PubMed HealthSearch

Biomedical subjects

S H Heywang

Publications and source records attributed to S H Heywang.

At least 19 recordsLinked to original sources

MR imaging of the breast with Gd-DTPA: use and limitations.

Between August 1985 and November 1987, 150 patients with 167 biopsy-proved lesions were examined with magnetic resonance (MR) imaging enhanced with gadolinium diethylenetriaminepentaacetic acid, mammography, and palpation. Of these patients, 113 with 123 lesions were also examined with ultrasound. Enhancement above 300 normalized units (NU) on MR images was considered significant; between 250 and 300 NU, borderline; and below 250, nonsignificant. All 27 fibroadenomas and 70 of 71 carcinomas showed significant enhancement; one carcinoma showed borderline enhancement. Nonproliferative dysplasia showed nonsignificant enhancement in 15 of 16 cases and significant enhancement in one, whereas proliferative dysplasia showed usually diffuse enhancement varying from nonsignificant (five of 30 cases) to borderline (five of 30 cases) to significant (20 of 30 cases). In the nonblind evaluation of the modalities, MR imaging compared favorably. When limitations of the technique were considered, MR imaging seemed beneficial as a supplement in selected, diagnostically difficult cases.

Adenofibroma

[Nuclear magnetic resonance tomography using gadolinium-DTPA in the diagnosis of spinal lesions].

In spinal lesions GD-DTPA has led to a better diagnosis of tumors concerning the extent and differential diagnosis. Important indications for the application of GD-DTPA are intramedullary tumors: excellent information with respect to extent and differentiation cyst from tumor. At extramedullary intradural tumors we got distinction of extramedullary from intramedullary tumors and more information in the differential diagnosis for example in cases of neurinomas and meningiomas. Additional information is also obtained by means of GD-DTPA in extradural tumors: better delineation from the myelon, better possibilities to differentiate between meningiomas, neurinomas and scar and tumor.

Breast Neoplasms

[Dynamic contrast medium studies with flash sequences in nuclear magnetic resonance tomography of the breast].

In this study the dynamic contrast behavior after Gd-DTPA of different breast tissues and tumors has been investigated with a series of T1-weighted FLASH-sequences during the first 5 minutes after the application of Gd-DTPA. The results of these dynamic FLASH-measurements have been compared to the results of the SE-sequences 6-10 and 11-15 minutes after Gd-DTPA in 40 patients with 54 different breast tissues. It could be shown that in a number of cases a better differentiation (e.g. DD between carcinomas and proliferative dysplasia) was possible on FLASH-scans early after contrast medium than on the late SE-scans. Only the distinction between non-proliferative and proliferative dysplasia was better on the late SE-scans. Evaluation of the enhancement dynamics may be helpful in some cases as an additional information. Further investigations are necessary to confirm these findings and to assess their value.

Breast

[Contrast enhancement of the nipple in nuclear magnetic resonance tomography of the breast with Gd-DTPA].

Contrast enhancement around the nipple has been evaluated retrospectively in 51 of 70 patients in respect of the underlying breast disease. 2 of the patients had to be considered separately because of malignant disease of the nipple or areola itself. The remaining 49 patients showed no close relation between the underlying breast disease and the amount of contrast enhancement in the nipple. This phenomenon of a non-pathological significant contrast enhancement of the nipple appears important to avoid false positive diagnoses in MRI of the breast with Gd-DTPA.

Breast

MRI of the breast--histopathologic correlation.

132 solid breast masses have been examined at our institution by MR and have consequently been histopathologically correlated. T1- and T2-weighted SE and multi-echo sequences have been evaluated visually. It was found that signal intensities of tissues on T2-weighted images correlated with the contents of fibrosis, cells or water. Thus in some lesions (which consisted of different tissue components), a characteristic internal structure was visible on T2-weighted images, reflecting their histopathologic structure. Corresponding to their different composition, differences of signal intensity have also been noted between those fibroadenomas with a high contents of fibrosis and all other well-circumscribed breast lesions (fibroadenomas, carcinomas). However, for the majority of lesions with irregular contours a discrimination based on signal intensities or calculated T1- and T2-values did not seem possible. This overlap can also be explained by the macroscopically similar composition (amount of fibrosis, water or cells) of benign and malignant irregular lesions.

Breast

[Nuclear magnetic resonance tomography of the spine and spinal cord compared with computed tomography and myelography].

In cases of syringomyelia MR is superior to CT and myelography in visualisation and delineation of the extent of the process. In diagnosing spinal tumours MR is a more sensitive method than CT and myelography. MR provides additional information on sagittal and frontal planes regarding the extent of the tumour. In diagnosis of disc prolapse MR seems to be as accurate as CT or myelography. We obtained additional information in diagnosis of degenerated disc tissue. Spinal stenosis is easily recognisable. CT was superior in differentiation of bony and disc protrusion. The results show that MR has opened up new possibilities in the diagnosis of spinal diseases and will result in a reorientation of the diagnostic approach.

Arteriovenous Fistula

[Use of Gd-DTPA in the nuclear magnetic resonance study of the breast].

55 patients with altogether 60 breast masses have been examined postoperatively by plain MR, MR with Gd-DTPA and mammography at our institution. All breast carcinomas and fibroadenomas did enhance significantly. Non-proliferative dysplasia, normal breast tissue and scar tissue did not enhance significantly. Borderline enhancement has been found in cases of proliferative dysplasia. The diagnostic accuracy has been improved by MR with Gd-DTPA. Advantages have been an improved visualization of tumors in dense breasts, an improved differentiation between irregular dysplasia and carcinoma and an improved differentiation between post-therapeutic changes (after radiation, surgery or silicon implants) and carcinoma. Nevertheless both technical improvements and further clinical experience is necessary.

Breast

Magnetic resonance imaging compared with computed tomography and myelography in the diagnosis of spinal masses.

Magnetic resonance imaging (MRI) is superior to computed tomography (CT) and myelography in the demonstration and delineation of the extent of syringomyelia. In the detection of intramedullary tumors MRI is more sensitive than CT and myelography. MRI provides additional information on the sagittal and frontal planes regarding the extent of tumors. In the diagnosis of disc prolapse MRI seems to be as accurate as CT or myelography. Additional information is available with MRI in the diagnosis of degenerated disc tissue. Spinal stenosis is easily recognizable. CT was superior in the differentiation of bony and disc protrusion. The results show that MR has opened up new possibilities in the diagnosis of spinal diseases and will lead to a reorientation of the diagnostic approach.

Diagnosis, Differential

[Technical adaptation of a breast coil to the clinical demands at 1 tesla].

Evaluating the increase of signal intensity on the T1-weighted pulse sequences is the simplest way of measuring the enhancement in MR studies of the breast. A good homogeneity within the coil is a prerequisite for such an evaluation. A coil with 3 parallel windings and good homogeneity is presented.

Breast

Advantages and pitfalls of ultrasound in the diagnosis of breast cancer.

Ultrasound has become more and more widespread in the diagnosis of breast disease. However, opinions still diverge concerning its exact place in the diagnosis of breast cancer. An understanding and awareness of the principal pitfalls and limitations of this modality is essential for its optimum and responsible usage. An analysis of four interesting cases illustrates the benefits and limitations of this technique.

Adult

[Calcifications after tylectomy and irradiation for breast cancer. Their symptomatic picture and diagnostic value].

In several institutions lumpectomy combined with radiation treatment is being investigated as an alternative method in the primary management of breast cancer (1-5). In 8 of 53 patients, who had undergone this treatment, new calcifications developed after therapy. In 2 of the 53 patients postoperatively persisting calcifications were encountered. The authors report about their preliminary experience in the diagnosis of calcifications after this therapy.

Brachytherapy

[Nuclear spin tomography in breast diagnosis].

The authors report about their preliminary experience with MRI in the diagnosis of breast disease. 50 breast masses in 41 consecutive patients have been evaluated by MRI and mammography, some of which have been evaluated by ultrasound, as well. All masses have consequently been biopsied. They include 32 carcinomas, 1 secondary malignant lymphoma, 4 fibroadenomas, 2 papillomas, 3 cysts, 1 hamartoma and 5 dysplastic nodules. Advantages and disadvantages of MRI of the breast are discussed. Possible future indications are suggested for selected cases.

Adenofibroma

[Nuclear magnetic resonance tomography in breast cancer diagnosis--present status and future outlook].

Due to its high soft tissue contrast MR appears particularly well suited for the examination of the breast. However, it was only after the development of breast coils and the concomitant improvement of the image quality that examinations regarding the potentials of MR in breast cancer diagnosis became interesting. Thus, MR of the breast is still in the initial stage. First results indicate that at present the expected tissue differentiation by MR parameters T1, T2 ...) is not possible MR proved nevertheless advantageous for selected cases. Further research is necessary.

Breast Neoplasms

Peripheral DSA with automated stepping.

Peripheral digital angiography can be applied with automated stepping and in digital subtracted technique to evaluate the complete lower extremities angiographically with one single injection of contrast medium. Altogether 25 DSA-examinations were compared with non-substracted technique. By DSA-technique additional series could be reduced to only those, where significantly different flow in both extremities necessitated different timing as known from conventional angiography. DSA-technique with automated stepping may in the future totally replace conventional angiography of the peripheral arteries.

Angiography

Carcinoma of the breast behind a prosthesis--comparison of ultrasound, mammography and MRI (case report).

Silicone prostheses are known to impair the diagnostic evaluation of the breast. The authors report about a case of a small carcinoma of the breast, which was examined by MRI, ultrasound and mammography. The diagnostic capabilities of these imaging modalities are discussed and MRI is presented as a new possible tool for an improved evaluation of breasts with silicone implants.

Breast Neoplasms

MR imaging of the breast using gadolinium-DTPA.

In a preliminary study 20 patients underwent breast examinations by magnetic resonance (MR) imaging without and with Gd-DTPA as contrast medium. All carcinomas enhanced, whereas dysplastic tissue enhanced slightly or not at all. Significant additional diagnostic information was available on the Gd-DTPA examinations in at least four of 20 cases compared with MR without contrast medium and X-ray mammography. Our preliminary results indicate that MR imaging of breast using Gd-DTPA may be helpful for the evaluation of dense breasts and the differentiation of dysplasia and scar tissue from carcinoma.

Biopsy

MR imaging of the breast: comparison with mammography and ultrasound.

Fifty-seven biopsy proven breast masses have been examined at our institution by magnetic resonance (MR), mammography, and ultrasound. The three techniques have been evaluated concerning their capability to visualize the lesion and the diagnostic information obtained. Magnetic resonance proved comparable to mammography and superior to sonography in the fatty to medium dysplastic breasts but inferior to the combined examination by mammography and sonography in the dense breasts. In some selected cases, however, special advantages of MR have been found.

Adenocarcinoma, Scirrhous