Association of cervical SIL and HIV-1 infection among Zimbabwean women in an HIV/STI prevention study.

A cross-sectional study was conducted on women attending family planning clinics in Harare, Zimbabwe to determine the prevalence of cervical neoplasia among HIV-1 positive women relative to an HIV-1 negative control group. Five hundred and fifty four women were recruited and the prevalence of HIV-1 was 36.8%. Cervical cytology was abnormal in 25.6% of HIV-infected women compared to only 6.7% HIV-1 seronegative women. Cervical neoplasia was significantly associated with HIV infection (chi(2)=42.4, P<0.001). Cellular changes typical of HPV infection (koilocytocis) were recorded in 6.4% of HIV infected women compared with 1.7% of HIV-1-uninfected women (chi(2)=8.43, P=0.004). HIV-1-positive women had twice the risk of having abnormal cervical cells than HIV-negative women (relative risk 2.47, odds ratio 10.14, P<0.001). Therefore the introduction of national cervical screening programme in HIV-1 endemic countries like Zimbabwe where the highest burden of pre-malignant lesions is among HIV-1-infected women needs careful planning because these women have other competing health needs including high rates of opportunistic infections.

Comparison of various techniques of iron oxide-enhanced breath-hold MR imaging of hepatocellular carcinoma.

The purpose of our study is to compare qualitatively and quantitatively the abilities of various superparamagnetic iron oxide (SPIO)-enhanced breath-hold magnetic resonance imaging (MRI) techniques to detect hepatocellular carcinoma (HCC). Eight patients with HCCs were imaged. The images were obtained with conventional T2-weighted spin-echo imaging (CSE), half-Fourier single-shot turbo spin-echo (HASTE), single-shot gradient-echo type echo planar imaging (GE-EPI), and single-shot spin-echo type echo planar imaging (SE-EPI) before and after SPIO administration. The liver signal-to-noise ratios (SNRs) in CSE and each EPI sequence were significantly decreased after SPIO administration. GE-EPI had the highest decrease ratio (DR) of liver SNR, followed by SE-EPI (TE=98), SE-EPI (TE=28), CSE, and HASTE in this order. The relative contrasts with GE-EPI and SE-EPI (TE=98) were significantly higher than that with CSE after SPIO administration. On receiver operating characteristic (ROC) analysis, diagnostic accuracy did not differ significantly among the pulse sequences after SPIO administration. GE-EPI and SE-EPI (longer TE) were useful for SPIO-enhanced breath-hold MRI performed to detect HCC.

Intraosseous pneumatocyst of the scapula.

Intraosseous pneumatocyst is a gas-containing cyst-like lesion that occurs most frequently in the ilium, sacrum or vertebrae. We present a case involving the left scapula that was found incidentally on CT. To our knowledge, intraosseous pneumatocyst of the scapula has not been previously reported.

Usefulness of MR angiography in detection of persistent trigeminal arteries.

OBJECTIVES: To examine the usefulness of magnetic resonance angiography (MRA) in detection of persistent trigeminal arteries (PTA). MATERIAL AND METHODS: 3D-time-of-flight (TOF)-MRA images obtained from 1100 patients (798 males and 302 females aged 6-75 years with a mean of 55 years) at our and related institutions were examined retrospectively for PTA. The course of the PTA was classified into the posteromedial type and posterolateral type. Charts of the patients were also examined retrospectively for clinical symptoms related to PTA. RESULTS: PTA was observed in 5 (0.45%) of the 1100 patients, and no aneurysm or arteriovenous malformation was noted in any of these 5 patients. PTA was the posteromedial type in 2 and posterolateral type in 3. PTA was possibly related with clinical symptoms in only 1 patient with oculomotor paresis. CONCLUSION: MRA is useful for non-invasive screening for PTA.

MRI appearances of fascioliasis complicating liver iron overload.

A case of hepatic fascioliasis with an unusual appearance on MRI due to liver iron overload is presented. The diagnosis of fascioliasis was based on positive serological tests and the presence of eggs in the bile. Hepatic lesions of fascioliasis exhibited hyperintense signals on T1 weighted images as well as proton density and T2 weighted images. Histological study of biopsy specimens from the lesions showed central necrosis and peripheral fibrosis with inflammatory cells including eosinophils. Abundant iron deposition in hepatocytes and Kupffer cells was found in specimens from the surrounding liver. These findings suggested that this appearance on MR images was probably due to a decrease in signal intensity in surrounding liver.

Time-course changes of contrast enhancement in iron colloid enhanced MRI in patients with hepatocellular carcinoma.

Time-course changes in contrast enhancement of chondroitin sulphate iron colloid (CSIC), an MR contrast agent, were determined in 12 patients with 20 lesions of classical hepatocellular carcinoma (HCC). Spin echo T1 weighted (T1WI) and T2 weighted images (T2WI) were obtained before administration of CSIC and 1, 6 and 24 h after injection. The signal-to-noise ratio (SNR) in the tumour region and the liver and the tumour-to-liver contrast-to-noise ratio (CNR) were calculated, and time-course changes of these ratios were determined. SNRs for tumour before the administration of contrast medium did not differ significantly from SNRs after administration on T1WI or T2WI. SNRs for the liver on both T1WI and T2WI were significantly lower at each time point after administration than before administration. The tumour-to-liver CNRs for both T1WI and T2WI were significantly higher after administration than before administration. The maximum CNR was observed 6 h after administration on both T1WI and T2WI. The contrast enhancement was maintained for at least 24 h, with a peak at 6 h after administration. The prolonged enhancement obtained with CSIC has extended the time during which effective contrast is maintained.

Hepatocellular carcinoma exhibiting a concentric structure of different histologic grades: evaluation by chondroitin sulfate iron colloid-enhanced MR imaging.

A patient with hepatocellular carcinoma exhibiting a concentric structure of different histologic grades was examined with chondroitin sulfate iron colloid (CSIC)-enhanced MR imaging. After CSIC injection, the advanced component was enhanced in comparison with the surrounding liver, and the well-differentiated component was not enhanced. CSIC-enhanced MR imaging was helpful in evaluating histologic grade on the basis of reticuloendothelial function.

Use of iron colloid-enhanced MRI for study of acute radiation-induced hepatic injury.

We present a case with acute radiation-induced hepatic injury using chondroitin sulfate iron colloid (CSIS)-enhanced MRI. Uptake of CSIC was decreased in the irradiated portion of the liver. CSIC-enhanced MRI is useful for obtaining information on the function of the reticuloendothelial system and demarcates between irradiated and nonirradiated zones.

Basic analysis of dynamic study in cases of hepatocellular carcinoma using inversion recovery snap shot FLASH MR imaging with Gd-DTPA.

Twenty patients with hepatocellular carcinoma were studied by dynamic sequential inversion recovery snap shot fast low angle shot (FLASH) imaging after the bolus injection of various amounts of Gd-DTPA. We determined the optimal dose of Gd-DTPA for depicting tumors as early marked enhancement and compared the method with dynamic CT by matching data acquisition time. The optimal dose was estimated to be 0.1 mmol/kg. Compared with dynamic CT, dynamic MRI showed rapid short-term enhancement in the early phase, while the contrast enhancement in the late phase lasted longer and was stronger than that of CT.

Correlation between chondroitin sulfate iron colloid-enhanced MR imaging and the histological grade of hepatocellular carcinoma.

The association between contrast enhancement by chondroitin sulfate iron colloid (CSIC) and the histological grade of hepatocellular carcinoma (HCC) was evaluated in 24 patients diagnosed by histological examination of surgical specimens (26 nodules: 11 well-differentiated and 15 poorly-moderately-differentiated nodules). In the well-differentiated HCC nodules, the tumor-liver contrast to noise ratio (CNR) was not significantly increased after i.v. CSIC injection on both T1-weighted and T2-weighted images. In the moderately-poorly-differentiated HCC, CNR was significantly increased after CSIC administration on both T1-weighted and T2-weighted images (p < 0.01). MR imaging using CSIC may be useful for diagnosing the degree of HCC differentiation.

Chondroitin sulfate iron colloid-enhanced MR imaging in patients with hepatocellular carcinoma. Comparison with CT during arterial portography.

Chondroitin sulfate iron colloid (CSIC) was used as an MR contrast agent for the detection of hepatocellular carcinoma (HCC). The findings of 25 surgically confirmed HCCs in 19 patients were retrospectively analyzed. T1-, T2- and proton density-weighted spin echo MR images were obtained before and after i.v. injection of 23.6 microM Fe/kg of CSIC. Unenhanced and CSIC-enhanced MR images and images obtained by CT during arterial portography (CT-AP) were correlated with surgical pathology findings. The sensitivities of CSIC-enhanced and unenhanced MR imaging, and CT-AP were 92%, 80%, and 88%, respectively. No significant differences were noted. Portal flow abnormalities demonstrated by CT-AP did not affect the detection of HCC by CSIC-enhanced MR imaging. CSIC-enhancement at MR imaging was a disadvantage in the detection of lesions less than 1 cm in diameter. CSIC-enhanced MR imaging is a supplemental method for the detection of HCC.

Double contrast MR imaging with iron colloid and Gd-DTPA in cholangiocellular carcinoma.

Double contrast MR imaging with combined use of chondroitin sulfate iron colloid (CSIC) and Gd-DTPA was attempted in 3 cases of cholangiocellular carcinoma (CCC). In all cases, nonenhanced spin echo T1- and T2-weighted images, and T1-weighted images after i.v. injection of Gd-DTPA were obtained. Within one week, the MR sequences were repeated one hour after i.v. injection of CSIC. Double contrast (CSIC/Gd-DTPA) T1-weighted imaging was evaluated and compared with the other sequences in terms of tumor detectability, tumor spreading and tumor characterization. Double contrast MR imaging was comparable in tumor detectability and superior as to the evaluation of spreading and characterization to the other MR imaging modalities.

Chondroitin sulfate iron colloid as MR contrast agent in differentiation between hepatocellular carcinoma and adenomatous hyperplasia.

Using a 1.5 T MR imaging unit, T1- and T2-weighted images were obtained before and after i.v. administration of chondroitin sulfate iron colloid (CSIC) in order to differentiate hepatocellular carcinoma (n = 20) from adenomatous hyperplasia without atypia (n = 16). Differentiation was made from the tumor-liver contrast to noise ratio (CNR) and visual evaluation of the nodule, with reference to signal intensity relative to that of the surrounding liver. The CNR of adenomatous hyperplasia was on T1-weighted images significantly decreased after CSIC administration (p < 0.01). On T2-weighted images, there was no significant difference in CNR after CSIC administration. On the other hand, the CNR of hepatocellular carcinoma was significantly increased after CSIC administration on both T1- and T2-weighted images (p < 0.01). CSIC reflects intratumor reticuloendothelial cellular functions, and is therefore useful in differentiating hepatocellular carcinoma from adenomatous hyperplasia without atypia.