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K Smolarz

Publications and source records attributed to K Smolarz.

26 records · Page 2Linked to original sources
PubMed1991

Magnetic resonance imaging of cardiac function and morphology in patients with transposition of the great arteries following Mustard procedure.

In order to assess the diagnostic possibilities of magnetic resonance imaging (MRI), 30 children (mean age 11.5 years) with d-transposition of the great arteries (TGA) corrected by the Mustard procedure were studied. Patient values were compared to those of 10 healthy volunteers. The most important postoperative abnormalities such as baffle leaks, systemic or pulmonary venous obstructions, left ventricular outflow tract (LVOT) stenosis and tricuspid regurgitation were assessed. Cardiac volumes and muscle mass were measured. Baffle leaks were found in 5 and obstruction of the baffle limbs in 6 patients. On gradient echo images 13 patients showed signs of LVOT stenosis and 12 tricuspid incompetence. Right ventricular end diastolic volumes in patients were significantly higher than the left ventricular volumes, but slightly lower than right ventricular volumes in the normals. In patients with TGA and ventricular septal defect (VSD) (n = 7) right ventricular (RV) volumes were found to be higher than in patients with intact ventricular septum (n = 23) and in normals. In contrast to the normal RV function of patients after Mustard surgery only patients with previous VSD showed a diminished RV ejection fraction. The muscular mass in TGA patients showed a ratio of 1.9:1 between right and left ventricles. In normals the ratio was 1:1.5. Magnetic resonance imaging allows a quantitative insight into the ventricular function and the morphology of the heart after inflow correction. Thus, it supplements the noninvasive evaluation of TGA patients.

Adolescent↗
PubMed1991

[Diagnosis and classification of tricuspid valve insufficiency with dynamic magnetic resonance tomography: comparison with right ventricular angiography].

To evaluate the diagnostic potential of magnetic resonance imaging (MRI) to diagnose and evaluate tricuspid incompetence (TI), right ventricular angiography (RVA) and MRI were compared in 51 patients. For angiographic semi-quantification a 4-grade modified Sellers classification was used. Several MRI-parameters (jet volume, jet area, number of slices with visible jet, duration of the regurgitation and volume of the right atrium) were examined concerning their validity to evaluate TI and compared to the angiographic data. Limits for MRI jet areas and volumes for each angiographic group were defined to obtain the best agreement with angiographic results. Thirty of 34 patients with angiographically visible TI (sensitivity = 88%) were diagnosed correctly with MRI. The 4 remaining patients also showed a small regurgitant jet which was, however, interpreted as physiologic. One of the 17 patients without angiographic TI was diagnosed as mild TI by MRI (specificity = 94%). MRI classification using jet volume (46/51 = 90% correct classifications) was not significantly better than the easier and faster MRI classification using jet area (43/51 = 84%). The other parameters (number of slices, duration of regurgitation and volume of the right atrium) showed considerable overlap between angiographic groups and did therefore not allow a classification into 4 grades. However, simple classification into hemodynamic relevant and irrelevant TI was possible. Thus MRI is able to diagnose TI with good sensitivity and specificity. Classifications based on jet volume and jet area showed good agreement with angiographic results. However, both parameters depend on the magnet and the pulse sequence used and must therefore be specifically determined for each imaging routine.

Adult↗
PubMed1991

[The early diagnosis of Perthes disease: the value of bone scintigraphy and magnetic resonance imaging in comparison with x-ray findings].

The value of conventional radiology, bone scintigraphy and magnetic resonance imaging (MRI) in the early diagnosis of Legg-Calvé-Perthes disease (LCPD) was assessed. The initial results were compared with the clinical and radiological findings of long-term follow-up in 43 children. Radiological and scintigraphic examination resulted in a relatively high number of equivocal findings (16% and 10%, respectively). MRI findings were less equivocal (3%). Depending on whether such findings were classified as normal or as pathological, the diagnostic accuracy ranged as follows: radiography 88-93%, bone scintigraphy 88-91%, and MRI 97-99%. Therefore, MRI by itself seems to be sufficient to detect or exclude LCPD. The results of this study and the radiation exposure associated with radiography and scintigraphy raise the question whether MRI should be the diagnostic method of choice in patients with suspected LCPD.

Child↗
PubMed1991

[Bone marrow changes in patients with thyroid carcinoma].

In 62 patients with thyroid carcinoma 79 MRI bone marrow examinations and 48 bone marrow scintigraphies were recorded before or following radioiodine therapy, to study the extent of bone marrow expansion. The results of both methods were the same. In 34/79 investigations normal findings were seen, in 18 the bone marrow expanded to the middle third and in 26 to the distal third of the femur. One patient showed bone marrow expansion to the tibia. These results were compared with the following data: histology of tumor, TNM-staging, time passed since thyroidectomy, accumulated doses of radioiodine therapy, results of 131I scintigraphy, hematological changes, thyroglobulin level, age and sex. No significant correlations were found between these and the bone marrow imaging results. Bone marrow changes in patients before radioiodine therapy were similar to those in patients treated with up to 48 GBq 131I. Blind biopsy of the posterior iliac crest in five patients showed slightly pathological reactive changes. In only 2/17 follow-up studies an increase of bone marrow expansion was seen. In 8 patients localized findings indicating malignant infiltration were observed. In 4/8 patients metastases of thyroid carcinoma were known or confirmed by pathological radioiodine uptake and in 2/8 metastatic involvement was assumed because of an increased thyroglobulin level.

Adenocarcinoma↗
PubMed1991

[Retrosternal lymph node metastases in breast cancer: lymphoscintigraphy and magnetic resonance tomography].

In 21 patients with breast cancer (pT1-4, N0, M0) internal mammary lymphoscintigraphy and magnetic resonance imaging (MRI) were performed to evaluate retrosternal lymph node metastases. In 6 patients normal findings of lymphoscintigraphy were confirmed by MRI. In the 15 patients with focal defects seen by lymphoscintigraphy no lymph nodes were found by MRI in 5 in the corresponding area, 5 showed normal-sized lymph nodes (less than 1 cm) and 5 enlarged lymph nodes indicating metastatic infiltration. In addition to internal mammary lymphoscintigraphy MRI may offer the possibility to improve TNM staging in patients with breast cancer.

Adult↗
PubMed1991

[Tumor scintigraphy using 123I-labeled estradiol in breast cancer--receptor scintigraphy].

The estrogen receptor (ER) status is an important factor for prognosis and endocrine therapy of breast cancer. Therefore 16-alpha-123I-iodoestradiol-17-beta (123I-E2) as a receptor-specific radiopharmacon was used for scintigraphic tumor detection in 62 patients suspected of breast cancer. The studies were performed as a multicenter trial (5 university hospitals) to validate the method and to overcome methodical problems. A fast tracer elimination from the blood pool into the liver was seen, followed by biliary excretion allowing early imaging of the thorax due to low background activity but resulting in difficult imaging conditions of the abdomen. In 42 patients (30 carcinomas, 12 benign lesions) the overall sensitivity was 66% (ER status cut-off: 10 fmol/mg). Some patients with breast cancer showed focal or diffuse uptake in the area of primary lymph drainage (parasternal, axillary) without any clinical correlation, demanding follow-up investigations. There was only one false-positive result in a receptor-negative primary carcinoma; thus, the non-invasive determination of the ER status seems to be feasible. The sensitivity of 123I-E2 in the detection of primary breast cancer or metastases and recurrences is low compared to mammography and other methods; therefore, 123I-E2 scintigraphy cannot be used as a screening method. Differentiation of malignant and benign tissue is even more difficult as both may have a positive ER status, for example in mastopathy. Nevertheless, 123I-E2 scintigraphy is an in vivo imaging technique for the detection of breast cancer depending on the ER status and provides information about tumor localisation. It may become a specific method for the non-invasive diagnosis of the ER status and may be helpful in follow-up studies. As a receptor-specific agent 123I-E2 may give answers to questions of tumor heterogeneity and changes of the ER status during therapy.

Aged↗
PubMed1990

[Magnetic resonance tomography of the bone marrow in cancer patients with a solitary area of increased uptake in the bone scintigram].

Solitary abnormalities in bone scintigrams of cancer patients are a finding causing special diagnostic problems. In a prospective study the value of MRI imaging of the bone marrow was to be ascertained when compared to recognized X-ray studies, as a method of clarifying suspect bone scintigraphy findings. 25 cancer patients presenting with a solitary suspect abnormality in bone scintigrams were examined by X-rays and MRI. In 15 patients, MRI showed that metastases were the probable cause of the hot spot. In 7 patients, radiography, the routinely used method to confirm or exclude the presence of metastases, failed to detect these metastases. In the remaining 10 patients other causes of increased activity in the bone scintigrams could be demonstrated, e.g. fracture, degenerative disease, benign tumour. The results were confirmed by biopsy, operation, autopsy or follow-up. Considering the clinical consequences of the diagnosis of bone metastases, we suggest that a bone marrow MRI of the affected region should be performed to clarify the cause of a solitary hot spot in bone scintigrams of cancer patients, especially if X-ray studies are inconclusive.

Adult↗