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At least 469 records · Page 26Linked to original sources
PubMed2006

[Value of MRI in the assessment of invasion depth by endometrial carcinoma].

OBJECTIVE: To evaluate the value of MR imaging in the assessment of invasion depth by endometrial carcinoma. METHODS: Data of 122 patients with endometrial carcinoma proved by postoperative pathology were retrospectively reviewed. Preoperatively, all patients underwent conventional and contrast-enhanced MR scan. Compared with the results of pathology, the sensitivity, specificity and accuracy of different invasion depth determined by MRI were analyzed with SPSS software based on whether the junctional zone was involved or not as the criterion of myometrial invasion. RESULTS: (1) Based on MRI image, the tumor was confined to the endometrium in 17 patients, causing superficial myometrial invasion 60, deep-myometrial invasion 40 and having penetrated the serosa 5. Compared with postoperative pathology results, the incidence of sensitivity, specficity and accuracy of MRI assessment for tumor confined to endometrium was 64.7%, 94.3%, 90.2%, respectively; to superficial myometrial invasion: 64.6%, 82.5%, 70.5%, respectively; to deep-myometrial invasion: 94.4%, 77.9%, 80.3%, respectively; to tumor having penetrated the serosa: 80.0%, 99.1%, 98.4%, respectively. (2) Based on intact junctional zone as the criterion of tumor confined to endometrium, the sensitivity, specficity, accuracy, positive and negative predictive value was 92.9%, 67.9%, 73.1%, 43.3%, 97.3%, respectively. Based on the interruption of junctional zone as the criterion of tumor having involved the myometrium, the sensitivity, specficity, accuracy, positive and negative predictive value was 67.9%, 92.9%, 73.1%, 97.3%, 43.3%, respectively. CONCLUSION: MRI is valuable in the assessment of the invasion depth by endometrial carcinoma, and the dose plays an important role for the clinician in selecting proper way of therapy.

Adult↗
PubMed1992

DNA quantitation of Wilms' tumour (nephroblastoma) using flow cytometry and image analysis.

AIMS: To compare flow cytometry (FCM) with image analysis (IA) in the DNA quantitation of Wilms' tumour (WT) and to correlate data so obtained with recognised clinical and pathological prognostic parameters. METHODS: Thirty six patients with histologically proved WT diagnosed between 1980-89 were investigated. Fifteen patients had stage I disease, 10 stage II, six stage III, two stage IV and three stage V. Suspension of nuclei obtained by pepsin digestion of paraffin wax embedded tumour tissue was analysed using a FAC-Scan flow cytometer, and a CAS-100 image analyser. RESULTS: Tumours were concordant in most instances, however, IA identified aneuploidy in two tumour samples which were diploid by FCM. Aneuploidy was detected in 5/33 tumours with favourable histology and 3/3 with unfavourable histology. Three of 28 patients with Stage I, II and V disease and 5/8 patients with stage III and IV had aneuploid tumours. All patients with unfavourable histology died of disease. In the group with favourable histology, 4/5 patients with aneuploid tumours developed recurrent disease compared with 1/27 diploid tumours (p less than 0.0001). CONCLUSIONS: Ploidy may be a useful additional prognostic indicator in Wilms' tumour with favourable histology. Larger scale studies are needed to confirm the relation of ploidy to survival in early stage WT.

Child↗
PubMed1985

[Pseudotumoral and subacute pathology of the epididymis. Contribution of ultrasonics].

Three patients presented with atypical subacute epididymal disorders diagnosed clinically as a scrotal tumor. Ultrasound imaging provided satisfactory morphologic data on lesions. Cold surgery was performed, either because of major functional disturbance (multiple epididymal abscesses) or because of doubt with respect to diagnosis (spermatic granuloma and epididymal hematoma). Castration was the final procedure in each case. Even though this surgical attitude appears logical because of the serious nature of the lesions, the revised clinical diagnosis provided by ultrasonography and the very good correlation between pathologic and ultrasonic findings should lead to a more eclectic therapeutic attitude in other cases.

Acute Disease↗
PubMedDate not supplied

Accuracy of computed tomography and magnetic resonance imaging in staging bronchogenic carcinoma.

Sixty-three patients with non-small cell bronchogenic carcinoma were prospectively and independently assessed by computed tomography (CT) and magnetic resonance imaging (MRI) before surgery. Images were interpreted by four radiologists who had no knowledge of other imaging studies, except chest x-ray, and were blinded to surgical findings. The data were compared with pathologic and histologic findings. The accuracies of CT and MRI in determining tumor classification and assessing mediastinal and hilar lymph node metastases were compared. Sensitivity of CT in determining T factor was 78%, and specificity was 96%. The values for MRI were 84% and 96%, respectively. There was no significant difference between CT and MRI in staging tumors. MRI is more accurate than CT in diagnosing mediastinal invasion in staging superior sulcus tumors and complex tumors. There was no significant difference between the accuracies of CT and MRI in detecting mediastinal node metastases; the sensitivities were 82% and 90%, respectively, and specificities were 88% and 93%, respectively.

Carcinoma, Bronchogenic↗
PubMed2006

Technology Insight: imaging of low back pain.

Chronic low back pain is a common condition that has significant economic consequences for affected patients and their communities. Despite the prevailing view that an anatomic diagnosis is often impossible, an origin for the pain can frequently be found if current diagnostic techniques are fully used. Such techniques include a mixture of noninvasive and invasive imaging. Prevalence data suggest that the intervertebral disc is one of the most common sources of back pain, accounting for around 40% of cases. The pathologic basis for discogenic low back pain might be full-thickness radial tears of the annulus fibrosus. Unfortunately, only MRI can image the internal morphology of the disc, and both CT and MRI lack the necessary specificity to validate this hypothesis. Many so-called radiographic abnormalities seen on CT and MRI are commonly encountered in asymptomatic individuals. Invasive techniques such as joint injections, nerve blocks and provocative discography can show the connection between an abnormal image and the source of low back pain, but do have notable related risks. The development of a noninvasive, low-risk technique that can show this connection is desirable.

Humans↗
PubMed2000

[The diagnostic problems in magnetic resonance tomography of the bone marrow in patients with malignomas under G-CSF therapy].

AIM: To study the effect of G-CSF therapy directly by MRI and 1H MRS in the lumbar and femoral bone marrow and differentiate between malignant bone marrow infiltration (MBMI) and reconversion of red marrow. METHODS: Thirteen patients could be examined twice, before and during G-CSF medication and another six only during treatment. T1 weighted spin-echo and opposed-phase gradient-echo images as well as the spectroscopic data (T2 values, water content) were analysed. RESULTS: After G-CSF a pathologic bone marrow signal intensity was seen in 8/13 (lumbar) and 11/13 (femoral) patients respectively. The majority of the signal alterations were diffuse (6 and 8), the minority focal (2 and 3). If a patient was successfully stimulated, a significant increase in water content occurred (21% lumbar, 34% femoral). T2 values did not change significantly, nor did they correlate with the stimulation success. CONCLUSIONS: MR tomography and -spectroscopy are suitable to detect lumbar and femoral bone marrow stimulation by G-CSF quantitatively and qualitatively. The changes may simulate MBMI. The adequate judgement of G-CSF treated bone marrow without pretherapeutic images is not possible.

Adult↗
PubMed1990

Ocular drug-safety study with the HMG-CoA reductase inhibitor pravastatin.

35 pravastatin-treated patients with familial hypercholesterolemia were included in an ocular drug-safety study. Besides general examinations performed by the department of internal medicine a complete ophthalmological examination with special respect to lens opacities was carried out at the beginning, followed by control visits every six months. Scheimpflug photography of the eyes and densitometric image analysis provided objective data on lens transparency. After 18 months of treatment there is no evidence for any pathological lens changes induced by the drug applied. A decrease in visual acuity of 0.2 or more as seen in two eyes was not accompagnied by a corresponding increase in lens opacities. These observations correspond with the results of other HMG-CoA reductase inhibitors tested so far.

Anterior Eye Segment↗
PubMedDate not supplied

Application of telethermography in the evaluation of preterm premature rupture of the fetal membranes.

The development of chorioamnionitis is a serious complication associated with preterm premature rupture of the fetal membranes (PPROM). There is no reliable early indicator of this infection. The objective of this study was to determine the sensitivity of telethermography (TTG) in the detection of subclinical chorioamnionitis in women with PPROM. Fourteen pregnant women with PPROM between 23 and 34 weeks' gestation were the subjects of the study. Serial frontal-abdominal TTG scans were obtained up to the time of delivery using the MARK-1026 telethermography imager. Following delivery, placental cultures and pathology results were obtained and infant sepsis evaluation was performed. Images were analyzed for temperature differences between umbilical, inguinal, four-quadrant average, and abdominal-wall hot spots. Data were compared with norms obtained from 12 pregnant women with intact membranes who served as gestational age-matched controls. Of five patients with pathology-proven chorioamnionitis and TTG scans within three days of delivery, four demonstrated significant increases in temperature differences between umbilical and abdominal-wall hot spots versus inguinal and four-quadrant averages (z-scores > or = 2.0). All three patients with negative pathology and cultures as well as scans within three days of delivery showed no increase in temperature differences of the above variables. No patient had any overt clinical sign of chorioamnionitis. This limited but consistent evidence demonstrates that telethermography is a sensitive, noninvasive diagnostic method for detecting subclinical chorioamnionitis in pregnant women with preterm rupture of the fetal membranes.

Chorioamnionitis↗
PubMed1982

A clinicopathologic correlation of mammographic parenchymal patterns and associated risk factors for human mammary carcinoma.

The five-year screening experience for 10,131 asymptomatic women evaluated at the Louisville Breast Cancer Detection Demonstration Project (LBCDDP) disclosed 144 breast carcinomas in 1,209 patients (12%) aged 35 to 74 years in whom 904 biopsies and 305 aspirations were performed. This study included 44,711 high-quality xeromammograms (XM) prospectively classified by the modified Wolfe mammographic parenchymal patterns into low-risk (N(1), P(1)) versus high-risk (P(2), DY) groups, with expansion of the P(2) cohort into three additional categories. Using BMDP computer-program analysis, each XM pattern was collated with 21 nonneoplastic and 18 malignant pathologic variables and commonly associated risk factors. A separate analysis of epithelial proliferative and nonproliferative fibrocystic disease of the breast (FCDB) was performed. The histopathology for each biopsy, with distinction of FCDB and neoplasms, was analyzed with regard to the statistical probability of influencing the XM pattern. An average of 1.05 biopsies per patient were performed in women with findings suggestive of carcinoma at clinical and/or XM examinations. An equal distribution of the N(1), P(1), and P(2) DYXM patterns was observed in the 10,131 screenees. Of 8.5% of the screened population having biopsies, 623 were observed to have nonproliferative FCDB and 137, proliferative FCDB. For women 50 years of age or younger, these pathologic variables were seen more frequently in the P(2) DY patterns (p < 0.001), whereas no difference in XM pattern distribution was observed for the screenee 50 years of age or older for proliferative FCDB (p = 0.65). Sixteen percent of the biopsied/aspirated lesions were carcinomas, yielding a biopsy/cancer ratio of 6.25:1. These in situ and invasive neoplasms were more commonly (p < 0.04) observed in 55% of the P(2) (P(2f), P(2n), P(2c)) categories, while 64% of all cancers appeared more frequently in the P(2) DY subgroup (p <0.001), compared with this pattern in the screened population. An equal distribution frequency of the XM classification existed for screenees 50 years of age or older with cancer (p = 0.50), while screenees 35-49 years of age were more often observed to have the high-risk P(2), DY patterns (p <0.001). Analysis of 1,759 histologic characteristics in biopsies of 863 patients with FCDB revealed ductal and lobular hyperplastic lesions, sclerosing adenosis, or epithelial cyst(s) to be the major constituents of 64-69% of the high-risk P(2) (P(2f), P(2n), P(2c)) image (p < 0.001). These data suggest that XM parenchymal patterns observed in asymptomatic screenees incompletely correlate with known pathologic variables and risk factors. Additionally, benefit for recognition of these preinvasive proliferative pathologic factors and carcinomas appears restricted to the younger screenee. The clinical integration of these risk factors with XM patterns may allow preselection of patients deserving of frequent follow-up for breast cancer; however, these data do not support the contention that Wolfe XM patterns are predictors for screening strategies or that they decisively enhance patient management.

Adult↗
PubMed1996

Routine use of a higher order interpolator and bone algorithm in thoracic CT.

OBJECTIVE: This study was designed to evaluate the utility of the routine use of high spatial frequency algorithms and higher order helical interpolators for imaging lung parenchyma during routine thoracic CT. SUBJECTS AND METHODS: We evaluated 50 consecutive patients undergoing clinically indicated thoracic CT using the same imaging parameters and scanner. The helical volume was reconstructed three separate times using standard and higher order (180 degrees linear with double-sided lobes) interpolators and standard and high spatial frequency (bone) algorithms. The images were photographed and given to five separate readers who were kept unaware of the interpolator and algorithm and who were asked to evaluate simultaneously each patient's three sets of images for best, in-between, and worst images of the lung interstitium, pathology, and normal anatomy. RESULTS: All five readers rated the standard interpolator and algorithm images as the worst (p < .01). All five readers consistently rated the double-sided lobe interpolator and bone algorithm images as the best (p < .01). CONCLUSION: A second reconstruction of routine thoracic helical CT data using higher order helical interpolators and a bone algorithm significantly improves interstitial detail of lung parenchyma and overall visualization of normal anatomy and pathologic processes.

Aged↗
PubMed1993

Clinical relevance of magnetic resonance imaging and computed tomography in Cogan's syndrome.

The Pathologic changes in the inner ears of 5 patients with Cogan's syndrome were studied by a combined application of MR imaging and CT scanning. We used T1- and T2-weighted MR imaging sequences and a special three-dimensional MR imaging technique which allows a very detailed imaging of the inner ear structures. By the use of a CT scan simultaneously, calcified and noncalcified obliterations could be differentiated. The aim of the study was to visualize membranous labyrinth pathology in Cogan's syndrome and correlate them with the clinical findings. In one patient who recovered completely without hearing loss, the MR and CT investigations revealed no pathology. In the remaining 4 cases, narrowing or obliteration of parts of the vestibular labyrinth was seen. In 3 patients, we found aberrations in the cochlea consistent with the audiological data. The gadolinium-enhanced T1-images showed enhancement of the cochlea and vestibular labyrinth in one case, probably indicating an active process with interruption of the "blood-labyrinth barrier". The results are consistent with the hypothesis that the inner ear pathology in Cogan's syndrome is probably caused by obstructive vasculitis.

Adult↗
PubMed2001

Malignant melanoma: patterns of metastasis to the small bowel, reliability of imaging studies, and clinical relevance.

OBJECTIVES: The aims of this study were to determine the frequency of different patterns of melanoma metastases to small bowel on radiological examination, and to assess the reliability of the most commonly used radiological methods for detecting these lesions. METHODS: The records of cases archived as melanoma metastatic to the small bowel of the Armed Forces Institute of Pathology were reviewed. The clinical information, type of imaging procedure performed, and radiological features were analyzed and compared to the findings at surgery and at autopsy. RESULTS: A total of 32 patients had clinical and surgical data with pathological confirmation. Seven patients had metastasis involving the duodenum, 22 had jejunal involvement, and 11 had ileal involvement. Metastases were categorized as polypoid, cavitary, infiltrating, or exoenteric. The polypoid pattern was seen in 20 patients (63%), six of whom showed multiple polypoid lesions (>10), referred to as polyposis. The "target lesion," a discrete polypoid mass with a central ulceration, was observed in only three (9%) of the 32 patients. Eight patients (25%) demonstrated a cavitary pattern, a circumferential mass with inner marginal necrosis, and five (16%) showed an infiltrating pattern. One patient (3%) had an exoenteric lesion with a fistulous tract. The small bowel follow-through demonstrated 32 of 55 metastases (sensitivity 58%). Contrast-enhanced CT demonstrated 32 of 48 masses (sensitivity 66%). Of the six cases of malignant polyposis, none were identified using CT, and only two were diagnosed by small bowel follow-through. CONCLUSIONS: The polypoid pattern, equally distributed between the jejunum and ileum, is the most common manifestation of metastatic melanoma to the small bowel. The target lesion was infrequently seen in this series. Small bowel follow-through and conventional CT seem to be unreliable in demonstrating melanoma metastases to the small bowel.

Adult↗
PubMed1986

Nuclear magnetic resonance imaging characterization of a rat mammary tumor.

Intradermal injection (1 X 10(6) cells) of rat mammary adenocarcinoma (13762A) was made in the back skin in 12 rats. Tumor growth and characterization was followed with nuclear magnetic resonance imaging (NMRI) in 9 rats (3 rats died before completion of the study) at 3, 4, and 5 weeks after injection, using spin echo, inversion-recovery, and calculated T1 techniques. Three rats were sacrificed after each of the three imaging periods for histological studies designed to distinguish solid tumor mass from necrosis. Qualitative NMR imaging T1 values increased as the tumors increased in size as evidenced by a progressive decrease in image intensity compared to the surrounding tissues on the T1 weighted images. Calculated T1 values also increased as the tumors aged (Week 3 = 0.3 +/- 0.11; Week 4 = 0.45 +/- 0.07; Week 5 = 0.42 +/- 0.03). Planimetry of tumor areas on histological sections showed that as tumors increased in size, the ratio of necrotic area to solid tumor area increased (Week 3 = 0.3 +/- 0.11; Week 4 = 0.45 +/- 0.07; Week 5 = 0.51 +/- 0.05). These findings indicate that the progressive increase in T1 observed on NMR images may be secondary to the increasing degree of necrosis, with a resultant change in water content and state. Thus, the range of T1 values observed in tumors of similar type may be due to change in tumor physiology and anatomy as tumor growth progresses. In conclusion, careful correlation of histological data with NMR image data is necessary before NMR imaging can be used to provide reliable noninvasive histological information concerning tumor pathology.

Adenocarcinoma↗
PubMed1995

Myxoma in childhood: an analysis of 10 cases.

PURPOSE: The object of this study was to present a series of myxoma in children and to evaluate possible differences between young and adults patients. MATERIALS AND METHODS: All tumors of patients under 16 years of age (10 cases), were separated from the 80 myxomas found in the Oral Pathology Laboratory, Faculty of Odontology, Buenos Aires University, and were analyzed in terms of clinical data, radiographic image, histopathology, treatment, and evolution. RESULTS: Myxoma in childhood represented 12.5% of the 80 cases in our series. The mean age was 11.6 years. Six patients were boys and four were girls. Both jaws were affected equally, predominantly in the premolar-molar region. Eighty percent of the tumors were larger than 2 cm. Only one case was clinically diagnosed as myxoma. Radiologically the most frequent image was unilocular with cortical expansion and tooth displacement. Histologically seven cases were diagnosed as myxoma and three as fibromyxoma. Treatment involved surgical resection in most cases. Two patients showed recurrence within the first year after surgery. CONCLUSIONS: The frequency of myxoma in childhood may be higher than that of other aggressive odontogenic tumors, although some literature refers to this tumor as very uncommon in children. Clinically this tumor may not always be taken into account in the differential diagnosis of intraosseous radiolucencies in young patients. The histologic appearance is similar in young and adult patients, but myxoma in children may be larger. It was not possible to correlate the histologic type of myxoma and the age of the patients.

Adolescent↗
PubMed2005

MRI as a marker for disease heterogeneity in multiple sclerosis.

BACKGROUND: Whereas recent data from imaging studies challenge the prevailing notion that multiple sclerosis (MS) is purely an inflammatory disease, pathologic studies suggest differences in the disease processes between individual patients with MS. The ability to dissect the pathophysiologic disease heterogeneity, if it indeed exists, by methodologies that can be applied in vivo is important both for the development of new therapeutics and for the ability to identify the optimal therapy for an individual patient. OBJECTIVE: To design a stratification algorithm for patients with MS based on accepted MRI measurements reflective of inflammation and axonal damage/tissue loss and to assess if such MS subgroups retain their intergroup differences long term. METHODS: Mathematical modeling was used to select three discriminatory MRI measures for clinical outcome based on the cross-sectional analysis of 71 patients with untreated MS and tested general applicability of the stratification scheme on the independent longitudinal cohort of 71 MS patients. RESULTS: By consecutive employment of MRI measures reflective of inflammation and tissue loss, the authors were able to separate MS patients into four clinically meaningful subgroups. The analysis of the longitudinal confirmatory cohort demonstrated persistence of the intergroup differences in selected MRI measures for 8 years. CONCLUSIONS: The inflammatory activity and destructiveness of the multiple sclerosis process are to some degree independent of each other, and the successive evaluation of both of these variables can strengthen prediction of clinical outcome in individual patients.

Adult↗
PubMed1994

Clinical diagnosis from digital displays: results and conclusions from the St Mary's evaluation project.

Preliminary results with the first commercially available digital display system to be installed in a British radiology department were published in 1989: these consisted of data from observer performance studies of digitized images displayed using a 1024-line monitor, showing a single pathological feature--subperiosteal resorption in renal osteodystrophy. Further experiments have now been conducted with the successor to this equipment, a 1280-line digital display system. Formal observer performance studies were undertaken for four pathological conditions, and the results show statistically significant differences in performance between the digitized displayed images and those on film. The display system was not considered to be good enough for the task of primary radiological diagnosis of subtle lesions; findings support the conclusion that careful, objective clinical evaluation of digital display systems is important before they are introduced into clinical use.

Bone Resorption↗
PubMed2004

Uncertainties in depth determination and comparison of multivariate with univariate analysis in confocal Raman studies of a laminated polymer and skin.

Confocal Raman microscopy data are reported for a laminated polymer (Paramount) and for pigskin. The nature of the laminated structure of the polymer provides a useful test for evaluation of thickness distortions in confocal measurements in soft samples, which are found to be quite significant. The spatial variation in line profiles generated from univariate analyses with scores derived from factor loadings are consistent for both samples and provide distinct diagnostic markers for stratum corneum and epidermis regions of skin. Univariate analysis of the C-C stretching region of skin reveals a spatial dependence of chain conformational order. In addition, variations in keratin-containing areas of the stratum corneum are readily identified from area maps of the S-S stretching vibrations. These data indicate that confocal Raman imaging studies of molecular structure changes in particular regions of skin during pathological processes will prove quite valuable in dermatology.

Animals↗