[Respiratory symptoms in hantavirus infection].
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Adult↗
Biomedical subjects
M Varpula
Publications and source records attributed to M Varpula.
Magnetic resonance imaging of the uterus in vivo and in vitro at an ultra low magnetic field (0.02 T): assessment of its normal structure and of leiomyomas.
The purpose of this investigation was to analyze the normal anatomy and leiomyomas of the uterus with an ultra low field (0.02 T) magnetic resonance imaging (MRI) device. MR imaging was performed on 18 uteri, 11 of which were imaged both preoperatively (in vivo) and as an operative specimen (in vitro), 6 only as an operative specimen, and 1 only preoperatively. All uteri were examined histologically after imaging. The junctional zone was much better delineated in vivo than in vitro, indicating that its appearance on MR is partly due to blood flow. No structures contributing to its visibility in vitro could be demonstrated histologically. Twenty leiomyomas (size range 7-79 mm) in 12 uteri were found with MRI. They were slightly better discerned in vivo than in vitro. The leiomyomas, having no degenerative changes, had a signal intensity which was the same or lower than that of the myometrium. On images obtained in vitro the signal intensity of these leiomyomas relative to that of myometrium correlated directly with their muscular content (R = 0.74, p = .002). The authors conclude that the junctional zone is a sum of physiological and structural factors, the latter being responsible for its in vitro delineation. MR imaging of the uterus in vitro did not give more information than MR imaging in vivo. All leiomyomas larger than 10 mm could be detected, indicating that MR imaging at 0.02 T is an accurate method for the imaging of the uterine leiomyomas.
Female↗
Imaging of uterine carcinoma by carbon-11-methionine and PET.
UNLABELLED: L-[methyl-11C]methionine ([11C]methionine) is probably one of the most useful positron-emitting tracers for metabolic imaging of human cancer. In this study, we investigated whether human uterine cancer can be imaged with [11C]methionine and PET. METHODS: Fourteen patients with primary uterine malignancy participated in the study. Eight patients had endometrial carcinoma and six had cervical carcinoma. The normal endometrium was analyzed in four additional patients with no uterine malignancy and in one patient with cervical cancer. Tracer uptake was quantitated by calculating both the standardized uptake values (SUVs) and the kinetic influx constants (Ki values) for the tracer. RESULTS: All patients with either cervical or endometrial carcinoma had increased uptake of [11C]methionine in the PET image. The mean SUV of the carcinomas was 8.4 (n = 13; s.d., 1.5) and the mean Ki was 0.15 min-1 (n = 12; s.d., 0.08 min-1), whereas the mean SUV of the normal endometrium was only 4.6 (n = 5; s.d., 0.8). Histologically poorly (Grade III) or moderately (Grade II) differentiated endometrial carcinomas accumulated more [11C]methionine than the well-differentiated (Grade I) ones (p = 0.04 for the SUVs, and p = 0.05 for the Ki values). There were also variable physiological accumulations of [11C]methionine in the pelvis. CONCLUSIONS: Uterine carcinoma accumulated [11C]methionine more than the normal endometrium. However, the physiological accumulations of [11C]methionine in the pelvis may confuse the interpreter of the PET image; thus, morphological imaging also needs to be performed as a reference to localize the tumor accurately. We conclude that human uterine carcinoma can be effectively imaged with [11C]methionine and PET.
Adenocarcinoma↗
CT and ultra low field (0.02 T) MR imaging of uterine cervical carcinoma.
Nineteen pelvic MR and 21 CT examinations were performed in 21 patients with uterine cervical carcinoma. The results were compared with clinical (FIGO) staging in all patients, and with the histopathologic results after operation in 8. In the evaluation of local tumor growth CT agreed with clinical staging in 29%, MR imaging with clinical staging in 47% and CT with MR in 53%. The greatest discrepancy between the imaging methods and clinical examination was in the evaluation of parametrial extension. From 8 Stage I tumors with surgical confirmation the local tumor growth was overestimated with CT in 3 cases, with clinical examination in 2 and with MR imaging in 2 cases. CT and MR imaging at 0.02 T did not differ in the evaluation of parametrial tumor growth. Clinical examination overestimated parametrial growth but was relatively accurate in detecting vaginal wall involvement. MR imaging at 0.02 T is a convenient, inexpensive and accurate method for the local staging of early uterine cervical carcinoma.
Adenocarcinoma↗
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 time changes of the uterus during the menstrual cycle: correlation with hormonal status.
Six women volunteers underwent pelvic MR imaging at 0.02 T four times during their menstrual cycle. The T1 and T2 relaxation times of the myometrium and endometrium were measured and correlated with the serum estradiol and progesterone levels. The magnitude of the relaxation times were highly individual but the pattern of their variation during the menstrual cycle was similar. The relaxation times were shortest at the beginning and end of the cycle. The most rapid increase occurred during the proliferative phase, followed by little or no increase through to the middle of the secretory phase. The T1 and T2 times of the endometrium correlated directly with the serum estradiol levels during the entire menstrual cycle (r = 0.5, P = 0.02) and the T2 times of the endometrium with the serum progesterone levels during the secretory phase (r = 0.6, P = 0.05). The correlation between the relaxation times of the myometrium and the serum hormonal levels was poor. The results indicate that the relaxation times of the myometrium and endometrium vary during the menstrual cycle reflecting the serum hormonal status. MR imaging of the uterus with relaxation time measurements may be clinically useful to examine the menstrual cycle and its pathology.
Adult↗
Magnetic resonance imaging of female pelvic masses and local recurrent tumors at an ultra low (0.02 T) magnetic field: correlation with computed tomography.
Pelvic MR (41 patients) and CT (36 patients) examinations were performed on 14 females with a primary pelvic complaint, and on 28 females with a suspicion of local recurrent disease of gynecologic malignant tumor. Benign cystic tumors were found in eight patients, five patients had endometriomas, one had a lymphoma, and one had a small androblastoma. Ten local recurrent tumors were confirmed histopathologically or cytologically. All cysts, one endometrioma, the lymphoma, and six recurrent tumors were detected on images obtained by our ultra low field magnetic unit. The smallest cyst detected was 16 mm in diameter. Small scattered implants of endometriosis were not discerned. The appearance of the tumors did not differ essentially from those described at high magnetic fields. Physical examination detected all 10 recurrent tumors, CT detected 8 of them, and MRI 6 out of 9 cases. The sensitivities of physical examination, CT and MRI to find recurrent diseases were 100%, 80%, and 67%, respectively. Corresponding specificities were 93%, 67%, and 80%. The results indicate that physical examination is most important in recurrent diseases. CT is the basic method for imaging malignant pelvic tumors. MR imaging at 0.02 T magnetic field provides a convenient and inexpensive method for more specific information, if CT findings are equivocal. MRI at 0.02 T is also accurate in detecting benign pelvic masses, but the findings are not very specific.
Evaluation Studies as Topic↗
Magnetic resonance imaging of the uterus at an ultra low (0.02 T) magnetic field.
In vivo pelvic imaging of 39 women and in vitro relaxation time measurements of four uterine specimens were performed using an ultra low field (0.02 T) MRI unit. Average T1 times measured in vitro at 37 degrees C for the myometrium and endometrium were 206 ms (SD 47 ms) and 389 ms (SD 21 ms), respectively. Corresponding T2 times were 95 ms (SD 20 ms) and 167 ms (SD 13 ms). The proton relaxation of almost all myometrial specimens proved to be biexponential, but of all endometrial specimens was monoexponential. Contrast measurements between endometrium versus myometrium and myometrium versus the junctional zone were performed after imaging 18 volunteer women using different pulse sequence parameters. Normal uterine structures were optimally demonstrated by SE 700/70. Relatively short repetition times could be used, because spin-lattice relaxation times were short at the low magnetic field. Consequently, the short repetition times allowed averaging of four excitations to create adequate images within an acceptable scanning time. In addition to T2-weighted images a T1-weighted inversion recovery sequence with a short inversion time of 50 ms (IR 1000/50/40) adequately differentiated the three uterine zones. Although pathologic lesions of the uterus including leiomyomas, anomalies and carcinomas were well demonstrated, especially with the T2-weighted spin echo pulse sequence, further investigations are needed to evaluate the optimal technique for ultra low field MR imaging of uterine tumors.
Adenocarcinoma↗
[Diagnostic value of ultrasound in dentistry].
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Diagnosis, Oral↗
Hysterosalpingography with a balloon catheter versus a cannula: evaluation of patient pain.
The amount of procedural and post-procedural pain due to hysterosalpingography performed with a standard cannula (28 patients) versus a balloon catheter (23 patients) was compared. Patients completed questionnaires in which they rated the pain they experienced during insertion of the instrument, during injection of contrast material, immediately after the examination, several hours after the examination, and over the next 6 days. The balloon catheter produced less discomfort during the procedure but significantly more discomfort after the procedure than did the standard cannula. These results indicate that hysterosalpingography with the balloon catheter is not as painless as has been claimed.
Adult↗
Cough urethrocystography: the best radiological evaluation of female stress urinary incontinence?
Urethrocystography and simultaneous urethrocystometry were performed on 40 women with primary urinary incontinence. The posterior urethrovesical angle, inclination angle, urethropelvic angle, and an orifice descent angle, not earlier described, were measured on radiographs obtained at rest, during coughing and during straining. The orifice descent angle was used to describe the descent of the internal urethral orifice in the cough radiographs, and was the only measurement that provided a significant correlation with urethrocystometry. The other angles measured, and radiographs obtained at rest or during straining were not useful in the evaluation of female stress urinary incontinence. The authors conclude that the best imaging method for the evaluation of female stress urinary incontinence is urethrocystography employing a single lateral view taken during coughing, with measurement of the orifice descent angle.
Cough↗
Double-contrast examination of the stomach: 100mm fluorography vs. full-size radiography.
Full-size radiographs and 100mm fluorographic spot views taken with an image intensifier were compared during double-contrast examination of the stomach. Differences in image quality between the two modalities were small; there was also a small decrease in absorbed dose, since fluoroscopy comprised more than half of the total dose. The authors recommend that 100mm spot views be used routinely in double-contrast examination of the stomach.
Contrast Media↗
Survival markers related to bone metastases in prostate cancer.
Prognostic value of a bone resorption marker, tartrate-resistant acid phosphatase isoform 5b (TRACP 5b), and two matrix metalloproteinases (MMP-2 and MMP-9) was compared with the standard clinical analyses of total alkaline phosphatase (tALP) and prostate-specific antigen (PSA), in prostate cancer (PC) patients with (BM+) or without (BM-) bone metastases. Diagnostic accuracy evaluation showed the highest area under the curve for tALP (AUC=0.98), followed by PSA (AUC=0.87), TRACP 5b (AUC=0.82), MMP-9 (AUC=0.62) and MMP-2 (AUC=0.53). Significantly shorter survival was observed for patients with tALP (p<0.001), TRACP 5b (p=0.002) and PSA (p<0.001) levels, above the determined cut-off values compared with lower marker levels. In multivariate Cox regression analysis, only tALP and PSA, in addition to Gleason score were independent prognostic factors for survival. Of the three novel markers tested, only TRACP 5b proved to be predictive of survival in PC with bone metastases. MMP-2 and -9 are thus not recommended for further studies in this context.
Acid Phosphatase↗