[en] Spin-echo (SE) MR imaging (N = 25) and gradient-echo (GE) MR imaging (N = 15) were performed in 25 patients with angiographically (N = 25) verified atrial septal defect (ASD). Type of ASD was correctly identified in 23 of 25 patients on SE images. Anomalous return of pulmonary veins was demonstrated in all five patients. Demonstrating shunt flow by GE MR imaging was useful in small ASDs that were not identified on SE images. With the use of both MR imaging methods, all ASDs were correctly diagnosed. Distinction of pulmonary veins from surrounding tissues also was facilitated by GE MR imaging. Shunt volumes determined by GE MR imaging in nine patients correlated well with angiographic values (r = .95). Combined SE and GE MR imaging characterizes the anatomic and functional abnormalities in ASD, including anomalous pulmonary vein connections

[en] PURPOSE: In evaluating lesions of the mandible, it is important to visualize the cortical margins, cancellus bone, mental and mandibular foramina, inferior alveolar canal, and other anatomic structures. The routine intraoral and panorex films presently used for this are suboptimal. This paper evaluates 15 mandibular lesions using DentaScan (A CT soft- ware program that displays multiple axial, panarax, and cross-sectional images of the mandible) and compared them with the standard films. Fifteen mandibular lesions (including cancer, radiation necrosis, Gaucher disease, stafne bone cyst, osteomyelitis, and odontogenic cyst) were scanned with a 9800 General Electric scanner usning a bone algorithm, dynamic mode, and section thickness and overlap of 1.5 and 0.5 mm, respectively. Images were reformatted with DentaScan software and then compared with the standard films

[en] This paper reports on twenty-three patients with surgically (n = 18) or angiographically (n = 5) verified aortic dissection who underwent transverse gradient-echo GE MR imaging. All patients underwent spin-echo (SE) MR imaging and CT for comparison. GE MR imaging provided the correct diagnosis in all patients. One dissection was not detected with SE MR imaging, and two were not detected with CT. GE MR imaging facilitated the differentiation between true and false lumen in all cases by demonstrating earlier blood flow in the true than in the false lumen. It also improved visualization of the intimal flap, which moved considerably in patients with acute dissection and was therefore at times difficult to visualize with SE MR imaging or CT. The additional flow information facilitated differentiation between slow blood flow and intravascular thrombus. In 15 patients, and intimal tear was identified, with turbulent blood flow between true and false lumen reflection the site of an entry

[en] In 130 patients with malignant lymphoma, bone marrow (BM) scintigraphy and MR imaging of BM were correlated with the histologic findings of BM biopsy. Findings were classified as normal, reactive, or indicative of malignant infiltration. In 66 patients, findings from BM scintigraphy, MR imaging, and histologic examination correlated. Normal BM scintigrams and MR images excluded BM infiltration with an accuracy of 95%. In ten of 12 postmortem MR imaging examinations, MR imaging findings were confirmed by histologic study of the suspect areas. In conclusion, there was a good correlation between BM scintigraphy, MR imaging, and histologic changes. In case of different results, a new biopsy of the suspect area is necessary and should be guided by scintigraphic or MR imaging findings

[en] This paper assesses the value of conventional radiography, bone scintigraphy, and MR imaging in the early diagnosis of Legg-Valve-Perthes disease (LCPD), the results of these imaging methods at initial examination were compared with the clinical and radiologic findings at long-term follow-up (examination intervals ranged from 30 months to 2.5 years). Plan radiography of the pelvis, Lauenstein radiography of the hips, three-phase bone scintigraphy, and MR imaging with T1- and T2-weighted coronal views were acquired in 41 patients. Because of suspected contralateral LCPD in 6 patients, a second examination was performed. Therefore, a total of 88 hips underwent an initial examination. Diminished radionuclide uptake of the hip epiphysis at bone scintigraphy was considered LCPD, as were zones of decreased signal intensity and deformation of the femoral head on MR images. Radiographs were classified into the four radiographic LCPD stages and as equivocal in cases with only a widening of the articular space. For conventional radiography, results were true-positive in 16/22 cases, false-positive in 0, true-negative in 55/66, false-negative in 1, and equivocal in 15 (10 later found to be negative, 5 positive)

[en] The authors evaluated 30 patients with chronic lymphocytic leukemia (CLL) by bone marrow scintigraphy (BMS) and MR imaging. The results were compared with those of 140 patients with Hodgkin and non-Hodgkin lymphomas. Although bone marrow infiltration is essential in CLL, normal findings were seen in BMS in 12 patients and on MR imaging in six patients. In 18 patients, BMS showed a slight or marked expansion of bone marrow without focal lesions, while 35 patients of the reference group demonstrated focal pathologic findings. MR imaging of the bone marrow in CLL patients showed a smooth spotty pattern of slightly diminished signal intensity, a symmetric appearance, and no focal lesions > 1 cm. This pattern could be observed in 68% of regions in patients with CLL, but in only 12% in regions in the reference group. False-negative findings occurred in 20% of the MR studies and 40% of the BMS studies

[en] In a study to evaluate the patency of coronary artery bypass grafts (CABGs), 22 patients with 47 CABGs were examined with angiography and MR imaging. Transverse sections of the heart were imaged with spin-echo (SE) and gradient-echo (GE) techniques. The bypasses were assessed in three separate groups according to their vessel of insertion. With GE and SE MR imaging, 34 of 47 and 35 of 47 CABGs, respectively, were correctly assessed. The sensitivities of the two techniques were 60% and 55%, respectively; the specifities, 82% and 89%. These results indicate that MR imaging is only of limited value in the noninvasive assessment of CABGs. Patent CABGs are more reliably identified with both pulse sequences than occluded grafts. SE MR imaging was limited by low-signal-intensity artifacts from clips, whereas breathing and fat-water shift artifacts led to false diagnoses with GE MR imaging

[en] This paper reports on a study to evaluate whether gradient-echo (GE) MR imaging improves the detection of left ventricular (LV) thrombi. 12 patients with LV aneurysms underwent spin-echo (SE) and GE MR imaging. LV thrombi were independently confirmed or ruled out by means of angiocardiography, echocardiography, or CT. LV thrombi were correctly visualized with GE MR imaging in all patients and with SE MR imaging in 11 of 12. On SE images, thrombus was difficult to distinguish from the blood pool in four of 11 patients, due to either intraventricular flow signal or thrombus motion. In contrast, these thrombi were unequivocally depicted on GE images, because even slowly moving blood had higher signal intensity than thrombus and thrombus movement was clearly visualized on GE movies. Although SE MR imaging has high sensitivity and specificity in the detection of LV thrombi, GE images improve the differentiation of thrombi from the surrounding blood pool

[en] In patients undergoing surgical intensive care, who were not known to have any prior endocrine disease, testosterone and, in some instances, LH and FSH plasma levels were found to be reduced. Assays were therefore extended to other hormones. We examined 10 patients aged between 55 and 75 years who did not receive any hormonal treatment and were admitted to an intensive care unit postoperatively for peritonitis, acute respiratory insufficiency, acute renal insufficiency as welll as hemorrhagic or endotoxic shock. Basal plasma levels of prolactin, LH, FSH, testosterone, adrostenedione, dehydroepiandrosterone (DHEA), total estrogen, 17-β-estradiol, progesterone and 17-hydroxyprogesterone were assayed radioimmunologically. It was of interest to note that plasma testosterone levels were reduced in all patients. In addition, prolactin and DHEA were lower than normal in 2, while FSH, androstenedione and 17-β-estradiol were diminshed in one. In 2 patients androstenedione, 17-β-estradiol and 17-hydroxyprogesterone were increased, and in 1 patient either prolactin, FSH, DHEA or progesterone were higher than normal. All females showed elevated plasma prolactin, 17-β-estradiol and progesterone levels as well as reduced LH and FSH concentration. 4 patients had high testosterone and 2 elevated androstenedione and 17-hydroxyprogesterone levels. DHEA was lower than normal in 3 cases. Radioimmunological data suggest that prolactin, gonadotropin, androgen, estrogen or gestagen secretetion may be impaired in patients undergoing postoperative intensive care. (Autrhor)

[en] In interpreting the results of bone marrow scintigraphy (BMS) and MR imaging in patients with malignant lymphoma, infiltration should be differentiated from changes due to radiation and chemotherapy. Results of BMS and MR imaging in 142 patients with chemotherapy have been compared with those in 81 without chemotherapy. No systemic changes were found. In 15 patients, bone marrow imaging was performed before and after chemotherapy. Only in three with clinical remission did BMS and MR results improve. Bone marrow findings in 63 patients with radiation were compared with those in 67 without therapy. Radionuclide uptake was reduced markedly in 44 of 63 patients (two of 67 without therapy) and slightly in 12 of 63 (26 of 67). In seven of 63 cases, all of them shortly after radiation, BMS findings were normal (39 of 67). Typical fatty degeneration was found by MR imaging in 33 of 61 patients (all ≥ 4 months after radiation)