Showing papers in "Acta Radiologica in 2007"
TL;DR: CT and SPIO-enhanced MR imaging are more sensitive but less specific than PET in the detection of LM and PET/CT can detect more patients with extrahepatic tumor than CT alone.
Abstract: Background: The choice of imaging before liver surgery is debated regarding the use of magnetic resonance (MR) imaging, computed tomography (CT), and positron emission tomography (PET). No studies have compared contrast-enhanced PET/CT with superparamagnetic iron oxide (SPIO)-enhanced MR imaging.Purpose: To compare PET/CT with superparamagnetic iron oxide (SPIO)-enhanced MR imaging, PET, and CT in the detection of liver metastases (LM) and extrahepatic tumor from colorectal cancer (CRC).Material and Methods: Thirty-five patients with suspected LM underwent PET/CT with a contrast-enhanced CT protocol and SPIO-enhanced MR imaging. Readers independently analyzed images from MR imaging, PET/CT, and the CT part and PET part of the PET/CT study. Imaging findings were compared with surgical and histological findings.Results: Lesion-by-lesion sensitivity and accuracy for liver lesions was 54% and 77% for PET alone, 66% and 83% for PET/CT, 82% and 82% for SPIO-enhanced MR imaging, and 89% and 77% for CT alone, res...
129 citations
TL;DR: The elasticity of tumors in six patients evaluated by MRE agreed with the tumor consistency given by the operative results, suggesting that MRE could be used as an imaging technique for noninvasive assessment of the consistency of brain tumor in vivo.
Abstract: Purpose: To investigate the potential value of magnetic resonance elastography (MRE) in evaluating the consistency of brain tumors.Material and Methods: Six patients with known solid brain tumor underwent brain MRE studies. Consistency of brain tumors was evaluated at surgery. Correspondence of MRE evaluation with operative result was studied.Results: The elasticity of tumors in six patients evaluated by MRE agreed with the tumor consistency given by the operative results.Conclusion: MRE could be used as an imaging technique for noninvasive assessment of the consistency of brain tumor in vivo.
116 citations
TL;DR: Radiofrequency ablation (RFA) therapy is an effective method to treat liver metastases from colorectal carcinoma and survival is improved and comparable with survival following surgical resection.
Abstract: Purpose: To evaluate the results of radiofrequency ablation (RFA) therapy with regard to long-term survival and rate of complications in patients with liver metastases from colorectal carcinoma.Material and Methods: A total of 102 patients were included and treated with RFA. In 100 patients, resection was not possible; two patients refused surgery. The patients had a total of 332 colorectal liver metastases. Pre- and post-treatment evaluation was performed with contrast-enhanced computed tomography. Survival from time of diagnosis of liver metastases was calculated by Kaplan-Meier analysis. Complications were recorded as minor or major in accordance with the definitions of the Society for Cardiovascular and Interventional Radiology.Results: Estimated median survival from time of diagnosis of liver metastases was 52 months (95% CI 34–82). Estimated 1-, 2-, 3-, 4-, and 5-year survival was 96%, 79%, 64%, 52%, and 44%, respectively. Minor complications were recorded following seven RFA treatments (4.0%) and m...
110 citations
TL;DR: Liver tumor growth in an embolized lobe accelerates after PVE, in patients with HCC, to retrospectively evaluate the effects of PVE on the growth of liver tumors in the embolization lobes.
Abstract: Background: Portal vein embolization (PVE) is now widely accepted as a useful preoperative procedure in selected patients undergoing extended hepatectomy. However, the effect of PVE on the growth o...
105 citations
TL;DR: Close clinical follow-up, postprocedural chest radiographs, and chest CT scans, if necessary, are important for the detection of pulmonary cement embolism at an early stage.
Abstract: Background: Percutaneous vertebroplasty (PV) has recently become a very common procedure for vertebral compression fractures. Extravasation of cement, a common event associated with vertebroplasty, may lead to cement emboli in the lungs.Purpose: To determine the frequency of pulmonary cement embolism after percutaneous vertebroplasty.Material and Methods: Between 2002 and 2006, 128 percutaneous vertebroplasties were performed in 73 patients (56 women and 17 men) in our institution. Postprocedural chest radiographs were obtained for all patients and assessed for the presence of pulmonary cement emboli.Results: Pulmonary cement embolism was detected on chest radiographs and confirmed with chest computed tomography (CT) in four patients treated with percutaneous vertebroplasty for osteoporotic collapse and one patient treated for multiple myeloma. The imaging finding of pulmonary cement embolism was solitary or multiple fine radiodense lines with occasional branching patterns. The frequency of pulmonary ceme...
101 citations
TL;DR: Intra- and interobserver agreement of the evaluation of variables describing vertebral signal changes, i.e. Modic type, location, volume, maximum height, and endplate area, were all found to have substantial to almost perfect agreement, and a detailed evaluation protocol of vertebral endplate signal change, the Nordic Modic Classification was found to be convincing reproducibility.
Abstract: Background: The lumbar vertebral endplate is considered a potential cause of specific low back pain. However, in relation to future research, there is need for a reliable and detailed magnetic resonance imaging (MRI) protocol to be used in the evaluation of vertebral endplate signal changes.Purpose: To assess the intra- and interobserver reliability of the “Nordic Modic classification” protocol.Material and Methods: MRI scans of 50 individuals representative of the general Danish population aged 40 were evaluated by two observers. Criteria for grading the changes were developed by the Nordic Modic Consensus Group. After consensus was established, all 50 MRI examinations were evaluated independently by each observer. Intraobserver reliability was assessed by re-evaluation of the 50 examinations by one of the observers. Kappa statistics were used to calculate agreement.Results: Intra- and interobserver agreement of the evaluation of variables describing vertebral signal changes, i.e. Modic type, location, v...
100 citations
TL;DR: Left ventricular volumes assessed by the newest-generation MDCT scanners are significantly higher compared with MRI, whereas ejection fraction and cardiac output are significantly lower in MDCT, as a result of the frequent application of beta-blockers prior to MDCT examinations.
Abstract: Purpose: To quantify left ventricular function and mass derived from retrospectively ECG-gated 64-detector-row computed tomography coronary angiography data sets in comparison to cine magnetic resonance (MR) imaging as the reference standard. We hypothesized that the administration of beta-blockers prior to multidetector computed tomography (MDCT) coronary angiography has a significant impact on left ventricular functional parameters.Material and Methods: Multiplanar reformations in the short-axis orientation were calculated from axial contrast-enhanced CT images in 21 patients (16 male, five female; age range 41–75 years, mean 64.3±6.8 years) referred for CT coronary angiography. Patients whose heart rates exceeded 60 bpm received 5 mg bisoprolol orally 1 hour before the MDCT examination. In case of insufficient heart-rate reduction, up to four vials (20 mg) of metoprolol were injected intravenously. The end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV), ejection fraction (EF), ca...
94 citations
TL;DR: Gd-EOB-DTPA may provide adequate hepatobiliary imaging within a shorter time span than Gd-BOPTA and facilitate scheduling at the MR unit and further studies in patients are required to compare the imaging advantages.
Abstract: Purpose: To evaluate the biliary enhancement dynamics of the two gadolinium chelates Gd-BOPTA (MultiHance®) and Gd-EOB-DTPA (Primovist®) in normal healthy subjects.Material and Methods: Ten healthy volunteers were evaluated with both agents by magnetic resonance (MR) imaging at 1.5T using a breath-hold gradient-echo T1-weighted VIBE sequence. The relative signal intensity (SI) differences between the common hepatic duct (CHD) and liver parenchyma were measured before and 10, 20, 30, 40, 130, 240, and 300 min after contrast medium injection.Results: Biliary enhancement was obvious 10 min post-injection for Gd-EOB-DTPA and was noted at 20 min for Gd-BOPTA. At 40 min delay, Gd-BOPTA reached its peak biliary enhancement, but at neither 30 nor 40 min delay was there any significant difference compared with that of Gd-EOB-DTPA. At later delays, the contrast between CHD and liver continued to increase for Gd-EOB-DTPA, whereas it decreased for Gd-BOPTA.Conclusion: The earlier onset and longer duration of a high c...
91 citations
TL;DR: In an experienced observer, DW-MRI together with T2W imaging can significantly improve tumor identification in prostate cancer.
Abstract: Background: Conventional T2-weighted (T2W) imaging alone has a poor sensitivity for prostate cancer detection.Purpose: To evaluate combined T2W and diffusion-weighted magnetic resonance imaging (DW...
90 citations
TL;DR: MDCT angiography with axial, MPR, MIP, and 3D VR images is effective in the detection of vascular renal anomalies such as RLRV and differentiating it from other pathologic conditions causing hematuria is important in order to avoid complications during retroperitoneal surgery or interventional procedures.
Abstract: Purpose: To evaluate the appearance, type, frequency, and clinical importance of retroaortic left renal vein (RLRV) in patients examined with multidetector computed tomography (MDCT) angiographyMa
79 citations
TL;DR: CBCT proved to be at least as accurate as routinely used MSCT in revealing the clinically and surgically important middle-ear structures and shows that high-quality imaging of the middle ear is possible with the current CBCT device.
Abstract: Purpose: To determine the applicability of cone-beam computed tomography (CBCT) in otological imaging, and to compare its accuracy with the routinely used multislice helical CT (MSCT) for imaging of the middle- and inner-ear areas.Material and Methods: Thirteen unoperated human cadaver temporal bones were imaged with CBCT and MSCT. Sixteen landmarks of the middle and adjacent inner ear were evaluated and compared for their conspicuity according to a modified Likert scale. Total scores and scores for subgroups including landmarks of specific clinical interest were also compared.Results: No significant differences were found between the imaging techniques or subgroups when scores of individual structures were compared. While the middle ear itself was visible in all cases with CBCT, parts of the inner ear were “cut off” in four cases due to the limited field of view. For the same reason, the evaluation of the whole mastoid was not possible with CBCT. The cochlear and vestibular aqueducts were not visualized ...
TL;DR: A patient managed with TAE can expect return of normal menses and preservation of future fertility and successful pregnancies, and PPH after cesarean section might need to be embolized with metallic coils in addition to Gelfoam in order to achieve secure hemostasis.
Abstract: Background: Transcatheter arterial embolization (TAE) is considered a safe, life-saving procedure in postpartum hemorrhage (PPH), but its long-term effect on menstruation and fertility is unclear.Purpose: To investigate technical aspects and the evaluation of complications, focused on menstrual cycle and fertility, using TAE in patients with PPH.Material and Methods: A retrospective study including 20 patients (seven with vaginal and 13 with cesarean delivery) with severe PPH treated with bilateral TAE of the uterine artery was carried out. All patients were asked to answer a questionnaire regarding their post-embolization history. In six patients, the radiation dose was measured.Results: All 20 cases underwent bilateral TAE of the uterine artery. Gelfoam was used as the embolic agent. However, after cesarean delivery in six patients who had clear contrast medium extravasation and/or pseudoaneurysm-like lesion, metallic coils had to be used in order to achieve hemostasis. No major short- or long-term comp...
TL;DR: Pathology-proven infectious cases are presented in both immunocompetent and Immunocompromised patients, with a discussion of the characteristic findings of each pathogen.
Abstract: The radiologist plays a crucial role in identifying and narrowing the differential diagnosis of intracranial infections. A thorough understanding of the intracranial compartment anatomy and characteristic imaging findings of specific pathogens, as well incorporation of the clinical information, is essential to establish correct diagnosis. Specific types of infections have certain propensities for different anatomical regions within the brain. In addition, the imaging findings must be placed in the context of the clinical setting, particularly in immunocompromised and human immunodeficiency virus (HIV)-positive patients. This paper describes and depicts infections within the different compartments of the brain. Pathology-proven infectious cases are presented in both immunocompetent and immunocompromised patients, with a discussion of the characteristic findings of each pathogen. Magnetic resonance spectroscopy (MRS) characteristics for several infections are also discussed.
TL;DR: US was better for diagnosing positive findings, while CT was betterFor excluding diagnosis of appendicitis, and a low negative appendectomy rate can be achieved.
Abstract: Purpose: To determine the diagnostic accuracy and the clinical impact of ultrasound (US) and computed tomography (CT) in diagnosing appendicitis, and to evaluate the impact of laboratory tests on the treatment of acute appendicitis.Material and Methods: All patients who, during 2005, underwent an acute ultrasound or CT investigation due to suspected appendicitis, or were diagnosed and/or surgically treated for appendicitis at Umea University Hospital, Umea, were included. The type of radiological investigation, its findings, the choice of treatment, final diagnosis, C-reactive protein (CRP), leukocyte particle count (LPC), body temperature, age, and sex were recorded for each patient. The histological result from surgery was considered the gold standard.Results: The material included 305 cases with an overall appendicitis prevalence of 58%. Fifty-two percent of the patients were female. The mean age was 29 years, with a total range of 2–94 years. Twenty percent (60/305) underwent a CT investigation, 40% (...
TL;DR: The imaging findings of idiopathic granulomatous mastitis have a wide spectrum, and they are inconclusive for differentiating malignant and benign lesions.
Abstract: Purpose: To evaluate the radiological, ultrasonographic, and magnetic resonance imaging (MRI) findings of idiopathic granulomatous mastitis.Material and Methods: Between April 2002 and June 2005, the mammography, ultrasound, color Doppler ultrasound, nonenhanced MR, and dynamic MR findings of nine patients with the preliminary clinical diagnosis of malignancy and the final diagnosis of granulomatous mastitis were evaluated.Results: On mammography, asymmetrical focal densities with no distinct margins, ill-defined masses with spiculated contours, and bilateral multiple ill-defined nodules were seen. On ultrasound, in four patients a discrete, heterogenous hypoechoic mass, in two patients multiple abscesses, in one patient bilateral multiple central hypo peripheral hyperechoic lesions, in two patients heterogeneous hypo- and hyperechoic areas together with parenchymal distortion, and in one patient irregular hypoechoic masses with tubular extensions and abscess cavities were seen. Five of the lesions were v...
TL;DR: This study demonstrates alterations in normal-appearing gray and white matter brain parenchyma of patients with NPSLE by means of abnormal ADC, FA, and eigenvalues, which may be based on loss of tissue integrity in part due to demyelination.
Abstract: Purpose: To investigate whether apparent diffusion coefficient (ADC), fractional anisotropy (FA), and eigenvalues in neuropsychiatric systemic lupus erythematosus (NPSLE) patients differ from those of healthy controls.Material and Methods: Eight NPSLE patients (aged 23–55 years, mean 42.9 years) and 20 healthy age-matched controls (aged 22–59 years, mean 44.4 years) underwent conventional brain magnetic resonance (MR) and diffusion tensor imaging (DTI). The ADC, FA, principal eigenvalue (λ∥), and the corresponding average perpendicular eigenvalue (λ⊥) ( = (λ2+λ3)/2) were measured in selected regions of normal appearing gray and white matter brain parenchyma. For statistical evaluation of differences between the two groups, a Student's t-test was used. The P value for statistical significance was set to P = 0.0025 after Bonferroni correction for multiple measurements.Results: Significantly increased ADC values were demonstrated in normal-appearing areas in the insular cortex (P<0.001), thalamus (P<0.001), ...
TL;DR: The overall agreement on the diagnosis of PE by MDCT for general radiologists and radiology trainees is very good, and it is believed that the initial management of patients with suspected PE could be based on the preliminary assessment performed by on-call radiologists with 2 years of experience.
Abstract: Purpose: To assess the interobserver variability of radiologists with varied levels of experience in the interpretation of multidetector computed tomography (MDCT) pulmonary angiographies.Material and Methods: Review of CT pulmonary angiographies performed on patients included in a diagnostic study evaluating a decision-based algorithm for diagnosing pulmonary embolism (PE). Five radiologists, three board-certified general radiologists and two radiology trainees with 2 years' experience, participated in the study.Results: According to the consensus reading, PE was present in 91 (31%) and absent in 194 (67%) patients, while in five patients (1.7%) the interpretations were regarded as equivocal. The per-patient agreement on the diagnosis of PE achieved by each of the four readers compared to the consensus reading was very good (κ range 0.85–0.92), but peripheral emboli were missed in four to six patients by three of four observers. The agreement on the most proximal level of PE (per-proximal level) assessed...
TL;DR: The results indicate a 35–40% reduction in breast cancer deaths by attending the Icelandic breast cancer screening program, consistent with the overall evidence from other observational evaluations of mammography-based programs.
Abstract: Background: The Icelandic breast cancer screening program, initiated November 1987 in Reykjavik and covering the whole country from December 1989, comprises biennial invitation to mammography for w...
TL;DR: Balloon kyphoplasty is an effective, minimally invasive procedure for the stabilization of pathological vertebral fractures caused by osteolytic lesions of vertebral bodies due to metastatic disease and gives a statistically significant reduction of pain and prevents further kYphotic deformity of the spine.
Abstract: Purpose: To evaluate the clinical and radiographic outcomes of balloon kyphoplasty in patients with fractures of the thoracic and lumbar spine caused by metastatic disease.Material and Methods: 64 ...
TL;DR: Imaging-guided core needle biopsy was accurate in differentiating between fibroadenomas and phyllodes tumors and US classification was unreliable due to considerable overlap in the findings.
Abstract: Background: The diagnosis of phyllodes tumors of the breast is challenging due to many similarities with common fibroadenomas.Purpose: To determine the diagnostic accuracy of core needle biopsy in diagnosing phyllodes tumors and to analyze the ultrasonographic (US) features of phyllodes tumors and fibroadenomas.Material and Methods: From 1999 to 2003, 1010 breast lesions underwent imaging-guided core needle biopsy. Of these, 57 fibroadenomas and 12 phyllodes tumors were removed surgically. The US and needle biopsy results of a total of 64 lesions (52 fibroadenomas and 12 phyllodes tumors) were further analyzed, compared, and correlated with surgical histological results.Results: The median sonographic sizes of the phyllodes tumors and the fibroadenomas were 3.2 cm and 1.6 cm, respectively. At US, 58% of the phyllodes tumors (7/12) were classified as equivocal or suspicious of malignancy and 42% (5/12) as probably benign, while 54% of the fibroadenomas (28/52) were classified as probably benign and 46% (24...
TL;DR: This review article is to provide a brief overview of the recent literature on the two main types of percutaneous biopsy methods done in the spinal column: fine needle aspiration biopsy and core needle biopsy.
Abstract: The purpose of this review article is to provide a brief overview of the recent literature on the two main types of percutaneous biopsy methods done in the spinal column: fine needle aspiration biopsy (FNAB) and core needle biopsy (CNB). FNAB is the process of obtaining a sample of cells and bits of tissue for examination by applying suction through a fine needle attached to a syringe. Core needle biopsy involves extracting a cylindrical sample of tissue using a large, hollow needle. The decision for needle biopsy is a joint effort between the clinician, pathologist, radiologist, surgeon, and patient. Specific techniques and approaches with varying needle systems are described for each spinal region. Percutaneous image-guided spine biopsy is a safe and effective procedure. It is the procedure of choice in definitive diagnosis of pathologic lesions of the spine.
TL;DR: A patient with reduced renal function faces the unpleasant choice of risking contrast medium-induced nephropathy (CIN) after administration of iodine-based CM or NSF after exposure to gadolinium-basedCM, and new knowledge has complicated work in the imaging department.
Abstract: For more than 10 years, it has been believed that it would be better for the kidneys if patients with reduced renal function were referred to enhanced magnetic resonance imaging (MRI) rather than undergoing radiography (e.g., arteriography, computed tomography [CT]) with iodinated contrast media (CM) (20). It may indeed be better for the kidneys, but recently it has been shown that it may be associated with another severe adverse reaction: a potentially disabling and life-threatening disease, nephrogenic systemic fibrosis (NSF), may occur in the weeks following exposure to certain extracellular gadolinium-based contrast media (13, 19). Thus, a patient with reduced renal function (chronic kidney disease [CKD] stage 4 and 5: glomerular filtration rate [GFR]v30 ml/min) faces the unpleasant choice of risking contrast medium-induced nephropathy (CIN) after administration of iodine-based CM or NSF after exposure to gadolinium-based CM (17). This new knowledge has complicated work in the imaging department.
TL;DR: It is demonstrated that patients with hepatic cirrhostic have cognitive control deficiency and the abnormal brain network of the ACC–PFC–parietal lobe–TFG is the neural basis of cognitive control impairment in cirrhotic patients.
Abstract: Background: Many studies have claimed the existence of attention alterations in cirrhotic patients without overt hepatic encephalopathy (HE). No functional magnetic resonance imaging (fMRI) study in this respect has been published.Purpose: To investigate the neural basis of cognitive control deficiency in cirrhotic patients using fMRI.Material and Methods: 14 patients with hepatic cirrhosis and 14 healthy volunteers were included in the study. A modified Stroop task with Chinese characters was used as the target stimulus, and block-design fMRI was used to acquire resource data, including four stimulus blocks and five control blocks, each presented alternatively. Image analysis was performed using statistical parametric mapping 99. After fMRI examinations were complete, behavior tests of Stroop interference were performed for all subjects. Overall reaction time and error numbers were recorded.Results: Both healthy volunteers and patients with hepatic cirrhosis had Stroop interference effects. Patients with...
TL;DR: Calculating the ADC appears to be useful in differentiating pleomorphic adenomas from other types of parotid gland tumors, and between subjects with healthy parOTid glands and those with a tumor.
Abstract: Background: The differential diagnosis of parotid gland tumors is often difficult with conventional magnetic resonance imaging.Purpose: To determine whether the calculation of the apparent diffusion coefficient (ADC) is valuable for making the differential diagnosis of parotid tumors.Material and Methods: Thirty parotid masses in 28 patients and 24 healthy parotid glands in 12 controls were examined in this prospective study. Diffusion-weighted magnetic resonance imaging with echo-planar spin-echo sequences was used to evaluate each subject. The ADC of each tumor and each healthy parotid gland was calculated. Tumor diagnoses were confirmed by the results of histopathologic analysis.Results: The following types of masses were identified: 11 Warthin tumors, nine pleomorphic adenomas, seven malignant tumors, one basal cell adenoma, and two benign cysts. The mean ADC value for the Warthin tumors was 0.97±0.16×10−3 mm2/s, for the pleomorphic adenomas was 1.74±0.37×10−3 mm2/s, for the malignant tumors was 1.04±...
TL;DR: MRE could be an imaging technique for assessing the elasticity of brain tissue by producing propagating shear waves in brain tissue through a modified phase-contrast gradient-echo sequence.
Abstract: Purpose: To study the application of magnetic resonance elastography (MRE) in the human brain.Material and Methods: An external force actuator was developed, which produced propagating shear waves in brain tissue. A modified phase-contrast gradient-echo sequence was developed. The propagating shear waves within the brain were directly imaged. The wave images were processed to obtain the elasticity image. Shear waves at 100 Hz, 150 Hz, and 200 Hz were applied.Results: The propagating shear waves in the brain were visualized on wave images. The elasticity image revealed the difference in tissue elasticity between gray and white matter of the brain.Conclusion: MRE could be an imaging technique for assessing the elasticity of brain tissue.
TL;DR: Evaluation of parenchymal blood flow from that of nodules may prove beneficial in the diagnosis of underlying thyroid diseases in patients with type 1 AIT and CFDS appeared to be of clinical relevance as regards therapeutic choice.
Abstract: Background: Amiodarone-induced thyrotoxicosis (AIT) may be caused by excessive thyroidal hormone synthesis and release (type 1) or by a destructive process (type 2). This differentiation is considered essential for therapeutic choice.Purpose: To evaluate the utility of color-flow Doppler sonography (CFDS) in the differential diagnosis and management of AIT.Material and Methods: The clinical and laboratory data, thyroid sonography (grayscale sonography [GSS], CFDS), thyroid radioiodine uptake (RAIU) and thyroid scintigraphy, treatment, and clinical outcome were retrospectively reviewed in 21 AIT patients. The CFDS pattern of thyroid nodules was separately described from that of the perinodular parenchyma, and AIT was classified as type 1 (increased blood flow) or type 2 (low/no blood flow). Type 1 AIT patients were treated with methimazole (alone or associated with potassium perchlorate), while type 2 patients were treated with prednisone or amiodarone withdrawal alone.Results: Eleven patients with increas...
TL;DR: This article will review pertinent vaginal anatomy, vaginal and pelvic MRI technique, and the MRI features of a variety of vaginal lesions with pathological correlation, which can be used to evaluate post-treatment changes related to previous surgery and radiation therapy.
Abstract: The detection of vaginal lesions has increased with the expanding use of cross-sectional imaging. Magnetic resonance imaging (MRI)—with its high-contrast resolution and multiplanar capabilities—is often useful for characterizing vaginal masses. Vaginal masses can be classified as congenital, inflammatory, cystic (benign), and neoplastic (benign or malignant) in etiology. Recognition of the typical MR imaging features of such lesions is important because it often determines the treatment approach and may obviate surgery. Finally, vaginal MR imaging can be used to evaluate post-treatment changes related to previous surgery and radiation therapy. In this article, we will review pertinent vaginal anatomy, vaginal and pelvic MRI technique, and the MRI features of a variety of vaginal lesions with pathological correlation.
TL;DR: MR imaging with phased-array receiver coils at 3T facilitated both visualization of different pathologic conditions of the rectum and accurate determination of tumor stage in rectal carcinomas, appearing highly suitable for the assessment of patients with suspected rectal cancer.
Abstract: Purpose: To assess image quality and overall accuracy of 3-Tesla (3T)-sustained high-resolution magnetic resonance (MR) imaging for diagnostic preoperative workup in suspected rectal carcinoma.Material and Methods: Twenty-three patients with suspected rectal cancer underwent unenhanced and contrast-enhanced fat-suppressed pelvic high-resolution MR imaging using a four-channel phased-array pelvic coil at 3T. Image quality, tumor stage, distance from the anorectal margin, and sphincter-saving resectability were prospectively assessed by two blinded readers. The results were correlated with clinical, surgical, and histopathologic findings.Results: In all 23 patients, MR images were of diagnostic quality, and malignancy was correctly identified in 21 patients. The accuracy for determining sphincter-saving resectability was 100% (19/19). T stage and N stage were correctly diagnosed in 95% and 91%, respectively. MRI allowed correct identification of tumor extension and its relation to surgically relevant pelvic...
TL;DR: 3.0T time-of-flight (TOF) magnetic resonance angiography (MRA) is superior to 1.5T TOF-MRA for the characterization of cerebral AVMs and is still far from equal to DSA, which remains the gold standard for characterization of AVM.
Abstract: Background: The characterization of brain arteriovenous malformation (AVM) angioarchitecture remains rewarding in planning and predicting therapy. The increased signal-to-noise ratio at higher field strength has been found advantageous in vascular brain pathologies.Purpose: To evaluate whether 3.0T time-of-flight (TOF) magnetic resonance angiography (MRA) is superior to 1.5T TOF-MRA for the characterization of cerebral AVMs.Material and Methods: Fifteen patients with AVM underwent TOF-MRA at 3.0T and 1.5T and catheter angiography (DSA), which was used as the gold standard. Blinded readers scored image quality on a four-point scale, nidus size, and number of feeding arteries and draining veins.Results: Image quality of TOF-MRA at 3.0T was superior to 1.5T but still inferior to DSA. Evaluation of nidus size was equally good at 3.0T and 1.5T for all AVMs. In small AVMs, however, there was a tendency of size overestimation at 3.0T. MRA at 3.0T had increased detection rates for feeding arteries (+21%) and supe...
TL;DR: PET, side-by-side PET+CT, and PET/CT revealed similar detection rates for primary tumors in cervical MUO patients, and cervical metastases of an unknown primary may be assessed with either of these imaging modalities.
Abstract: Background: Identification of primary tumor in patients with cervical lymph node metastasis of unknown primary (MUO) has a great impact on therapy approach and potentially on patient prognosis.Purpose: To assess the diagnostic accuracy of combined positron emission tomography (PET)/computer tomography (CT) for primary tumor detection in cervical metastases of unknown origin compared to PET, CT, and PET+CT side-by-side evaluation.Material and Methods: 39 consecutive patients (eight women, 31 men; mean age 59.9±11.2 years) with MUO were enrolled in this study. PET/CT images were obtained 1 hour after injection of 350 MBq of fluorodeoxyglucose. Oral and intravenous contrast agents were administered in all patients to ensure diagnostic CT data. Fused PET/CT data were evaluated for primary tumor detection. Diagnostic accuracy was calculated and compared with CT alone, PET alone, and side-by-side PET+CT evaluation. Statistical analysis of differences in diagnostic performance between the different imaging proce...