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Results for “pathological imaging data”

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PubMed2006

Transcutaneous contrast enhanced sonography of the chest for evaluation of pleural based pulmonary lesions: experience in 137 patients.

PURPOSE: Transcutaneous ultrasound enables visualization of pleural based lesions but with a poor correlation to specific pathology. Ultrasound contrast agents in conjunction with contrast specific imaging techniques are increasingly accepted in clinical use. Up to date there are no data about the use of contrast enhanced sonography (CES) in a large series of pleural based pulmonary lesions. MATERIALS AND METHODS: From August 2004 to August 2005, 137 consecutive patients with pleural based pulmonary lesions on B-mode sonography were studied by CES using a transcapillary second-generation contrast agent (SonoVue(R)). The following CES parameters were retrospectively evaluated. Time to enhancement (TE) of contrast agent after i. v. application was determined and classified as short TE (< = 6 sec) vs. delayed TE (> 6 sec). Extent of enhancement (EE) was evaluated during the arterial phase (2 - 30 sec) and the parenchymal phase (1 - 5 minutes) by using the normal splenic tissue as an in vivo reference, and classified in reduced EE (anechoic/hypoechoic) vs. marked EE (isoechoic/hyperechoic) during both phases. Homogeneity of enhancement (HE) was classified as homogeneous vs. inhomogeneous. 60 patients had histologically confirmed malignant lesions due to central lung cancer (n = 31), and peripheral malignant lesions (n = 29). 77 patients had benign pleural based lesions including pneumonia (n = 32), pulmonary embolism (n = 20), compression atelectasis (17), and other benign pleural based lesions (n = 8). RESULTS: Malignant and benign lesions did not vary significantly regarding TE, EE, and HE. However, there were highly significant differences in the ratio of short vs. delayed TE and reduced vs. marked EE between the six disease groups. Characteristic patterns were short TE with marked EE in all compression atelectasis cases and in 62 % of patients with pneumonia. Delayed TE and reduced EE was seen in all patients with pulmonary embolism and in 62 % of patients with peripheral malignant lesions. Central lung cancer and benign nodules did not present with such specific patterns. No significant differences in HE were seen between subgroups. CONCLUSION: Pulmonary lesions are characterized by different CES-patterns of arterial supply as evidenced by TE and EE which depends on underlying causes, but CES does not allow to distinguish benign from malignant pleural based lesions in general.

Adult↗

PubMed1986

[Comparison of clinical findings and nuclear magnetic resonance tomography in syringohydromyelia and intramedullary tumors].

Magnetic resonance imaging allowed a distinct differentiation between syringohydromyelia (9 patients) and intramedullary tumour (2 patients). In syringohydromyelia the morphological evaluation showed a greater extension of the cavitation, especially in the caudal direction, than the estimation according to clinical findings. Tumours were visualised indirectly by changing the physiological shape of the spinal cord; therefore, small parts were not recognisable on magnetic resonance images but detected by the corresponding clinical symptoms. Clinical and morphological data were complementary and both necessary for a comprehensive appreciation of the pathological process.

Adolescent↗

PubMed2005

The accuracy of Bardscan: a new tool for the measurement of the bladder volume.

The Bardscan has been recently introduced into clinical practice with the potential advantage of providing real time ultrasound imaging and hence the ability for an accurate estimation of bladder volume, and concurrently the detection of any incidental bladder pathology. Independent clinical data regarding this machine is limited, and therefore this study was carried out to ascertain whether the Bardscan machine is accurate in the estimation of bladder volume for women in the urodynamic clinic and in the postoperative period. Fifty four women had a Bardscan estimation of their bladder volume which was compared with an immediately obtained catheter volume. The results show that the Bardscan volumes correlate closely with the bladder volumes detected on catheterization (r =0.982, p=0.16). This study has shown that the Bardscan is an accurate tool in the measurement of bladder volume in women with the advantages of being safe, non-invasive and well tolerated by patients. The aim of this study was to evaluate the accuracy of the Bardscan machine in the measurement of urinary bladder volume.

Adult↗

PubMed1997

The influence of chemical shift artifact on magnetic resonance imaging of the ligamentum flavum at 0.5 tesla.

STUDY DESIGN: Retrospective clinical magnetic resonance imaging study and prospective magnetic resonance imaging volunteer study of the appearance of the ligamentum flavum. OBJECTIVE: To demonstrate the effect of chemical shift artifact on the apparent thickness of the ligamentum flavum on axial magnetic resonance images. SUMMARY OF BACKGROUND DATA: The ligamentum flavum is a symmetric structure clearly seen on magnetic resonance images. Apparent unilateral thickening may be interpreted as indicating a pathologic process, and the influence of chemical shift artifact on the apparent thickness of the ligamentum flavum has not been emphasized. METHODS: Ligamenta flava thicknesses were measured from axial T1-weighted gradient echo magnetic resonance scans of 12 consecutive patients and various axial sequences in seven volunteers. RESULTS: The ligamentum flavum appeared consistently thicker on the lower side of the readout gradient field. This chemical shift effect could be manipulated by swapping phase and frequency or patient orientation in the magnet. CONCLUSIONS: Caution should be applied in attributing apparent asymmetry of the ligamenta flava to disease; the influence of chemical shift artifact should be considered.

Adolescent↗

PubMed1997

Paraplegia due to ossification of ligamenta flava in X-linked hypophosphatemia. A case report.

STUDY DESIGN: Spinal canal decompression at the most prominent of multiple posterior calcified thoracic lesions in a case of X-linked hypophosphatemia was undertaken for treatment and diagnosis purposes, as well as to assess possible nature of the pathophysiology underlying the presenting deficits. OBJECTIVES: To discuss the clinical assessment diagnostic and treatment aspects of this rare coincidence of ossification of ligamenta flava in the patient with the skeletal deformities of X-linked hypophosphatemia. SUMMARY OF BACKGROUND DATA: The patient with the stigmata and chemical findings of an X-linked hypophosphatemia presented with paraplegia and multiple calcified posterior spinal thoracic lesions. This was studied with magnetic resonance imaging and electrophysiologic studies of the spinal sensory pathways of the legs. These data constituted the preoperative information required to assess later results of surgical intervention. METHODS: Presurgical clinical, imaging and electrophysiologic studies and laboratory and pathologic investigations of the surgical specimens. RESULTS: Resolution of the paraplegia with walking and return to work in a physically demanding job for the last 4 or 5 years of postoperative follow-up after surgical decompression of the spinal cord only at the worst and highest of the effected spinal levels. CONCLUSION: The coincidence of X-linked hypophosphatemia and ossification of ligamenta flava has been reported only in two or three cases in the literature. Removal of the offending ossifying lesion is known to result in resolution of the clinical deficits but similar lesions at other spinal levels are suspected of producing recurrences. The return of function and of the corresponding electrophysiologic correlates indicate a neurono-apractic nature of the neurologic symptoms.

Bone and Bones↗

PubMed1978

Screening for breast cancer. Report from Edinburgh Breast Screening Clinic.

As part of a trial to determine the feasibility of screening for breast cancer, 3952 women aged 40--59 years were screened once or more over two years. They represented 82% of those invited by a personal letter from their GPs. Each woman underwent mammography, two clinical examinations, and, usually, thermography. Further investigations included needle aspiration of cysts, xeromammography, and biopsy. Of the 125 women who underwent biopsy, 18 proved to have cancer. Because of the high response rate and consequent large sample of normal women the biopsy and cancer detection rates were low. Clinical examination and mammography together were more effective in detecting significant lesions than either procedure alone, and knowledge of the mammographic findings enabled the examiner to detect more abnormalities. Screening was expensive: each cancer detected cost about 6000 pounds, excluding data processing, surgical, and pathological costs. The clinic has now adopted a more simplified screening regimen, which should reduce costs, but more accurate imaging techniques and ways of identifying high-risk cases are needed.

Adult↗

PubMed2003

Amygdala volumetry in "imaging-negative" temporal lobe epilepsy.

OBJECTIVE: Although amygdala abnormalities are sometimes suspected in "imaging-negative" patients with video EEG confirmed unilateral focal epilepsy suggestive of temporal lobe epilepsy (TLE), amygdala asymmetry is difficult to assess visually. This study examined a group of "imaging-negative" TLE patients, estimating amygdala volumes, to determine whether cryptic amygdala lesions might be detected. METHODS: Review of video EEG monitoring data yielded 11 patients with EEG lateralised TLE and normal structural imaging. Amygdala volumes were estimated in this group, in 77 patients with pathologically verified hippocampal sclerosis (HS), and in 77 controls. RESULTS: Seven of 11 "imaging-negative" cases had both significant amygdala asymmetry and amygdala enlargement, concordant with seizure lateralisation. Although significant amygdala asymmetry occurred in 35 of 77 HS patients, it was never attributable to an abnormally large ipsilateral amygdala. Compared with patients with HS, patients with amygdala enlargement were less likely to have suffered secondarily generalised seizures (p<0.05), and had an older age of seizure onset (p<0.01). CONCLUSION: Abnormal amygdala enlargement is reported in seven cases of "imaging-negative" TLE. Such abnormalities are not observed in patients with HS. It is postulated that amygdala enlargement may be attributable to a developmental abnormality or low grade tumour. It is suggested that amygdala volumetry is indicated in the investigation and diagnosis of "imaging-negative" TLE.

Adult↗

PubMed1997

Acute colonic diverticulitis: prospective comparative evaluation with US and CT.

PURPOSE: To compare the accuracy of ultrasonographic (US) and computed tomographic (CT) findings for diagnosis of acute colonic diverticulitis. MATERIALS AND METHODS: US and CT were prospectively performed in 64 consecutive patients suspected of having acute colonic diverticulitis. Images were interpreted independently in a blinded fashion. Imaging data were compared with the final diagnosis, which was based on initial clinical and follow-up examination results (n = 64) and pathologic (n = 22), endoscopic (n = 21), and contrast enema (n = 15) examination findings. RESULTS: Final diagnosis was acute colonic diverticulitis (n = 33), other acute abdominal condition (n = 24), or unknown (n = 7). Both CT and US findings yielded 84% accuracy. US and CT findings were not statistically significant different in terms of sensitivity (85% and 91%, respectively) and specificity (84% and 77%, respectively). Positive predictive value was 85% for US and 81% for CT; negative predictive value was 84% for US and 88% for CT. When determining alternative diagnoses, US and CT findings yielded sensitivity of 33% and 50%, respectively (difference not statistically significant). CT scans depicted a small pneumoperitoneum overlooked on plain radiographs and US scans. Six pericolic abscesses were depicted with both techniques; three were depicted with CT only. CONCLUSION: US and CT findings result in similar accuracy for the evaluation of patients suspected of having diverticulitis.

Acute Disease↗

PubMed2003

Neurofibromatosis 2 in the pediatric population.

Neurofibromatosis 2 is a severe autosomal dominant disorder characterized by the occurrence of bilateral vestibular schwannomas and other benign tumors of the nervous system. Excellent natural history studies exist for adults with neurofibromatosis 2, but limited outcome data are available for children with neurofibromatosis 2. In this study, we present clinical data on 12 patients with neurofibromatosis 2 and age at diagnosis before 18 years. Full record review included surgical reports, pathology reports, and imaging studies; all patients were personally examined by a single author. One third of the patients presented with hearing impairment and another third presented with other cranial nerve dysfunction. Tumor load was extensive, including cranial meningiomas in 75%, cranial schwannomas other than vestibular schwannomas in 83%, and spinal cord tumors in 75%. Family history was present in two thirds of the patients. Surgical removal of vestibular schwannomas was performed in 58%; none had full preservation of hearing postsurgery. Functionally, 75% of children had hearing loss, 83% had visual impairment, 25% had abnormal ambulation, and 25% were performing below grade level. In conclusion, increased clinical awareness, better imaging techniques, and molecular diagnostics have made pediatric diagnosis of neurofibromatosis 2 feasible, but outcomes appear to be worse than in adult patients. Further work is needed to determine optimal management of pediatric neurofibromatosis 2.

Adolescent↗

PubMed1987

Quantitative tissue characterisation in pancreatic disease using magnetic resonance imaging.

Twenty-nine patients, 27 of whom had either inflammatory disease of the pancreas or pancreatic tumour, were studied by magnetic resonance imaging (MRI) and computed tomography (CT). Six healthy volunteers were studied by MRI alone. The pancreatic T1 and T2 relaxation times were calculated using a multipoint iterative method with data from seven total saturation recovery and six spin echo sequences. Magnetic resonance imaging can demonstrate the normal pancreas and a variety of pathological processes greater than 1-2 cm in size, but with less spatial resolution than CT. The relaxation-time results indicated no significant discrimination between chronic pancreatitis and pancreatic tumour. A significant elevation in the relaxation times was observed, however, in those patients with calcific chronic pancreatitis compared with the non-calcific chronic pancreatitic group and normal controls, suggesting a different pathophysiology for the two subgroups of chronic pancreatitis. The active phase of acute pancreatitis was associated with significantly elevated relaxation times, which returned to normal levels during the resolved phase of the disease. Associated extrapancreatic fluid collections were characterised by their very long relaxation times. The problems associated with spatial resolution, respiratory motion and lack of quantitative tissue characterisation suggest that MRI of the pancreas, using present methods, is unlikely to contribute to the overall management of patients with exocrine pancreatic disease.

Acute Disease↗

PubMed2001

Trauma-related xanthogranulomatous interstitial nephritis: a clinicopathological analysis.

OBJECTIVE: To investigate the pathogenesis, exact nature, histologic feature of xanthogranulomatous interstitial nephritis (XGIN) as well as its significance in clinical medicine. METHODS: The medical histories concerned were collected with diagnostic images including CT scanning, ultrasonography, intravenous urography (IVU) and laboratory data being synthesized by comparison with what was discover ed during operations and pathologic examinations. RESULTS: All patients were ever struck on their loins or backs by blunt violence over 4-12 years. The diseases were clinically diagnosed as "renal cancer" before, during and after operations, and treated with ra dic al nephrectomy. Located at cortical parts, the tumor focus had penetrated the renal capsules and invaded other organs. However, immunohistochemistry demonstrated that the lesions were xanthogranulomas, not tumors, in which there were stacks of foam cells and lymphocytes with vast extends of fibrotic tissues obliterating the cortical interstitial structures. Urinary tracts yielded no bacterium, obstruction or calculus. CONCLUSIONS: XGIN is likely to be one kind of immunologic mediated granuloma following blunt renal trauma. It is imperative to clarify pathogenesis and character of this lesion so as to find out any approach to diagnosis and cure of such an unusual nephropathy.

Adult↗

PubMed2004

[Visual system involvement in selected zoonotic diseases. II. Trichinellosis].

Trichinellosis is the medical problem that is still actual in our country. The paper presents recent taxonomic data regarding Trichinella spp. as well as selected epidemiologic aspects. Pathomechanism of trichinellosis and the outline of clinical pathology are also discussed. The image of lesions involving organ of sight, diagnostic methods and treatment are described with details as well. The paper is highlighting the role of ophthalmologist in early diagnosis of trichinellosis.

Eye Infections, Parasitic↗

PubMed2004

Congenital bronchopulmonary sequestration presenting as a thoracic tumor: a case report.

The accurate diagnosis of fetal thoracic tumors still remains unclear despite the progress in imaging technology. The differential diagnosis between tumors and congenital anomalies of the fetus respiratory system, largely depends on the diagnostic approaches involved. We report a case of a 25-year-old woman, gravida 3 para 0, who was seen at the 23rd gestational week for routine obstetric examination. The ultrasound scan detected a lung mass, occupying the whole left hemithorax with a significant shifting of the mediastinum exhibiting features compatible with cystic adenomatoid malformation (CAM). No other congenital anomalies were noted. Color Doppler ultrasound failed to detect any blood supply to the mass. Amniocentesis disclosed a normal male karyotype. Pregnancy termination was performed according to the parents' request, with the use of misoprostol and a 500 g dead fetus was delivered. The autopsy followed by detailed histological examination, disclosed the diagnosis of pulmonary sequestration. It is important to emphasize that the initial impression concerning the sonographic appearance and the size of the mass is not always in accordance with the diagnosis of the lesion and the outcome of the pregnancy. These data suggest that in cases of fetal pulmonary tumors, a thorough and comprehensive combination of imaging approaches should be employed followed by a pathologic examination of the congenital anomaly in order to establish a definitive diagnosis.

Abortion, Induced↗

PubMedDate not supplied

Is decrease of tumor volume correlated with stage change after preoperative concurrent chemoradiotherapy?

BACKGROUND/AIMS: The significance of tumor volume and its change after concurrent chemoradiotherapy (CCRT) was evaluated. METHODOLOGY: Standard-dose external radiation and oral UFUR plus leucovorin were used to treat 30 middle and lower rectal adenocarcinoma patients. Volume of tumor calculated from images obtained by dynamic MRI of the rectum before and after CCRT was compared to pathological results after definite resection and other clinical data. RESULTS: The T-stage in 15 patients (50%), the N-stage in 13 (72.2%), and overall, the TNM stage in 18 (60%), were downstaged, including 7 (23.3%) with complete responses (CR). Volume of tumor before CCRT (Vpre) and after CCRT (VPost) was 10.3+/-6.1cm3 and 4.2+/-2.2cm3, respectively, and VPre correlated with initial T stage, N stage, age, and location. The net decrease ratio (NDR) of tumor volume was related to Vpre and initial T stage. As to the downstaging effect, VPre was related to incidence of CR; NDR was related to the downstaging of the N stage. CONCLUSIONS: All tumors showed volume reduction after CCRT, but the downstaging benefits were not in proportion to the size change. Initially larger tumors had higher ratios of volume reduction, and smaller tumors had higher chance of CR.

Adenocarcinoma↗

PubMed1985

Stereology and morphometry in histopathology. Principles of application.

The role of stereology and morphometry (including image analysis) in histopathology is considered. Diagnostic histopathology has its own character, which should be considered when quantitative methods are applied. Three different types of studies in histopathology can be distinguished: prospective, retrospective and routine diagnostic studies. The variation in these studies is due to differences in the methods and differences in how the methods are applied. The overall variation is smallest in prospective studies and largest in routine diagnostic studies. Statistical classification of the overall variation does not cover all relevant aspects of the situation in which we study the sample from one individual patient. In that situation, we do not get support from the samples of other patients. In fact, we should speak about group morphometry (statistical morphometry) when samples from several patients are studied and diagnostic morphometry when the sample from one individual patient is under investigation. In the former case, simple morphometric methods may be applicable (the researcher is interested in mean values). In the latter case, one would often like to analyze the sample in more detail. This is why the diagnostic situation may benefit from computerized image analysis, which allows collection of large amounts of data in a short time. On the other hand, the great variation between the pathologic and the normal can allow the use of simple methods. The above basic principles need be considered before morphometric and stereologic methods are applied. These methods are simple in practice and they should be included in the training of all pathologists.

Biopsy↗

PubMed1997

[Cine display of postprocessed 3D MR images of the thoracic aorta].

We have developed a cine display of postprocessed 3D MR images of the thoracic aorta. Maximum intensity projection (MIP) images of the thoracic aorta in each phase were reconstructed from consecutive 2D-cine MR data sets, and displayed in a cine loop. The postprocessed 3D MR images clearly showed the relationship between major cervical branches and aortic pathologies such as aneurysms, and cine display presented the flow pattern in the aorta. 3D-cine MR angiography seems to be useful for follow-up studies of thoracic aortic diseases especially in patients with renal dysfunction.

Adult↗

PubMed1994

In vivo morphometry of planum temporale asymmetry in first-episode schizophrenia.

Magnetic resonance imaging is a promising tool for in vivo analysis of the neuropathology underlying schizophrenia. One of the most consistent features emerging from the majority of published studies is the lateralization of pathological findings, and this has led to hypotheses of impaired hemispheric specialization in schizophrenia. In previous work, we have validated morphometry of supratemporal language-related cortex using high-resolution magnetic resonance imaging and analyzed the relation of the so defined planum temporale to functional parameters of hemispheric specialization. In the present study, we examined planum temporale structural asymmetry in first-episode schizophrenics. Asymmetry coefficients obtained in these patients did not differ significantly from those in equally right-handed controls and were not correlated to standard psychopathological measures. These data are contrasted with other studies reporting lateralized brain pathology in schizophrenia with special emphasis on methodological considerations in neuroimaging procedures.

Adult↗

PubMed2004

Analysis of cerebral microvascular architecture--application to cortical and subcortical vessels in rat brain.

Cerebral vascular morphology, including vascular diameters, lengths and branch points, was measured using quantitative three-dimensional (3D) imaging software developed in our laboratory, where data were collected from cortical and subcortical regions of a rat brain. To compare multiple records of the vascular morphological differences between anatomical regions with unpaired data, a simple analysis of variance (ANOVA) model may not be applicable, or may not be valid without considering correlation and unpaired data. In this paper, we formulate a novel outcome to study vascular morphological differences, discuss proper paired test statistics on unpaired data and apply the proposed methods to study the cerebral vascular morphological differences between cortical and sub-cortical regions in rats (N=6). The total vessel surface was analyzed as a composite of diameter, length and branches of vessels. The extended Fisher permutation test provides the paired test on unpaired data, which is equivalent to a permutation test based on the average of multiple sections; however, the permutation test may not be exact. The repeated measure analysis of variance using Generalized Estimating Equations (GEE) can be used to conduct the paired test on unpaired data as an alternative, when the permutation test is not exact. These new approaches can be applied in the study of treatment effects on changes of vascular morphology under physiological and pathological conditions.

Animals↗