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Biomedical subjects

T E van Zanten

Publications and source records attributed to T E van Zanten.

At least 19 recordsLinked to original sources

Imaging the bone marrow with magnetic resonance during a crisis and in chronic forms of sickle cell disease.

Five patients with sickle cell disease have been studied by magnetic resonance imaging (MRI) in three instances during a crisis. Attention was directed to the pelvis and lower extremities. Bone marrow pathology has been classified according to generalised or circumscribed alterations in signal intensity on T1 weighted spin-echo sequences. Both acute and chronic changes were observed.

Adult↗

Magnetic resonance imaging of meniscal lesions of the knee.

In a prospective study of 25 patients, magnetic resonance imaging (MRI) was employed to detect meniscal tears in the symptomatic knee. All patients underwent arthroscopy and 21 underwent double contrast arthrography. When correlated with these two diagnostic procedures MRI produced no false negative results. There were, however, six false positive MRI findings all of which related to the posterior horn of the medial meniscus. MRI appears to be reliable in detecting meniscal tears but long examination times continue to limit its clinical usefulness.

Adolescent↗

Nuclear magnetic resonance imaging of bone marrow in childhood leukaemia.

Bone marrow infarction is known to occur in childhood leukaemia. Although it may be suspected on clinical grounds, radiographic evidence is infrequent. We present three cases in which magnetic resonance imaging demonstrated unexpectedly extensive bone marrow lesions and discuss the evidence that these lesions were due to bone marrow infarction.

Adolescent↗

Invasion of laryngeal cartilage by cancer: comparison of CT and MR imaging.

Forty-two patients with laryngeal carcinomas were examined with computed tomography (CT) and magnetic resonance (MR) imaging. The accuracy of both CT and MR imaging in the depiction of cartilage invasion was evaluated in 16 patients by comparing findings at CT and MR with pathologic findings. Calcified cartilage that has been invaded by cancer is frequently seen on CT scans as having an intact contour. Tumor approaching nonossified cartilage may simulate cartilage invasion. On T1-weighted MR images, invaded marrow of ossified cartilage is of intermediate signal intensity, allowing it to be differentiated from normal bone marrow. On proton-density images, tumor is of increased signal intensity, which allows it to be differentiated from nonossified cartilage. In our experience, the specificities of CT and MR imaging were approximately equal (91% and 88%, respectively), but CT had a considerably lower sensitivity than MR (46% vs. 89%). Gross movement artifacts, which resulted in nondiagnostic images, occurred in 16% of the MR examinations. MR imaging is recommended as the modality of choice in the diagnosis of cartilage invasion.

Aged↗

Bone marrow magnetic resonance studies in childhood leukemia. Evaluation of osteonecrosis.

In 25 patients under treatment or during follow-up for acute lymphoblastic leukemia magnetic resonance imaging (MRI) of both knees was compared to history and physical examination to detect osteonecrosis. Results of MRI were classified as: O, normal bone marrow (BM); 1, diffuse decrease in signal intensity; 2, circumscript lesions. Patients clinically suspected of osteonecrosis had a statistically significant increased incidence of Type 2 lesions. Three patients with a BM relapse also showed Type 2 lesions. Circumscript lesions of the epiphyses were seen exclusively in the four patients with clinical suspicion of osteonecrosis during BM remission and this may be a MR finding strongly indicative of osteonecrosis. Patients with Type 2 lesions during BM remission had received systemic chemotherapy for a statistically significant longer period than the other patients. Using MRI findings we suspect that at least four patients suffered osteonecrosis due to chemotherapy. MRI is a promising means of detecting this disorder.

Adolescent↗

Intravenous urography as a prognostic indicator in vesical carcinoma.

A retrospective analysis of 1378 cases of urinary bladder tumor, showed that unilateral or bilateral ureteric obstruction seen on an intravenous urogram at presentation, was significantly associated with both decreased overall survival and tumor-free interval. A tumor shadow shown on standard projections did not correlate with survival. At 24 months only 35% of the ureteric obstruction group were tumor-free as compared with 65% of the unobstructed group. Survival at 5 years was 27% in the obstructed ureter group and 73% in the non-obstructed group. This difference although less marked, persists at 9-year follow-up.

Adult↗

Osteosarcoma with calcific mediastinal lymphadenopathy.

A case of osteosarcoma with calcific mediastinal lymphadenopathy is presented. The lesion caused increasing dysphagia and bronchial erosion, showed uptake of isotope on a bone scan and was seen to enlarge on follow-up CT scans.

Adolescent↗

CT and nuclear medicine imaging in vertebral metastases.

Three cases are presented to illustrate the value of CT in elucidating the diagnosis in cancer patients presenting with complaints that are clinically highly suspicious for osseous metastases, where isotope bone imaging and conventional radiography failed to confirm the clinician's suspicion.

Aged↗