[en] The purpose of this study was to determine the relationship between the apparent diffusion coefficient (ADC) and diffuse renal disease by diffusion-weighted echo planar magnetic resonance (MR) imaging (EPI). Ten volunteers, seven patients with chronic renal failure and eighteen recipients of renal transplants were examined with diffusion-weighted EPI. We compared renal function (serum creatinine level) with provided ADC value. The average ADC values were 2.63 x 10^-3 mm²/sec for the whole kidney, 2.67 x 10^-3 mm²/sec for the cortex and 2.61 x 10^-3 mm²/sec for the medulla in normal kidneys. ADC values in the whole kidney, the cortex and the medulla in chronic renal failure were significantly lower than those for normal kidneys. In renal transplantation kidneys, the ADC values in the cortex were significantly lower than those for normal kidney. There was a linear correlation between ADC value and serum creatinine level. Our results show that diffusion-weighted MR imaging may be useful to identify renal dysfunction. (author)

[en] We reviewed MR images of 50 patients with spondylolisthesis to disclose MR findings of spondylolysis. In almost half of our series, spondylolysis was detected as a low signal intensity band traversing in the pairs interarticularis on both T1 and T2 weighted images. Sagittal images was superior to axial image in detection of the low signal intensity band. In some patients, a focal high signal intensity accompanying the low signal intensity band was considered to be fluid collection within pseudoarthrosis due to spondylolysis on T2-weighted image. (author)

[en] Usefulness of MRI in monitoring preoperative chemotherapy effect in patients with osteosarcoma was evaluated. Six patients with conventional type osteosarcoma were studied. MRI was performed before and after courses of chemotherapy, and MRI-pathologic correlation was made after operation. Images were obtained with SE method except for one case, in which dynamic MRI was performed with FLASH method following a bolus contrast injection. Disappearance of the peritumoral reactive zone, clearification of the tumor margin, appearance of the marginal low signal intensity band, and decreased size of the extraosseous mass are indicative of a good response to the chemotherapy on MRI. However, an increased signal intensity of the extraosseous mass and an enhancement effect with contrast injection on SE images are not always indicative of a poor response. Most of these high intensity and/or enhanced areas consist of postnecrotic granulation tissue and loose fibrosis with proliferation of dilated small vessels. An early phase of dynamic MRI after a bolus contrast injection could delineate tumor vascularity in the largest tumor cut plane. Dynamic MRI seems to be a promising diagnostic imaging in evaluating preoperative chemotherapy effect. (author)

[en] Purpose: Twenty-two patients with advanced gynecologic cancer underwent extended intraarterial cisplatin infusion after alteration of the intrapelvic blood flow and implantation of a vascular access device (VAD). Methods: To maximize concentrations of cisplatin at the target lesion, the superior and inferior gluteal arteries were embolized with steel coils. The tip of the catheter was inserted into the internal iliac artery; the opposite end of the catheter was connected to the VAD. Results: Intensive radioisotope accumulation was demonstrated in the anterior division of the pelvis, seen by scintigraphy performed with technetium 99m macroaggregated albumin via the VAD. Local perfusion in the tumor was well seen by ultrasonographic angiography with CO₂ microbubbles via the VAD. Continuous consecutive infusion of cisplatin at a rate of 12.5 mg/day via the VAD minimized the toxicity. The overall response rate was 73%. Radical surgery was possible in 16 of the 22 patients after this intraarterial infusion. Conclusion: This method was useful for treating advanced gynecologic cancer without significant toxicity

[en] We used a vascular access system (VAS) for continuous arterial infusion (CAI) of a protease inhibitor in two patients with acute necrotizing pancreatitis. The infusion catheter was placed into the dorsal pancreatic artery in the first patient and into the gastroduodenal artery in the second, via a femoral artery approach. An implantable port was then connected to the catheter and was secured in a subcutaneous pocket prepared in the right lower abdomen. No complications related to the VAS were encountered. This system provided safe and uncontaminated vascular access for successful CAI for acute pancreatitis

[en] A case of peculiar chondroblastoma involving multiple tarsal bones in a 49-year-old woman is described. The patient presented with pain and swelling of the right foot. Radiographs revealed a lytic expansile lesion of medial, intermediate, and lateral cuneiform bones, navicular, cuboid, and tarsal bones of the right foot, indicating a malignant tumor. Biopsies demonstrated a diffuse proliferation of round cells with eccentric and indented nuclei with longitudinal grooves and eosinophilic cytoplasm. Atypia was prominent, but mitotic figures were rare. The stroma was chondroid with focal chicken-wire calcification. On electron microscopy, the tumor exhibited chondroblastic features. The patient is alive with the tumor 7 years after radiotherapy. The tumor is considered a chondroblastoma with low malignant potential. (orig.)