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Biomedical subjects

T H Berquist

Publications and source records attributed to T H Berquist.

At least 19 recordsLinked to original sources
PubMed1992

MR imaging of extraabdominal desmoids: differentiation from other neoplasms.

A retrospective review of MR images of 36 patients with histologically proved extraabdominal desmoids was done to define the MR characteristics of these tumors and to determine if MR could be used to differentiate desmoids from other benign and malignant soft-tissue neoplasms. The desmoids evaluated included eight primary and 30 recurrent lesions. Our study was conducted in parallel with another study in which the MR appearance of 95 benign and malignant soft-tissue masses was evaluated, and the MR images of these masses were compared with our findings. The four desmoids from that study are included in our data. The signal intensity of the tumor on T1- and T2-weighted images was graded relative to the intensities of muscle and fat. Homogeneity, margin, neurovascular and bone involvement, and fibrosis (low-signal regions within the tumor on both T1- and T2-weighted images) were evaluated. On MR imaging, the desmoids showed inhomogeneous signal (97%), poor margination (89%), neurovascular involvement (58%), and bone involvement (37%). Fibrosis was present in 88% of primary desmoids and 90% of recurrent ones, and intermediate signal (greater than that of muscle and less than that of fat) was present in 75% and 50% of these, respectively. Our results show that the MR features of desmoids have characteristics that are commonly found in malignant tumors (inhomogeneous signal, poor margination, and neurovascular involvement). MR features of desmoids that distinguish them from malignant neoplasms are the presence of fibrosis and intermediate signal in the regions of the tumor.

Adolescent↗
PubMed1991

Magnetic resonance imaging of the hand, wrist, and forearm: utility in patients with pain and dysfunction as a result of trauma.

We reviewed the clinical data, results of imaging studies, and surgical-pathologic correlations in 41 consecutive patients with pain in the hand, wrist, or forearm to evaluate the role of magnetic resonance imaging in comparison with that of other imaging techniques. Of the 41 patients, 24 had a trauma-related lesion. In 18 of these 24 patients, the findings on magnetic resonance imaging were equivalent to (6 cases) or better than (12 cases) the clinical findings or the findings on other imaging studies for the detection of lesions of the hand, wrist, or forearm. Moreover, the results of magnetic resonance imaging affected the clinical management in 7 of the 24 cases (29%).

Arthrography↗
PubMed1991

Magnetic resonance imaging for calf deep venous thrombophlebitis.

STUDY OBJECTIVE: To compare magnetic resonance imaging (MRI) of the calf with venography for patients with suspected calf deep venous thrombophlebitis (DVT). DESIGN: Ten consecutive adult patients with suspected calf DVT received venography and, within 48 hours, MRI scans. The tests were reviewed blindly by two radiologists, and results of the tests were compared. SETTING: The emergency department of a large teaching hospital with an annual census of 60,000 patients. MAIN RESULTS: All patients with negative venograms had no suggestion of DVT on MRI scan. Two of these patients had other significant demonstrable abnormalities. Four of the five patients with positive venograms had positive calf MRI scans. One patient with a venogram that was difficult to interpret had no DVT on MRI. A thigh DVT was seen on his venogram and was suggested by MRI findings. CONCLUSION: MRI may replace ascending venography as the standard for diagnosis of calf DVT.

Emergency Medicine↗
PubMed1991

Congenital cystic disease of the seminal vesicle.

Thirteen cases of congenital seminal vesicle cysts with pathologic correlation were diagnosed between 1970 and 1988. Twelve of the 13 patients had ipsilateral renal anomalies. Intravenous urography, performed in 11 of the 13 patients, demonstrated associated renal anomalies. Computed tomography, performed in nine of the 13 patients, demonstrated associated renal anomalies and displayed the cystic seminal vesicles. Transabdominal or endorectal ultrasonography, performed in eight patients, allowed characterization of the seminal vesicle masses as cystic. Magnetic resonance imaging, performed in three of the 13 patients, accurately demonstrated dilated ejaculatory ducts into which ectopic ureters inserted. The fluid in the seminal vesicle cysts had an increased signal intensity on T1- and T2-weighted sequences. Seminal vesiculographic study demonstrated anomalous communications with the seminal tract. Cystic disease of the seminal vesicles can be either congenital or acquired; congenital cysts are associated with anomalies of the ipsilateral mesonephric duct.

Adult↗
PubMed1991

Unilateral facet dislocations and fracture-dislocations of the cervical spine.

We treated 36 patients with unilateral facet dislocations or fracture-dislocations of the cervical spine at the Mayo Clinic between 1975 and 1986. Adequate records were available for 34: ten patients were treated by open reduction and posterior fusion, and 24 by nonoperative management. Of these, 19 had halo traction followed by halo-thoracic immobilisation, four had a simple cervicothoracic orthosis, and one received no active treatment. Anatomical reduction was achieved more frequently in the operative group (60% compared with 25%). Nonoperative treatment was more likely to result in cervical translation on flexion/extension lateral radiographs, and in significant symptoms. Only 36% of the patients treated by halo traction achieved anatomical alignment; in 25% halo traction failed to achieve or maintain any degree of reduction. During halo-thoracic immobilisation, half of the patients lost some degree of reduction and patient satisfaction with the appliance was low. Open reduction and internal fixation of unilateral facet injuries gave better results. 6

Adolescent↗
PubMed1991

MR imaging of synovial sarcoma.

The MR imaging findings in 12 cases of synovial sarcoma are illustrated. The MR appearance most indicative of the tumor is an inhomogeneous septated mass with infiltrative margins located close to a joint, a tendon, or bursae, especially if soft-tissue calcification can be seen on CT scans or plain radiographs.

Adolescent↗
PubMed1991

Premature partial physeal arrest. Diagnosis by magnetic resonance imaging in two cases.

The management of premature physeal arrest requires accurate assessment of not only the location but also the extent of the bar. Numerous imaging techniques are available to evaluate the physis. Multiplanar tomography has proven to be the most precise method. The utility of magnetic resonance imaging (MRI) of physeal bars has not been demonstrated. This article presents MRI results in two cases of physeal bars. MRI provides a means of assessing physeal bar formation with an accuracy approaching that of multiplanar tomography. In certain instances, its efficacy may exceed that of tomography, specifically when the physis cannot be properly oriented for tomographic evaluation, when more planes are desired, and when radiation exposure is thought to be excessive. With improvement of its capabilities and availability (which may also reduce cost), it may become the diagnostic imaging technique of choice.

Ankle Joint↗
PubMed1991

Magnetic resonance techniques in musculoskeletal diseases.

Magnetic resonance imaging provides a sensitive technique for detection of musculoskeletal pathology. In order to optimize this information and properly characterize lesions, it is important to select carefully image parameters. Patient selection criteria are also important due to the strength of magnetic fields used for magnetic resonance imaging. These factors must be clearly understood when determining if magnetic resonance imaging is the most appropriate examination for a given musculoskeletal problem.

Humans↗
PubMed1991

Radiologic evaluation of hand and wrist motion.

Abnormal motion due to instability at the carpus and distal radioulnar joint can be difficult to diagnose clinically, and radiologic evaluation can be very helpful. The anatomy and kinematics are complex, and a directed approach is necessary to detect the findings that may be subtle and transient. Plain radiographic evaluation of the distal radioulnar joint is very sensitive to slight variations in patient position, and CT is more accurate when pain or cast immobilization make positioning difficult or when there is associated distal radial deformity. Static carpal instability patterns are present on routine radiographs where examination of the lateral view provides the key to diagnosis. The relations between the longitudinal axes of the radius, lunate, capitate, and scaphoid form the basis for classification of these instabilities. In dynamic carpal instability, routine radiographs are normal. The instability is demonstrated only with positional change or manipulation. Motion views can be very helpful, although direct observation of wrist motion on videotape fluoroscopy is the key to the diagnosis of dynamic instability. MR imaging motion studies provide better soft tissue definition and may show subtle changes in the triangular-fibrocartilage-associated distal radioulnar instability, as well as periarticular tendon subluxation about the wrist. The clinical role of MR imaging in the evaluation of wrist motion has yet to be clearly defined.

Carpal Bones↗
PubMed1990

Anatomy of anal sphincters and related structures in continent women studied with magnetic resonance imaging.

Five anally continent nulliparas of reproductive age were studied with magnetic resonance imaging. The internal and external anal sphincters could be easily delineated, as could the intervening longitudinal musculature, puborectalis muscle, anococcygeal raphe, anorectal lumen, vagina, uterus, bladder, urethra, coccyx, and pubis. The shape of the sphincters was nearly cylindrical, with an anterior component averaging 18.3 mm thick and 28.0 mm long. Fifty-four percent of this anterior thickness was attributable to the internal sphincter. The anorectal angle varied considerably, with a mean of 86.8 +/- 19.1 degrees (range 60-112). The angle between the portion of the rectal lumen supported by the anococcygeal raphe, or levator plate, and the plane of the puborectalis muscle was consistent at 149.0 +/- 6.3 degrees (138-154). The finding of anterior anal sphincters with substantial thickness and length contrasts markedly with a view often pictured in the literature of a female anal sphincter that narrows anteriorly to half its posterior length and forms a small bundle of muscle rather than a broad band. Knowledge of these relationships is important in primary repair of obstetric sphincter lacerations as well as in surgical correction of anal incontinence.

Adult↗
PubMed1990

Radiologic anatomy of the painful bunionette.

Radiographs were studied of 91 feet in 62 patients with the diagnosis of bunionette and no prior bunionette or hallux valgus operations. Various radiologic measurements were compared to a matched control group with no bunionette symptoms or previous forefoot operations. The bunionette group had a significantly increased metatarsophalangeal 5 angle, intermetatarsal 4-5 angle, and intermetatarsal 1-2 angle compared to the control group. Bunionettes were not commonly associated with lateral bowing of the fifth metatarsal or with an increased fifth metatarsal head width. Symmetry was noted between symptomatic and opposite asymptomatic feet, with the exception of an increased intermetatarsal 4-5 angle in the symptomatic feet.

Adolescent↗
PubMed1990

Masses of the hand and wrist: detection and characterization with MR imaging.

To assess the value of MR imaging in the detection, delineation, and characterization of mass lesions of the hand and wrist, we reviewed the MR imaging findings of 38 patients referred for evaluation of such lesions. Twenty-five patients had a palpable mass. In an additional 13 patients an occult mass lesion was suspected as the cause of distal ulnar neuropathy. Twenty-two mass lesions (16 benign and six malignant) were detected by MR. All were correctly predicted to be benign or malignant. In nine (56%) of the 16 benign mass lesions, the specific diagnosis was suggested. In the remaining seven benign mass lesions and in the six malignant tumors, the MR findings were not specific enough to permit a diagnosis. Of the 14 patients referred for evaluation of a distal ulnar neuropathy, an occult ganglionic cyst compressing the ulnar nerve was revealed with MR imaging in three. MR imaging of the hand and wrist is accurate in the detection of mass lesions and can correctly distinguish benign from malignant tumors in the majority of cases. Specific diagnoses can be made in certain benign lesions. Occult mass lesions can be confirmed or excluded as the cause of distal ulnar neuropathy with MR imaging.

Adolescent↗
PubMed1990

Value of MR imaging in differentiating benign from malignant soft-tissue masses: study of 95 lesions.

MR imaging has largely replaced CT as the technique of choice for preoperative staging of patients with soft-tissue masses. Whether MR imaging can be used to differentiate benign from malignant masses is controversial. Our experience suggests that MR imaging often can characterize soft-tissue masses accurately. To evaluate this question further, we studied 95 consecutive lesions (50 benign and 45 malignant). Consecutive cases were selected to simulate our clinical practice. Surgical proof was available for all masses except hematomas, for which clinical follow-up confirmed the diagnosis. MR images were interpreted twice by three radiologists. The first review was accomplished without any clinical history and the second review with clinical history. Reviewers were asked to classify the lesion as benign or malignant on the basis of their clinical knowledge and analysis of MR image features (size, lesion margin, signal homogeneity, and neurovascular or bone involvement). Although interpretation varied somewhat because of the experience of the reviewers, the specificity and accuracy of diagnosis averaged 90% for both benign and malignant lesions. Negative predictive value for malignancy averaged 94% among the three reviewers. MR imaging is the technique of choice for identification and characterization of soft-tissue masses. The nature of the lesion (benign vs malignant) can be determined in the majority of cases.

Diagnosis, Differential↗
PubMed1989

Scaphoid malunion.

Forty-five patients with 46 scaphoid fractures were studied more than 6 months after union by clinical examination and trispiral tomography. Twenty had normal scaphoid alignment with lateral intrascaphoid angles less than 35 degrees; the rest had varying degrees of increased flexion angulation of the scaphoid, ranging from 36 degrees to 60 degrees. Increasing lateral scaphoid angulation, eventually resulting in a "humpback" deformity, was associated with progressively poor clinical and radiographic results. There were satisfactory clinical outcomes in 83% and posttraumatic arthritis in only 22% of those with normal scaphoid anatomy. Those with greater than 45 degrees of lateral intrascaphoid angulation present at the time of union had a satisfactory clinical outcome in 27% and posttraumatic arthritis in 54%. Union alone is an insufficient criterion for success in treating scaphoid fractures.

Adolescent↗
PubMed1989

Seminal vesicle imaging.

The purpose of this paper is to enhance the understanding of CT, MRI and US images of the seminal vesicles. Accurate interpretation of images requires knowledge of normal anatomy, embryology and pathology. Anatomy and a spectrum of abnormalities are reviewed and discussed. Cases are from an analysis of clinical and surgical files to show the diagnostic features of various cystic diseases of the seminal vesicles. Tissue characteristics of the seminal vesicles on CT, MRI and US images are emphasized.

Adult↗
PubMed1989

Scaphoid anatomy: evaluation with complex motion tomography.

Complex motion tomography was used to study the normal orientation of the axes of the proximal and distal scaphoid poles as a basis for comparison with displaced or malunited scaphoid fractures. Biplanar tomograms of 10 normal wrists were evaluated by seven physicians with the use of two standardized measurement techniques. The reference planes used for the first technique were the volar cortical surface of the proximal scaphoid and the dorsal cortical surface of the distal scaphoid. The apparent angulation between the reference planes with this technique averaged 32 degrees +/- 5 degrees on the sagittal view and 40 degrees +/- 3 degrees on the coronal view. The second technique used the orientation of the proximal articular surface relative to the distal articular surface of the scaphoid. The angulation between the axes averaged 24 degrees +/- 5 degrees in the sagittal plane and 40 degrees +/- 4 degrees in the coronal plane.

Carpal Bones↗
PubMed1989

Magnetic resonance imaging of musculoskeletal neoplasms.

Magnetic resonance imaging (MRI) has become a valuable technique in the evaluation of the musculoskeletal system. Its superior soft-tissue contrast and its ability to image in multiple planes provide significant advantages over other imaging techniques, including computed tomography. MRI has been particularly useful in the detection and staging of musculoskeletal neoplasms. Currently, it is the technique of choice for the evaluation of soft-tissue masses and many skeletal neoplasms. MRI is also useful in the evaluation of metastasis. The role of MRI in differentiating recurrent neoplasms from postoperative and radiation changes continues to evolve; spectroscopy may add considerable specificity in this setting.

Bone Neoplasms↗