ABSTRACT
We report a hemodynamical assessment of the blood turnover pattern as well as the imaging of cavernous hemangioma in a cavernous sinus using time-resolved contrast enhanced 2D projection MRA, also known as MR-DSA, and conventional digital subtraction angiography (DSA), before and after radiotherapy. MR-DSA showed very fast dynamical images of a contrast turnover pattern and was well matched with the findings obtained from DSA. MR-DSA is a non-invasive study, and can replace DSA in examining a vascular tumor for the initial work-up and follow-up examination.
Subject(s)
Female , Humans , Middle Aged , Angiography, Digital Subtraction/methods , Cavernous Sinus/diagnostic imaging , Hemangioma, Cavernous/diagnostic imaging , Hemodynamics , Magnetic Resonance AngiographyABSTRACT
We report the hemodynamic assessment in a patient with cerebral arteriovenous malformation using time-resolved magnetic resonance angiography (TRMRA), a non-invasive modality, and catheter-based digital subtraction angiography (DSA), before and after embolization. Comparison of the results showed that TR-MRA produced very fast dynamic images and the findings closely matched those obtained at DSA. For initial work-up and follow-up studies in patients with vascular lesions, TR-MRA and DSA are therefore comparable.
Subject(s)
Adult , Humans , Male , Angiography, Digital Subtraction , Cerebrovascular Circulation , Comparative Study , Embolization, Therapeutic , Follow-Up Studies , /diagnosis , Magnetic Resonance Angiography , Time FactorsABSTRACT
PURPOSE: To described the MR findings in the periodic changes of the size and signal intensity ofreconstructed anterior cruciate ligament (ACL) of the knee and the efficacy of oblique axial imaging in patientswho underwent arthroscopic ACL reconstruction using autogenous patellar tendon. MATERIALS AND METHODS: Twenty-onepatients who had undergone ACL reconstruction were evaluated by follow-up MRI at postoperative 1 week, 1, 2, 3 and6 months, and 1 year, Conventional Fast-Spin-Echo (FSE) sagittal and coronal images and oblique axial images(proton density and T2-WI; VEMP TR/TE, 2000/20/70) were obtained perpendicular to the ligament, and using an ROIcurve in the intra-articular area, periodic changes in the cross-sectional area were evaluated by proton densityimaging and signal intensity by T2WI imaging. Cross-sectional morphology was categorized as either smooth, andround or notch-shaped and periodic changes in configuration were observed. In three cases, we evaluated the retearof reconstructed ACL by comparing the oblique axizl image obtained by conventional sagittal and coronal imaging. RESULTS: The cross-sectional area and signal intensity of grafted ACL increased significantly (p<0.05) after 3months and at 1 year, respectively. Cross-sectional morphology was smooth and round in 86% of cases, and notchedin 14%, and during follow-up MR studies, no periodic changes were seen. Notch-shaped ACL and decreased perigraftsignal intensity, as seen on sagittal images, could lead to a misdiagnosis of partial tear ; on oblique axialimages, ACL and perigraft signal intensity were found to be normal. CONCLUSION: During the natural evolution ofgrafted ACL, cross-sectional area and signal intensity increased significantly after 3 months and at 1 year,respectively ; on follow-up MR studies, cross-sectional morphology did not change, however. Oblique axial imagingprovides important information for evaluating whether the reconstructed ACL is torn or not.
Subject(s)
Anterior Cruciate Ligament , Cross-Sectional Studies , Diagnostic Errors , Follow-Up Studies , Knee , Ligaments , Magnetic Resonance Imaging , Patellar Ligament , Prospective Studies , Protons , TransplantsABSTRACT
PURPOSE: The purpose of this study was to review the clinical and mammographic findings of pure mucinousbreast carcinoma. MATERIALS AND METHODS: In ten patients diagnosed as suffering from pure mucinous breastcarcinoma, we reviewed the clinical and mammographic findings. They were aged between 36 and 72(mean 46.3)years;nine were female and one was male. To describe breast mass, we used the terminology of the BreastImaging-Reporting and Data System developed by the American College of Radiology. RESULTS: All patients hadpalpable masses. The long-axis diameter of the tumors was between 1.0 and 7.0(mean, 2.81)cm, and in two patients,tumors were multiple. No cases involved metastatic axillary lymph nodes. During the follow-up period of 2 to78(mean, 36.3) months, no patient died. Mammographic findings included lobular circumscribed masses in fourpatients, round or oval circumscribed masses in three a lobular microlobulated mass in one, a round microlobulatedmass in one and a round spiculated mass in one. Microcalcifications were noted in two cases. Architecturaldistortion and nipple retraction were each found in one patient. CONCLUSION: On mammography, pure mucinous breastcarcinoma was most commonly seen as a lobular or round circumscribed mass; these masses were palpable and clinicalprognosis was relatively good.
Subject(s)
Female , Humans , Male , Breast , Follow-Up Studies , Information Systems , Lymph Nodes , Mammography , Mucins , NipplesABSTRACT
Primary hypertrophic osteoarthropathy is a rare hereditary disease without evidence of underlying diseases. We report a very unusual case of primary HOA accompanied by Crohn's disease with the primary HOA mimicking secondary HOA, which is a rare manifestation of Crohn's disease. We also review the literature to find the correlation, if any, between the two.
Subject(s)
Adult , Humans , Male , Crohn Disease/diagnostic imaging , Crohn Disease/pathology , Crohn Disease/complications , Osteoarthropathy, Primary Hypertrophic/diagnostic imaging , Osteoarthropathy, Primary Hypertrophic/complicationsABSTRACT
PURPOSE: To evaluate the therapeutic efficacy of intra-arterial infusion of Cis-Diamminedichloroplatinum (C-DDP) for the treatment of hepatocellular carcinomas with widespread involvement. MATERIALS AND METHODS: We retrospectively analyzed 22 patients who between July 1994 and June 1996 had undergone intra-arterial c-DDP infusion therapy for the treatment of hepatocellular carcinomas with widespread involvement. The hepatomas involved both lobes in ten, portal venous obstructions in fourteen, arterio-portal shunts in nine, and arterio-venous shunts in two. Proper hepatic artery was selected for infusion of 100mg/BSA of C-DDP. The same procedure was repeated every 3 to 4 weeks, and the total number of infusions was 65. On the basis of WHO criteria, response was classified as complete remission, partial remission, stable, or progression of the disease. Six-month and one-year survival rates were estimated, and adverse reactions were evaluated. RESULTS: Complete remission was noted in one patient (4.5%) and partial remission in three (13.6%), while 18 showed no response or progression after treatment. The six month survival rate was 59.1%, and the one-year survival rate was 32.1%. Adverse reactions included nausea/vomiting (59.8%), abdominal pain (9.2%), fever (8.0%), acute renal failure (2.3%) and hepatic encephalopathy (1.1%). These adverse reactions were, however, transient and reversible. CONCLUSION: Although the response rate is not high, intra-arterial C-DDP infusion therapy can be used as an alternative treatment for hepatocellular carcinomas with widespread involvement; adverse reactions are tolerable.
Subject(s)
Humans , Abdominal Pain , Acute Kidney Injury , Carcinoma, Hepatocellular , Cisplatin , Fever , Hepatic Artery , Hepatic Encephalopathy , Infusions, Intra-Arterial , Retrospective Studies , Survival RateABSTRACT
PURPOSE: To assess the role of contrast-enhanced dynamic Magnetic Resonance Imaging in evaluating disease activity of rheumatoid arthritis. MATERIALS AND METHODS: Forty-seven wrist joints with rheumatoid arthritis were examined prospectively. coronal images of the wrist were obtained using fat-suppression Fast multi-planar spoiled gradient recalled(FMPSPGR) acquisition in the steady state ; TR/TE=102/6.4m sec, flip angle=60.4 slices persequence, FOV=8cm, matrix=256X192 at 1.5 Tesla. Scans were carried out once before and five to eight times after an intravenous Gd-DPTA injection, at 30-second-intervals. The enhancement of synovium were measured, the enhancement ratio was calculated(postcontrast SNR/precontrast SNR) and time-enhancement ratio curves were plotted patients were divided into three groups according to the ratio of inital to peak enhancement: less than 30%; 30-80%; morethan 80%. Differences among the three groups were statistically tested using clinical indices and laboratory data as variables. RESULTS: Comparing one group with another, there were no significant differences in clinical indices and laberatory data except for the parameter of grip strength. CONCLUSION: Enhancement pattern measured in a single wrist joint was not comparable to a clinical index in predicting disease activity in rheumatoid arthritis.
Subject(s)
Arthritis, Rheumatoid , Hand Strength , Magnetic Resonance Imaging , Prospective Studies , Synovial Membrane , Wrist Joint , WristABSTRACT
PURPOSE: To compare the survival rates of patients with hepatoma using different methods of transcatheter arterial chemoemblization(THAE). MATERIALS AND METHODS: Four hundred and eighty three patients with hepatoma diagnosed by biopsy, serum alpha-fetoprotein, abdominal CT scan, abdominal ultrasonography or hepatic angiography were included, but not all had reccived surgical treatment. They were divided into two groups according to Child's classification and into subgroups according to different methods of THAE. Five-year survival rates among these groups were retrospectively Compared. The patients were aged between 24 and 85(mean, 58) ; male to female ratio was 324:61 for those who received THAE (396:87 when only hepatic angiography was considered). RESULTS: In the group with more than a single episode of chemoembolization, regardless of Child's classification, a better survival rate compared to the other groups with or without concommitant radiotherapy or without chemoembolization was noted. There was no difference in the survival rate of patients with multiple chemoembolization. Moreover, no difference in this rate was observed no matter what chemotherapeutic agents, including Adriamycin, Cis-Diaminedichloroplatinum or 1-131-Lipiodol, were used. Embolization by gelfoam in conjuction with Adriamycin resulted in no difference in survival rate regardless of requency of chemoembolization. CONCLUSIONS: An improved survival rate was seen when multiple episodes of chemoembolization were applied, but no difference was seen when there was concomitant application of either gelfoam or radiotherapy. Two different chemotherapeutic agents,Adriamycin and Cis-Diaminedichloroplatinum, were used, but there was no difference between them in their effect on survival rates.