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Biomedical subjects

M L Majurin

Publications and source records attributed to M L Majurin.

7 recordsLinked to original sources

Low-dose and conventional-dose high resolution CT of pulmonary changes in breast cancer patients treated by tangential field radiotherapy.

Twenty-seven consecutive breast cancer patients receiving tangential field radiation therapy were followed by high resolution CT (HRCT) in order to compare the accuracy of reduced-dose HRCT and conventional-dose HRCT in the evaluation of subtle pulmonary changes. Thin section 1-mm HRCT images were obtained at identical levels at 120 kVp, with 320 mAs, 200 mAs, 160 mAs, 120 mAs and 60 mAs settings. HRCT was performed during the planning of radiotherapy and 4, 8 and 24 weeks after the completion of radiotherapy. Radiation was administered according to an individual CT-based plan by tangential fields with 4 or 6 MV photons to the whole breast given with 5 fractions of 1.9 Gy weekly to a total dose of 50 Gy. The tumor bed was boosted by electrons to 60 Gy. Pathological changes were detected in 21 examinations of 10 patients: 9 patients out of 27 (33%) showed radiation induced changes; 1 patient developed metastases within the irradiated volume. Septal thickening appeared in 5 patients at 4 weeks and in another 5 patients at 8 weeks. Parenchymal consolidation was detected in 1 patient at 4 weeks and in 5 patients at 8 weeks. HRCT using 160 mAs yield good quality images of subtle radiation induced injuries. The diagnostic validity of HRCT using lower than 160 mAs depends on the detail analyzed.

Adult↗

High-resolution CT of the lung in asbestos-exposed subjects. Comparison of low-dose and high-dose HRCT.

The lowest possible mAs settings for high-resolution CT (HRCT) were studied on 45 individuals with suspected asbestos-related lung disease. All patients were investigated with 5 to 6 high-dose HRCT images (120 kVp/160 mA/2 s) at 3-cm intervals. At a selected level 4 additional low-dose images were obtained on each patient with lower mAs settings (100 mA/2 s, 80 mA/2 s, 60 mA/2 s, 30 mA/2 s). Thirty-seven subjects out of 45 had HRCT lesions compatible with asbestosis. HRCT images obtained with as low as 60 mA/2 s settings clearly showed pleural tractions and thickenings, parenchymal bands, honeycombing and subpleural curvilinear shadows, whereas in the evaluation of subpleural short lines and ground glass findings 80 mA/2 s were required. The lowest setting, 30 mA/2 s, was sufficient only in detecting and evaluating pleural tractions and thickenings. We conclude that 160 mAs yield good quality HRCT images, with substantial decrease of radiation dose, for the evaluation of asbestos-related lesions.

Adult↗

Relaxation times of normal breast tissues. Changes with age and variations during the menstrual cycle.

The influence of age on the relaxation times of normal breast parenchyma and its surrounding fatty tissue were evaluated, and the variations during a normal menstrual cycle were analyzed using an ultra low field 0.02 T imager. Thirty-nine healthy volunteers aged 21 to 59 years were examined to determine T1 and T2 relaxation times, and 8 of these volunteers were studied once weekly during one menstrual cycle. The only significant trend was an increase in the T2 of breast parenchyma with increasing age. During the menstrual cycle there was a slight but insignificant (p = 0.10) increase in T1 of the breast parenchyma values during the latter half of the menstrual cycle, and a corresponding increase in T2 values between the 2nd and 3rd weeks of the menstrual cycle, which was significant (p = 0.003).

Adult↗

Pulmonary manifestations in lysinuric protein intolerance.

STUDY OBJECTIVES: To evaluate the pulmonary manifestations and the course of acute respiratory insufficiency associated with lysinuric protein intolerance (LPI). DESIGN: Retrospective review of clinical data and chest radiographs (total 225) obtained during the lifetime follow-up of 31 LPI patients. About half of the 25 patients without respiratory symptoms underwent high-resolution computed tomography (HRCT) of the lungs, radionuclide perfusion imaging, whole body plethysmography, and diffusing capacity measurements. PATIENTS: Thirty-one Finnish patients with LPI. RESULTS: During the follow-up period, four children with LPI died in respiratory insufficiency, 1 adult had an episode of respiratory insufficiency, and another had chronic symptoms, whereas 25 patients remained symptom-free. The radiologic findings in acute progressive respiratory insufficiency were uniform: at first, reticulonodular interstitial densities and, later on, progressive airspace disease. At autopsy, three patients showed pulmonary alveolar proteinosis and one had pulmonary hemorrhage and cholesterol granulomas. One adult had reversible respiratory insufficiency with signs of bronchiolitis obliterans, another adult had recurrent episodes of chest pain, dyspnea, and hypoxia. Of the symptom-free patients, one third (8 of 25) had signs suggestive of pulmonary fibrosis evidenced on chest radiographs and two thirds (8 of 14) had signs evidenced by HRCT films. Most symptom-free patients showed mild abnormalities either in perfusion imaging (9 of 12) or in function tests (8 of 12). CONCLUSION: In childhood, patients with LPI are highly predisposed to develop pulmonary hemorrhages and alveolar proteinosis. Interstitial lung densities may precede the acute phase. Most adult LPI patients show radiologic signs of interstitial lung disease but only a few show clinical impairment.

Adult↗

Value of high contrast medium dose in brain CT.

Fifty-five patients with brain lesions were examined by computed tomography (CT) after two doses of contrast medium: a bolus injection of 65% meglumine diatrizoate, 1 ml/kg, and a bolus injection of 65% meglumine diatrizoate, 1.5 ml/kg, in combination with an infusion of 250 ml meglumine iodamide containing 110 mg I/ml. The studies were usually performed 2 days apart and were analyzed by three radiologists. In 25 patients, one or more of the radiologists changed the diagnosis or the number or size of the lesions when the two scans were observed separately. In three patients, the primary tumor or metastases were seen in the study performed after the higher dose only, and, in two other patients having cerebral metastases, a greater number of metastases were detected in the high dose study. The lower dose containing 15 to 31 g iodine (306 mg iodine/kg) seems to be inadequate in CT of the brain.

Brain↗