PubMed Health⌕ Search

Biomedical subjects

M J Kuhn

Publications and source records attributed to M J Kuhn.

At least 19 recordsLinked to original sources

A clinical comparison of the safety and efficacy of MultiHance (gadobenate dimeglumine) and Omniscan (Gadodiamide) in magnetic resonance imaging in patients with central nervous system pathology.

RATIONALE AND OBJECTIVES: The safety and diagnostic efficacy of MultiHance (gadobenate dimeglumine) in the central nervous system (CNS) were evaluated in a double-blind, multicenter, phase III clinical trial. METHODS: Two hundred five patients highly suspected of having a CNS lesion (by previous imaging exam) were enrolled at 16 sites in the United States. Patients were randomized to one of three incremental dosing regimens. Magnetic resonance imaging with Omniscan (gadodiamide) at doses of 0.1 and 0.3 mmol/kg was compared with MultiHance (gadobenate dimeglumine) at doses of 0.05 and 0.15 mmol/kg and at 0.1 and 0.2 mmol/kg. RESULTS: Compared with predose images alone, efficacy was demonstrated in each of the gadobenate dimeglumine and gadodiamide groups (single and cumulative doses) as indicated by the level of diagnostic information, number of lesions detected, and contrast-to-noise ratio measurements. The level of diagnostic information from gadobenate dimeglumine at 0.1 mmol/kg was equivalent to that with gadodiamide at the same dose. One of the two blinded reviewers found equivalence between the gadobenate dimeglumine 0.05 mmol/kg dose and gadodiamide at 0.1 mmol/kg. Both reviewers found the level of diagnostic information to be equivalent after the second dose of contrast for all three dosing regimens. The cumulative doses of gadobenate dimeglumine were well tolerated and as safe as gadodiamide. CONCLUSIONS: Gadobenate dimeglumine is comparable to gadodiamide in terms of safety and efficacy for imaging of CNS lesions, with a possible advantage in imaging applications owing to enhanced T1 relaxivity.

Brain Neoplasms↗

Magnetic resonance imaging in patients with central nervous system pathology: a comparison of OptiMARK (Gd-DTPA-BMEA) and Magnevist (Gd-DTPA).

RATIONALE AND OBJECTIVES: The objective of the two pivotal phase 3 studies was to evaluate the safety and efficacy of OptiMARK (Gd-DTPA-bis(methoxyethylamide) [Gd-DTPA-BMEA]) compared with Magnevist (Gd-DTPA) in magnetic resonance imaging of the central nervous system. METHODS: Two multicenter, randomized, double-blind, parallel group studies were conducted in 395 patients with known or suspected central nervous system pathology. Subjects were randomized to receive a single 0.1 mmol/kg intravenous injection of either Gd-DTPA-BMEA or Gd-DTPA. The safety of Gd-DTPA-BMEA and Gd-DTPA was monitored for up to 72 hours after study drug administration. Precontrast and postcontrast administration magnetic resonance scans were acquired using identical imaging planes and techniques. RESULTS: No deaths or unexpected adverse events were reported in either group. A comparison of adverse events by intensity and relation demonstrated no statistically significant differences between the two groups. Gd-DTPA-BMEA and Gd-DTPA were equivalent with respect to confidence in diagnosis, conspicuity, and border delineation. CONCLUSIONS: Gd-DTPA-BMEA and Gd-DTPA demonstrated comparable efficacy profiles, and the safety profiles were considered similar.

Adult↗

Wallerian degeneration after cerebral infarction: evaluation with sequential MR imaging.

The dynamic signal intensity changes at magnetic resonance (MR) imaging in active and chronic wallerian degeneration in the corticospinal tract were evaluated. Forty-three patients with wallerian degeneration seen on MR images after cerebral infarction were studied. When possible, patients with acute stroke were examined with MR imaging prospectively at the onset of symptoms and then at weekly intervals for several months. Focal infarction without distal axonal degeneration is demonstrated for the 1st month following onset of clinical symptoms. At 4 weeks, a well-defined band of hypointense signal appears on T2-weighted images in the topographic distribution of the corticospinal tract. After 10-14 weeks, the signal becomes permanently hyperintense. Over several years, accompanying ipsilateral brain stem shrinkage occurs. The dark signal intensity observed on T2-weighted images between 4 and 14 weeks is believed to result primarily from transitory increased lipid-protein ratio.

Adult↗

Wallerian degeneration: evaluation with MR imaging.

Twenty-three patients who underwent routine magnetic resonance (MR) imaging of the brain were found to have signal or structural abnormalities corresponding to white matter tracts. Images were evaluated for anatomic and MR signal characteristics of the involved tract, associated primary lesions, and, when possible, changes in MR signal and anatomic structures with time. Images from 20 patients demonstrated a thin band of abnormal signal contiguous with the primary lesion and conforming to the known anatomic pathway of a white matter tract. Cerebral infarction was the most common associated primary disorder (n = 17). Neoplasms (n = 2), demyelinating (n = 1) and posthemorrhagic (n = 2) conditions, and an idiopathic movement disorder (n = 1) were associated with white matter tract signal abnormalities that were indistinguishable from those seen with infarction. Signal abnormality corresponding to the corticospinal tract was the type most commonly seen. No change in signal characteristics was seen with time (six cases) or following contrast material administration (two cases). The authors conclude that MR imaging provides a sensitive method of evaluating wallerian degeneration in the living human brain.

Adult↗

Primary cerebral lymphoma in acquired immunodeficiency syndrome (AIDS)--CT manifestations.

Primary lymphoma of the brain in AIDS is being observed with increased frequency; five pathologically proven cases are presented. Although the CT patterns may correlate well with patterns previously described in lymphoma, occasionally an irregular ring-like lesion may occur which is difficult to distinguish from toxoplasmosis or other inflammatory processes without appropriate pathological material.

Acquired Immunodeficiency Syndrome↗

Low-osmolality contrast media: dosage comparison of ioversol and iohexol for cranial computed tomography.

One hundred patients undergoing cranial computed tomography were evaluated in this prospective, randomized, double-blind comparative study. Patients received 50 mL of ioversol 320 (16 g iodine), 75 mL of ioversol 320 (24 g iodine), 100 mL of iohexol 240 (24 g iodine), 100 mL of iohexol 300 (30 g iodine) or 150 mL of iohexol 240 (36 g iodine). Twenty patients were enrolled in each treatment group. No patient in any treatment group experienced any contrast-media-related adverse reaction. Results of this study coupled with our prior work suggests that the lowest dose and optimal concentration of low-osmolality contrast media necessary to produce diagnostic cranial computed tomography is 32 g of iodine administered in a concentration of 320 mg/100 mL iodine.

Adolescent↗

Primitive neuroectodermal tumor: CT, MRI, and angiographic findings.

Primitive neuroectodermal tumors (PNETs) are uncommon CNS neoplasms found usually in the first decade of life. This article presents a proven case of this lesion in a 14-month-old boy located deep in the left frontal lobe. This lesion was studied by CT, MRI, and cerebral angiography. The radiologic findings of this tumor were assessed and compared with those cases reported in the medical literature.

Angiography↗

Prenatal recognition of central nervous system complications of alloimmune thrombocytopenia.

The radiological findings associated with alloimmune thrombocytopenia have not been well described. We present two such cases diagnosed in utero by ultrasound and discuss the radiographic findings of intracranial hemorrhage and hydrocephalus secondary to alloimmune thrombocytopenia. An awareness of this entity and its early diagnosis and intervention may greatly reduce the morbidity and mortality associated with alloimmune thrombocytopenia.

Adult↗

Absence of the septum pellucidum and related disorders.

We present an illustration of the spectrum of intracranial abnormalities associated with absence of the septum pellucidum to better define and illustrate this disorder. CT and 1.5 Tesla MRI examinations of fifteen patients with absence of the septum pellucidum were meticulously analyzed and correlated with clinical and laboratory studies. The findings were compiled and categorized based upon the presence and type of associated radiologic abnormalities. Absence of the septum pellucidum may occur as an isolated abnormality (n = 3). In most patients (n = 12), associated complex developmental abnormalities are present which include heterotopias, hypoplastic falx, ventricular clefts, encephalocele, small pituitary gland, small optic nerves and chiasm, and corpus callosal dysgenesis. Inferior pointing and a squared-off appearance of the frontal horns are frequently noted. These, or other, more severe ventricular configuration deformities are present in all patients. We have portrayed the complete range of findings associated with absence of the septum pellucidum using an illustrative approach to clarify the different patterns of radiologic abnormalities which may be seen with this complex entity.

Adolescent↗