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PubMed1999

Effect of combined kinetic therapy and percussion therapy on the resolution of atelectasis in critically ill patients.

BACKGROUND: Some critically ill patients have difficulty in mobilizing their respiratory secretions. These patients can develop pulmonary atelectasis that may result in hypoxemia. There are some data to show that atelectasis may be prevented by turning a patient from side to side utilizing special beds. STUDY OBJECTIVES: To determine the role of kinetic therapy (KT) combined with mechanical percussion (P) in the resolution of established atelectasis of the lungs and hypoxemia in critically ill, hospitalized patients. (KT was defined as rotation of a patient along the longitudinal axis of > or = 40 degrees to each side continuously.) DESIGN: Prospective and randomized study (2:1 test to control group). PATIENTS: Twenty-four patients with respiratory failure, either mechanically ventilated or spontaneously breathing, who demonstrated segmental, lobar, or unilateral entire lung atelectasis were studied. SETTING: Medical ICU and adult respiratory ward in a county hospital in New York. INTERVENTIONS: Seventeen patients were treated with KT combined with mechanical P using a KT system (Triadyne Kinetic Therapy System; KCI; San Antonio, TX). Seven patients received manual repositioning and manual P every 2 h. Both groups received similar conventional therapy with inhaled bronchodilators and suctioning. RESULTS: Partial or complete resolution of atelectasis was seen in 14 of 17 patients (82.3%) in the test group as compared with 1 of 7 patient (14.3%) in the control group. The median duration to resolution of atelectasis was 4 days in the test group. Bronchoscopy was performed in 3 of 7 patients in the control group, but in none of the patients in the test group. A cost of $720 was incurred per patient for utilizing the specialty beds for a mean duration of 4 days. An improvement in oxygenation index occurred in the test group (change in baseline PaO2/fraction of inspired oxygen from 207.4+/-106.7 mm Hg to 318+/-100.7 mm Hg) at the end of therapy, while the control group showed a reduction over a similar duration of time (181.3+/-96.3 mm Hg to 112+/-21.2 mm Hg). CONCLUSIONS: KT and mechanical P therapy resulted in significantly greater partial or complete resolution of atelectasis as compared with conventional therapy. There was a generalized trend toward statistical significance in the improvement of oxygenation and a reduced need for bronchoscopy in the group receiving KT and P therapy.

Aged↗

PubMed2006

Resolution of thromboemboli in patients with acute pulmonary embolism: a systematic review.

STUDY OBJECTIVES: Much attention has been paid in recent years to optimizing the diagnosis of acute pulmonary embolism (PE). However, little is known about the changes in clot burden that occur at the level of the pulmonary arteries after documented PE. It is often problematic to distinguish between a new or residual defect on lung scintigraphy or helical CT. This may lead to falsely labeling patients with residual PE as having recurrent PE and consequent unnecessary treatment changes. DESIGN: We performed a systematic analysis of studies of imaging tests (radionuclide and CT) evaluating resolution rate of PE with independent assessment of predefined methodologic criteria by two investigators. RESULTS: We identified 29 clinical studies. Of these, 25 studies were excluded and 4 studies were included in our review. Because studies differed largely in patient selection, duration of anticoagulation, and timing of follow-up, the studies were not pooled but briefly described. The percentage of patients with residual pulmonary thrombi was 87% at 8 days after diagnosis, 68% after 6 weeks, 65% after 3 months, 57% after 6 months, and 52% after 11 months. DISCUSSION: This review shows that complete resolution of PE is not routinely achieved between 8 days and 11 months after diagnosis. More than 50% of patients with PE still have defects 6 months after diagnosis, after which resolution of thrombi appears to reach a plateau phase. Physicians should be aware of the high percentage of incomplete resolution of pulmonary emboli. Routine re-imaging after cessation of anticoagulant therapy in patients with PE to obtain a new baseline could be considered.

Acute Disease↗

PubMed2005

High resolution as a key feature to perform accurate ELISPOT measurements using Zeiss KS ELISPOT readers.

The enzyme-linked immunospot (ELISPOT) assay was originally developed for the detection of individual antibody secreting B-cells. Since then, the method has been improved, and ELISPOT is used for the determination of the production of tumor necrosis factor (TNF)-alpha, interferon (IFN)-gamma, or various interleukins (IL)-4, IL-5. ELISPOT measurements are performed in 96-well plates with nitrocellulose membranes either visually or by means of image analysis. Image analysis offers various procedures to overcome variable background intensity problems and separate true from false spots. ELISPOT readers offer a complete solution for precise and automatic evaluation of ELISPOT assays. Number, size, and intensity of each single spot can be determined, printed, or saved for further statistical evaluation. Cytokine spots are always round, but because of floating edges with the background, they have a nonsmooth borderline. Resolution is a key feature for a precise detection of ELISPOT. In standard applications shape and edge steepness are essential parameters in addition to size and color for an accurate spot recognition. These parameters need a minimum spot diameter of 6 pixels. Collecting one single image per well with a standard color camera with 750 x 560 pixels will result in a resolution much too low to get all of the spots in a specimen. IFN-gamma spots may have only 25 microm diameters, and TNF-alpha spots just 15 microm. A 750 x 560 pixel image of a 6-mm well has a pixel size of 12 microm, resulting in only 1 or 2 pixel for a spot. Using a precise microscope optic in combination with a high resolution (1300 x 1030 pixel) integrating digital color camera, and at least 2 x 2 images per well will result in a pixel size of 2.5 microm and, as a minimum, 6 pixel diameter per spot. New approaches try to detect two cytokines per cell at the same time (i.e., IFN-gamma and IL-5). Standard staining procedures produce brownish spots (horseradish peroxidase) and blue spots (alkaline phosphatase). Problems may occur with color overlaps from cells producing both cytokines, resulting in violet spots. The latest experiments therefore try to use fluorescence labels as a marker. Fluorescein isothiocyanate results in green spots and Rhodamine in red spots. Cells producing both cytokines appear yellow. These colors can be separated much easier than the violet, red, and blue, especially using a high resolution.

Animals↗

PubMed2002

Typing dinucleotide repeats under nondenaturing conditions with single-base resolution and high sizing precision.

Dinucleotide repeats are genetic markers that are useful for many purposes, including genetic epidemiology, population genetics, and genetic diagnostics. The accuracy of analyses based on dinucleotide repeat polymorphisms is highly dependent on the success achieved in minimizing genotyping errors. Genotyping errors in dinucleotide repeat typing may arise for various reasons, including polymerase chain reaction (PCR) processing errors and the use of unsuitable electrophoretic conditions for resolving amplification products (i.e., lack of single-base resolution and inadequate precision in allele sizing). We have recently described a nondenaturing electrophoretic system useful for detecting PCR processing errors that lead to misidentification of heterozygotes as homozygotes in (AC)n repeat typing. Here, we show that this system also allows resolution of (AC)n repeats in native conditions with single-base resolution and high sizing precision, on the basis of an analysis of seven human (AC)n repeats ranging in size from 72 to 217 bp. This PAGE system is thus also useful for reducing the likelihood both of allele misidentification due to the absence of single-base resolution and of inaccuracies in allele sizing due to anomalous electrophoretic migrations among the alleles within an (AC)n repeat.

Alleles↗

PubMed2003

In vivo biomicroscopy of the skin with high-resolution magnetic resonance imaging and high frequency ultrasound.

Noninvasive imaging and characterization of the skin is of great interest in dermatology. In order to get relevant diagnostic information, high-resolution imaging techniques have to be applied. Ultrasonic imaging is a potential method for this purpose where the special requirements concerning the spatial resolution make it essential to apply high frequency ultrasound (HFUS). Alternatively, magnetic resonance imaging (MRI), being a very promising imaging modality, also shows the perspective of becoming a valuable diagnostic tool in dermatology. However, to account for the small dimensions of the structures under observation, very specialized system designs have to be developed. In this paper, a HFUS imaging system working in the 50 MHz and 100 MHz range is applied for high-resolution skin imaging. Furthermore, a commercial MRI-system was equipped with specially designed low noise rf (radio frequency) coils with minimized volume, and customized imaging sequences were applied to optimize the signal-to-noise ratio. With HFUS and high-resolution magnetic resonance (HR-MR) imaging complementary imaging techniques for in vivo biomicroscopy of the skin are available.

Artifacts↗

PubMed2005

Neuronal computation of disparity in V1 limits temporal resolution for detecting disparity modulation.

The human ability to detect modulation of binocular disparity over time is poor compared with detection of luminance modulation. We examined the physiological origin of this limitation by analyzing neuronal responses to temporal modulation of binocular disparity in striate cortex of awake monkeys. When neurons were presented with random-dot stereograms in which disparity varied sinusoidally over time, their responses modulated at the stimulus temporal frequency, with little change in mean firing rate. We calculated modulation amplitude as a function of temporal frequency and compared this with the psychophysical performance of four human observers. Neuronal and psychophysical functions showed similar peak frequencies (2 Hz) and comparable high-cut frequencies (10 and 5.5 Hz, respectively). Thus, V1 (primary visual cortex) neurons appear to limit psychophysical performance. The temporal resolution of the same neurons for contrast modulation was approximately 2.5 times greater, which parallels the superior psychophysical performance for contrast. There is a simple mathematical explanation for this difference: it results from calculating cross-correlation between temporally broadband monocular images that are bandpass filtered before measuring correlation. The limit on temporal resolution is a direct consequence of the binocular energy model that adds to the list of properties of human stereoscopic performance that are explained by this simple model of disparity encoding in V1: the same neurons can account for the performance of psychophysical tasks that result in either high (contrast) or low (disparity) temporal resolution. Because this principle holds whenever a broadband input is bandpass filtered before computing correlation, it may limit the resolution of other neuronal systems.

Animals↗

PubMed2006

Ultra-high resolution imaging by fluorescence photoactivation localization microscopy.

Biological structures span many orders of magnitude in size, but far-field visible light microscopy suffers from limited resolution. A new method for fluorescence imaging has been developed that can obtain spatial distributions of large numbers of fluorescent molecules on length scales shorter than the classical diffraction limit. Fluorescence photoactivation localization microscopy (FPALM) analyzes thousands of single fluorophores per acquisition, localizing small numbers of them at a time, at low excitation intensity. To control the number of visible fluorophores in the field of view and ensure that optically active molecules are separated by much more than the width of the point spread function, photoactivatable fluorescent molecules are used, in this case the photoactivatable green fluorescent protein (PA-GFP). For these photoactivatable molecules, the activation rate is controlled by the activation illumination intensity; nonfluorescent inactive molecules are activated by a high-frequency (405-nm) laser and are then fluorescent when excited at a lower frequency. The fluorescence is imaged by a CCD camera, and then the molecules are either reversibly inactivated or irreversibly photobleached to remove them from the field of view. The rate of photobleaching is controlled by the intensity of the laser used to excite the fluorescence, in this case an Ar+ ion laser. Because only a small number of molecules are visible at a given time, their positions can be determined precisely; with only approximately 100 detected photons per molecule, the localization precision can be as much as 10-fold better than the resolution, depending on background levels. Heterogeneities on length scales of the order of tens of nanometers are observed by FPALM of PA-GFP on glass. FPALM images are compared with images of the same molecules by widefield fluorescence. FPALM images of PA-GFP on a terraced sapphire crystal surface were compared with atomic force microscopy and show that the full width at half-maximum of features approximately 86 +/- 4 nm is significantly better than the expected diffraction-limited optical resolution. The number of fluorescent molecules and their brightness distribution have also been determined using FPALM. This new method suggests a means to address a significant number of biological questions that had previously been limited by microscope resolution.

Aluminum Oxide↗

PubMed2000

Meta-analysis of dietary essential fatty acids and long-chain polyunsaturated fatty acids as they relate to visual resolution acuity in healthy preterm infants.

OBJECTIVE: To derive combined estimates of visual resolution acuity differences between healthy preterm infants consuming different compositions and ratios of essential fatty acids (EFAs) and docosahexaenoic acid (DHA), an omega-3 (n-3) long-chain polyunsaturated fatty acid (LCPUFA). DATA SOURCES: Electronic biomedical reference database (Medline and Health Star from 1965 to July 1999) searches with index terms omega-3, n-3, infant, vision, acuity, and human. Current review article, monograph, and book chapter bibliography/reference section hand searches. STUDY SELECTION: A total of 5 original articles and 4 review chapters were reviewed for details on study design, conduct, and outcome. Four prospective trials of EFA/LCPUFA supplementation were included in these analyses. For behaviorally based outcomes, there were 2 randomized comparisons each at </=1, 2, 6, 9, and 12 months of corrected age and 4 randomized comparisons at 4 months of corrected age. For electrophysiologically based outcomes (visual-evoked potential), there were 2 randomized comparisons each at </=1 and approximately 4 months of corrected age. DATA EXTRACTION: Dietary composition and EFA/LCPUFA balance, study design, and analytic characteristics (duration of feeding, source of EFAs/LCPUFAs, number of subjects in study population, number of subjects analyzed, and basis for estimating age), and experiment-based characteristics (location, number or sites, design, vision tests employed, testing protocol, and ophthalmic examination) were recorded independently by 2 researchers with a standardized protocol. DATA SYNTHESIS: The relative difference in visual resolution acuity between groups of infants who received a source of dietary EFAs/LCPUFAs and groups who did not was computed and then analyzed with the DerSimonian and Laird random-effects method. RESULTS: Analysis of the randomized comparisons (DHA-supplemented formula vs DHA-free formula) showed significant differences in visual resolution acuity at 2 and 4 months of age. Combined estimates of behaviorally based visual resolution acuity differences at these ages were.47 +/-.14 octaves and.28 +/-.08 octaves, respectively. A 1-octave difference is a reduction in the width of the stimulus elements by 50%. CONCLUSION: These results support efficacy of n-3 LCPUFA intake in early visual system development, although supplementation safety issues still must be addressed through larger randomized trials. Whether n-3 intake confers lasting advantage in visually based process development across the life-span is still to be determined.

Dietary Supplements↗

PubMedDate not supplied

Persistent asthma in adults: comparison of high resolution computed tomography of the lungs after one year of follow-up.

OBJECTIVE: The aims of this study were to evaluate the role of high resolution computed tomography of the thorax in detecting abnormalities in chronic asthmatic patients and to determine the behavior of these lesions after at least one year. METHOD: Fourteen persistent asthmatic patients with a mean forced expiratory volume in 1-second that was 63% of predicted and a mean forced expiratory volume in 1-second /forced vital capacity of 60% had two high resolution computed tomographies separated by an interval of at least one year. RESULTS: All 14 patients had abnormalities on both scans. The most common abnormality was bronchial wall thickening, which was present in all patients on both computed tomographies. Bronchiectasis was suggested on the first computed tomography in 5 of the 14 (36%) patients, but on follow-up, the bronchial dilatation had disappeared in 2 and diminished in a third. Only one patient had any emphysematous changes; a minimal persistent area of paraseptal emphysema was present on both scans. In 3 patients, a "mosaic" appearance was observed on the first scan, and this persisted on the follow-up computed tomography. Two patients had persistent areas of mucoid impaction. In a third patient, mucus plugging was detected only on the second computed tomography. CONCLUSIONS: We conclude that there are many abnormalities on the high resolution computed tomography of patients with persistent asthma. Changes suggestive of bronchiectasis, namely bronchial dilatation, frequently resolve spontaneously. Therefore, the diagnosis of bronchiectasis by high resolution computed tomography in asthmatic patients must be made with caution, since bronchial dilatation can be reversible or can represent false dilatation. Nonsmoking chronic asthmatic subjects in this study had no evidence of centrilobular or panacinar emphysema.

Adult↗

PubMed1992

Ultrahigh-resolution scanning electron microscopy of biological materials.

The age of ultrahigh-resolution scanning electron microscopy (SEM) began in 1985, when the UHS-T1, with a resolution of 0.5 nm, was developed. Commercial instruments of the same or similar types followed rapidly. As instrumental resolution progressed, conventional specimen preparation methods became inadequate, and a number of new techniques were devised. In this paper, detailed procedures for these preparation methods such as the CC plate method and heavy metal impregnation are described, together with precautions recommended for achieving ultrahigh-resolution. Some applications of the method to biological specimens are also reported. Morphological identification of immunoglobulins prepared from human blood was attempted, and although the identification was not completely successful this technique may yet come to be of use in the clinical examination of allergic or infectious diseases. SEM images of complement, Clq, proteoglycan and the helical structure of double stranded DNA are shown, as also is the visualization of immunolabelled cell-surface receptors.

Carbon↗

PubMed1994

Resolution of posttransplant hypertension after liver transplantation despite impaired glomerular filtration.

Hypertension developing after transplantation is characterized by widespread vasoconstriction including the kidney. Late resolution (mean, 29 +/- 4 months) of posttransplant hypertension has been observed in 15 (Group I) of 278 subjects monitored after liver transplantation. These studies were undertaken to define the systemic and renal changes associated with resolution, as compared with a group matched for age, sex, and time after transplant who remained hypertensive (Group II; N = 15) or a group who never developed hypertension (Group III; N = 23). Blood pressure during resolution paralleled changes in the systemic resistance index, which fell from 3,052 +/- 548 to 1,872 +/- 205 dyne/s.cm5/m2 (P < 0.01). GFR and RBF remained low, despite the resolution of hypertension, and renal vascular resistance did not change. Circulating endothelin levels remained above normal in all transplant recipients (Group I, 11.9 +/- 3.0 versus normal subjects, 7.0 +/- 1.1 pg/mL; P < 0.05), and urinary prostacyclin excretion was suppressed (880 +/- 120 versus 2,247 +/- 187 ng/day; P < 0.01). No hormonal differences were apparent between transplant groups. These results demonstrate the capacity for systemic vasodilation to occur after transplantation, independent of vascular tone in the kidney. They further suggest that renal vasoconstriction and impaired GFR alone are not sufficient to explain de novo hypertension after transplantation.

Adult↗

PubMed2005

Spatial resolution improvement of scanning microscopy based on thermal lens spectroscopy with a total-internal-reflection arrangement.

In scanning microscopy by total internal reflection with thermal lens spectroscopy, its spatial resolution depends on the distance between the sample and a converging lens, which corresponds to the objective lens in an ordinary optical microscope. It was found that the resolution was best when the signal induced by the thermal lens effect was maximum. The distance was precisely adjusted by monitoring the signal intensity, and the resolution became twice better than that previously reported. Using a shorter focal-length lens, a resolution of 1.9 microm was attained.

Journal Article↗

PubMed1999

Identification of relative protein bands in polyacrylamide gel electrophoresis (PAGE) using a multi-resolution snake algorithm.

In polyacrylamide gel electrophoresis (PAGE) image analysis, it is important to determine the percentage of the protein of interest of a protein mixture. This study presents reliable computer software to determine this percentage. The region of interest containing the protein band is detected using the snake algorithm. The iterative snake algorithm is implemented in a multi-resolutional framework. The snake is initialized on a low-resolution image. Then, the final position of the snake at the low resolution is used as the initial position in the higher-resolution image. Finally, the area of the protein is estimated as the area enclosed by the final position of the snake.

Algorithms↗

PubMed2001

Rapid spontaneous resolution of acute subdural hematoma occurs by redistribution--Two case reports.

Coronal magnetic resonance imaging provided evidence of redistribution during the rapid spontaneous resolution of acute subdural hematoma (ASDH) in two patients. A 79-year-old female was transferred to our hospital after a traffic accident. Computed tomography (CT) on admission demonstrated an ASDH in the right frontal cerebral cortex. CT 12 hours after the accident revealed spontaneous resolution of the ASDH. Coronal magnetic resonance (MR) imaging 3 days after the accident clearly detected a very thin, sharply demarcated layer diffusely covering the cerebral convexity and the middle cranial fossa. A 41-year-old female fell and sustained head trauma with the loss of consciousness. CT on admission demonstrated an ASDH in the left frontal cerebral cortex. CT 12 hours after the accident revealed spontaneous resolution of the ASDH. Coronal MR imaging 3 days after the insult clearly demonstrated the redistribution and dispersal of the hematoma. Although CT showed the disappearance of the hematoma, MR imaging demonstrated redistribution rather than disappearance of the blood in both cases. These cases indicate that spontaneous resolution of ASDH occurs by redistribution and dispersal of the hematoma.

Accidental Falls↗

PubMed2006

High spectral and spatial resolution MRI of breast lesions: preliminary clinical experience.

OBJECTIVE: In previous research, high spectral and spatial resolution (HiSS) echo-planar spectroscopic imaging (EPSI) was successfully applied to the human breast, obtaining improved contrast, anatomic detail, and sensitivity to contrast agents. To test HiSS in the clinical setting, we used HiSS MRI to image 30 women with suspicious breast lesions. SUBJECTS AND METHODS: Women with suspicious breast lesions were scanned before and after contrast administration using EPSI at 1.5 T (0.63-mm in-plane resolution, 2.6-Hz spectral resolution). Images with intensity proportional to the water signal peak height in each voxel were synthesized and compared with standard clinical fat-saturated and early dynamic subtraction images. Pre- and postcontrast HiSS images were compared to assess the effect of the contrast agent on water resonance structure. RESULTS: HiSS images scored significantly better than standard clinical images in lesion conspicuity, margin definition, and internal definition, even though they were acquired before contrast agent injection. Fat suppression was more complete and uniform and detail was shown on HiSS images more clearly than on conventional fat-saturation images. Thus, HiSS images often allowed easier evaluation of the lesion. Contrast agent-affected changes were often spatially and spectrally inhomogeneous. CONCLUSION: HiSS scans were successfully integrated into standard clinical examinations and provided diagnostically useful images before contrast agent injection. Thus, it might be possible to characterize suspicious lesions on the basis of precontrast high-resolution spectral information. This information and information about the effect of contrast agents could potentially improve the specificity of breast MRI.

Adult↗

PubMed1994

Volumetric high-resolution CT in the diagnosis of interstitial lung disease and bronchiectasis: diagnostic accuracy and radiation dose.

OBJECTIVE: The purpose of this study was to evaluate the diagnostic accuracy and radiation dose of volumetric high-resolution CT in the diagnosis of interstitial lung disease and bronchiectasis when four contiguous sections were acquired at each of three levels. The potential benefits were weighed against the increased radiation dose of multiple scans. SUBJECTS AND METHODS: High-resolution CT scans of four contiguous sections were obtained at each of three locations (the aortic arch, the carina, and 2 cm above the diaphragm) in 50 consecutive patients (mean age, 44 years old) with known or suspected interstitial lung disease or bronchiectasis who were referred for evaluation with high-resolution CT. Each individual scan was analyzed for the presence of motion-induced streaking, blurring, or doubling. The diagnostic information contained in each set of four scans was compared with that contained in the first of the four scans in the set. RESULTS: Motion degraded at least one of the four images in each set in 69 (46%) of 150 volumetric acquisitions. When the full set of four images was considered instead of just the first scan from the set, the number of motion-free studies in patients with suboptimal respiratory suspension was increased by 40% (from 99 to 139). Diagnostic accuracy was improved as more features were identified on contiguous scans: the sensitivity of the first scan compared with that of the complete set of four scans was 84% for the detection of bronchiectasis, 97% for ground-glass opacity, 88% for honeycombing, 88% for septal thickening, and 86% for nodular opacities. Although the integral radiation exposure for a set of four CT scans was 2.8 times that of a single scan obtained with standard technique, peak skin exposure was unchanged. Slightly increased image noise with the reduced technique compromised diagnostic ability in 6% of studies. CONCLUSION: The use of volumetric high-resolution CT increased diagnostic accuracy, particularly for bronchiectasis at the lung bases, without increasing peak skin radiation exposure. With the availability of four contiguous scans per anatomic level, the subjective confidence in interpretation and number of motion-free studies also increased.

Adult↗

PubMed1997

Resolution of abnormal MR signal intensity in patients with stress fractures of the femoral neck.

OBJECTIVE: The purpose of this study was to describe the natural evolution of abnormal MR signal intensity after the diagnosis of a stress fracture of the femoral neck and to ascertain the time to resolution of that abnormal signal intensity. SUBJECTS AND METHODS: Ten patients who had been previously diagnosed with stress fractures of the femoral neck after positive MR scans of the hip were examined with MR imaging at regular intervals. In each patient T1-weighted and short inversion time inversion recovery (STIR) sequences were obtained until the abnormally bright, diffuse MR signal intensity (representing edema) disappeared from the STIR images. Time to resolution was correlated with each patient's age and presence or absence of a fatigue line on MR imaging. Statistical analysis was done using Fisher's exact test. RESULTS: Edema resolved in seven patients within 3 months of initial diagnosis, in two patients within 6 months, and in the remaining patient within 12 months. We found no statistically significant correlation between time to resolution and patient age or the presence of a fatigue line on MR imaging. Residual sclerosis occurred in five patients, all of whom had a fatigue line. Two of these patients developed bright T1 signal (fatty marrow conversion) around the area of sclerosis. In the remaining three patients, STIR images revealed a brightened fatigue line, which we presumed was caused by granulation tissue. CONCLUSION: In this study, 90% of patients showed resolution of abnormal MR signal intensity on STIR imaging within 6 months of the initial diagnosis of stress fracture of the femoral neck. Such data may prove helpful in examining patients with recurrent symptoms who undergo repeated MR scanning. When an abnormally bright, diffuse MR signal intensity on STIR imaging is seen more than 6 months after an original injury, such abnormal signal intensity is likely to represent new injury.

Adult↗

PubMed1998

Nonspecific interstitial pneumonia with fibrosis: high-resolution CT and pathologic findings.

OBJECTIVE: The purpose of our study was to describe high-resolution CT findings of nonspecific interstitial pneumonia with fibrosis and to compare findings seen on CT with pathologic findings. MATERIALS AND METHODS: High-resolution CT findings of biopsy-proven non-specific interstitial pneumonia with fibrosis from 23 consecutive patients (one man and 22 women) were analyzed retrospectively by two chest radiologists. CT findings were compared with pathologic findings. RESULTS: The predominant high-resolution CT finding, seen in all patients, was bilateral patchy areas of ground-glass opacity with (35%) or without (65%) areas of consolidation. Irregular linear opacities (87%), thickening of bronchovascular bundles (65%), and bronchial dilatation (52%) were also frequently seen. Honeycombing was not seen in any patient. All parenchymal abnormalities showed subpleural predominance. Areas of ground-glass opacity with or without irregular linear opacity or bronchial dilatation on CT corresponded pathologically to areas of interstitial thickening caused by varying degrees of interstitial inflammation and fibrosis showing temporal uniformity. Areas of consolidation, seen at five biopsy sites, represented the areas of bronchiolitis obliterans organizing pneumonia, foamy cell collections in alveolar spaces, or microscopic honeycombing with mucin stasis. CONCLUSION: On high-resolution CT, nonspecific interstitial pneumonia with fibrosis is most commonly revealed as patchy subpleural areas of ground-glass opacity mixed with irregular linear opacity or bronchial dilatation. These areas represent interstitial thickening caused by varying degrees of interstitial inflammation, fibrosis, or both.

Adult↗