeminal neurofibroma.

Neurofibromas of the trigeminal nerve are uncommon tumours which usually present in patients in the third or fourth decade of life as a localised mass in the posterior or middle cranial fossa. A case is described of a plexiform neurofibroma of this nerve with unusual clinical and radiological features.

Adult

Detection of coronary artery bypass graft patency as assessed by magnetic resonance imaging.

In a study of 22 patients with 60 coronary artery bypass grafts, magnetic resonance imaging (MRI) correctly assessed graft patency or occlusion in 90% of cases when compared with selective coronary graft angiography and computed tomography. It is concluded that MRI can detect a normally functioning coronary artery bypass graft and could be used as a non-invasive technique to assess graft patency in patients presenting with post-operative angina.

Adult

Magnetic resonance imaging of the mini-pig heart: the effect of gadolinium-DTPA on normal myocardium.

The effect of gadolinium-diethylene-triamine-penta-acetic acid (Gd-DTPA) on normal, mini-pig myocardium was investigated with magnetic resonance imaging. Results indicate that intravenous administration of Gd-DTPA produces a significant enhancement of mini-pig myocardial signal intensity, which in all cases was maintained in excess of 50 min. No significant enhancement was demonstrated in skeletal muscle.

Animals

Magnetic resonance imaging of acoustic neuromas: the role of gadolinium-DTPA.

Magnetic resonance imaging (MRI) was performed in 20 patients with evidence on computed tomography (CT) of 21 acoustic neuromas before and after intravenous administration (0.1-0.2 mmol/kg body weight) of gadolinium-diethylene-triamine-pentaacetic acid (Gd-DTPA). Multi-section spin-echo (SE) sequences of varying repetition (TR) and echo (TE) times were performed in the transverse and coronal planes with a section thickness of 10 mm. All acoustic neuromas displayed marked enhancement on the T1-weighted (short TR/TE) SE sequence post-Gd-DTPA. The intrameatal component was particularly well demonstrated compared with non-enhanced magnetic resonance (MR) images and contrast-enhanced CT. Identification of intrameatal tumour was difficult on T2-weighted SE images and one tumour was not identified on the T1-weighted SE sequence prior to Gd-DTPA. Four of five intrameatal tumours measuring less than 8 mm could only be demonstrated on CT by using CT air meatography. Extrameatal tumour extension was demonstrated on contrast-enhanced CT, although the assessment of brain-stem involvement and displacement was not as clearly seen as on coronal MR images. In two patients with large acoustic neuromas and a cyst, the true relationship of the cyst to the tumour could only be identified on the post-Gd-DTPA scan. Magnetic resonance imaging with gadolinium-DTPA is a relatively quick, safe, well tolerated and effective method for the diagnosis of acoustic neuroma.

Adolescent