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Biomedical subjects

A Neuhold

Publications and source records attributed to A Neuhold.

At least 55 records · Page 3Linked to original sources
PubMed1989

Changes within the "normal" cerebral white matter of multiple sclerosis patients during acute attacks and during high-dose cortisone therapy assessed by means of quantitative MRI.

Changes in the apparently unaffected cerebral white matter of multiple sclerosis (MS) patients were studied during acute attacks as well as during high-dose prednisolone therapy. Serial MR scans of patients with a clinically definite diagnosis were performed on four defined occasions: before an episode, within three days after its onset, after 10 days of therapy as well as four weeks later. Thirteen patients agreed to cooperate in forming a MRI data base and to be rescanned immediately after the onset of an acute relapse. Within one year, six patients had such episodes, one of them had a second bout. Both T1 and T2 relaxation times within the apparently normal white matter were significantly prolonged in all cerebral lobes compared to a control group of healthy volunteers. During the acute attacks as well as during therapy the T1 values remained as before. The T2 values were elevated only in two out of six cases during the episode. After therapy a considerable clinical improvement was seen in all cases, but a significant T2 decrease as a possible effect of cortisone was noted in only one case. We conclude that the prolonged relaxation times T1 and T2 within the apparently normal cerebral white matter of MS patients are the result of a number of molecular events differing considerably among individual patients and that serial measurements of these relaxation times do not consistently change during an acute relapse and do not reflect clinical improvement after high dose prednisolone therapy.

Acute Disease↗
PubMed1989

[MRT of the status following augmentation plasty of the anterior cruciate ligament using carbon fibers].

In 19 patients treated with carbon-fiber ligament augmentation for the anterior cruciate ligament, the clinical findings were compared via MRI. Visualization of the intra- and extra-articular portion of the graft was possible in 84%. The integrity of the ligaments was be shown in an equal percentage. Thus, MRI is a useful diagnostic tool for non-invasive imaging for repeated follow-ups in patients with carbon-fiber ligament augmentation.

Adolescent↗
PubMed1989

Cine-MR in dissection of the thoracic aorta.

Magnetic resonance imaging (MRI) of the thoracic aorta, including cine-MRI, was performed in 25 patients suspected of having dissection of the thoracic aorta. MRI was correlated with echocardiography, CT and angiography. The sensitivity of MRI (100%) was most closely followed by CT and angiography (83% and 77% respectively). The specificity of MRI and angiography was equally good, at 100% each. MRI was able to demonstrate the intimal flap in all 9 cases of aortic dissection, and there were no false-positive results. Differentiation of thrombosis and slow flow was possible on proton density images, gradient echo images permitted detection of the entry and re-entry sites. The nature of the dissection was determinated correctly in 8 out of 9 cases. MRI is capable of providing all the relevant parameters necessary to decide appropriate treatment of dissecting aneurysms of the thoracic aorta.

Adolescent↗
PubMed1989

[Involvement of apparently normal white brain substance in the disease process of multiple sclerosis].

In a group of patients with a clinically definite diagnosis of multiple sclerosis (MS) the cerebral white matter was investigated by means of quantitative nuclear magnetic resonance imaging (MRI). Measurements were taken from plaque-free regions and compared to a control group of healthy volunteers. A significant prolongation of T1 and T2 values was seen for all regions investigated (frontobasal, temporal, temporoparietal, and upper parietal white matter). In a comparison of MS patients with a short duration of the disease (mean: 1.7 years) with MS patients with a long-standing course of the disease (mean: 15.2 years) a significant prolongation of T2 relaxation times was found in the upper frontal and upper parietal white matter only for the latter group. In keeping with neuropathological findings the noted prolongation of T2 values might most probably be due to an increase of extracellular water secondary to astroglial proliferation. The increase of relaxation times could either be due to degeneration of commissural fibers or be the result of an exhausted capacity for remyelination. Both events are known to occur predominantly in the later stage of the disease. It is concluded that MS represents a disease which is not restricted to limited areas of demyelination but rather involves the entire cerebral white matter. These findings imply possibilities for the assessment of disease progression as well as for therapy.

Adult↗
PubMed1989

[Magnetic resonance tomography in the assessment of questionable aneurysm of the thoracic aorta with or without dissection of the intima].

To assess the value of MRI in the diagnosis of aneurysm of the thoracic aorta with suspected or known dissection 23 patients were imaged with cardiac gating. Seven patients (group 1) had known dissection of the thoracic aorta; in 16 patients (group 2) an aneurysm was suspected by chest x-ray or 2D-echocardiography. Reference methods were: x-ray, 2D-echocardiography, angiography, and computered tomography. In the first group MRI clearly identified the intimal flap, could differentiate between true and false lumen, slow flow, and thrombus, respectively. In the second group MRI could exclude a dissection of the ectatic part of the thoracic aorta in 11 patients and demonstrate paracardiac or mediastinal mass in five patients. MRI can serve as an important diagnostic tool in known or suspected aneurysm of the thoracic aorta.

Adolescent↗
PubMed1989

Diagnostic imaging of the occipito-cervical junction in patients with rheumatoid arthritis. Plain films, computed tomography, magnetic resonance imaging.

Fifty-five patients with confirmed chronic polyarthritis were admitted to this prospective study. The occipito-cervical region was visualized by plain radiography, computed tomography (CT) and magnetic resonance (MR) imaging. These modalities and the results are compared. In the presence of chronic polyarthritis, radiography of the occipito-cervical region visualized only bone lesions, while CT provided a good picture of both bone lesions and soft-tissue alterations. CT is an effective modality for the diagnosis of chronic polyarthritis in the occipito-cervical region. MR imaging was less sensitive in depicting bone lesions. In comparison with CT, however, MR images produced more frequent and more impressive visualization of soft-tissue alterations. MR imaging is most suitable for visualizing complications of the spinal cord.

Adult↗
PubMed1989

[Comparison of the value of magnetic resonance tomography and computerized tomography in the follow-up of augmentation-plasties with carbon fiber ligaments of the anterior cruciate ligament].

17 patients--treated with unidirectional carbon-fibre-ligaments augmentation for the anterior cruciate ligament--have been followed-up by MRI and CT. The question has been, whether both methods show comparable results. The interval between operation and follow-up has been 34 months in average (43 to 30). Significance was put on the probants bedding. MR-Imaging in two planes seems to be essential to show the artificial ligament's integrity in its extraarticular "over the top"-position. Satisfying corresponding results could be found in MRI and CT.

Adolescent↗
PubMed1988

[Magnetic resonance tomography as a localization method in hyperparathyroidism].

Magnetic Resonance Imaging (MRT) was performed in 36 consecutive patients with hyperparathyroidism. MR tomograms of 31 patients were evaluated and compared with the results of operation and histology (n = 29). In the remaining 5 patients MR examination was not completed, due to claustrophobia or motion artefacts. MR examinations were performed in 2 superconductive magnets (0.5 and 1.5 Tesla). A surface coil with following spinecho sequences was used: SE: TR/TE: 550-700/15-30; 2000/22-100. All patients were subjected to additional sonography. Out of 28 parathyroid adenomas 25 were identified on MR tomograms (sensitivity: 73%, specificity: 90%). However, only 2 out of 6 hyperplastic parathyroid glands were localized on MR tomograms. Lesions missed on MR tomograms measured 15 mm and less in diameter. It is characteristic that parathyroid adenomas showed isointense MR signal to the thyroid (SE 550/30 and hyperintense MR signal to fat (SE 2000/100). Different signal intensities of the adenomas were observed in 25% of the cases. MR imaging is a valuable diagnostic method for preoperative localisation of parathyroid adenomas. We think that MR imaging should be performed when sonography and subtraction scintigraphy are not able to identify a suspected adenoma in the same location.

Adenoma↗
PubMed1988

Structural brain correlates of anterograde memory deficits in multiple sclerosis.

Progressive decline of anterograde memory functions has been increasingly recognized as a frequent symptom in chronic multiple sclerosis. In order to investigate the brain structures involved, magnetic resonance imaging was performed in 20 patients. Neuropsychological assessment included the WAIS and WMS subtests information, picture completion, similarities, digit span, logical memory, and paired associate learning. All patients with severely impaired memory functions (n = 5) showed bilateral lesions in the medial temporal lobe, whereas in those patients with moderate (n = 10) or no measurable impairment of memory testing (n = 5) either no lesions were seen in the medial temporal lobes or these lesions were restricted to one side. A post hoc cluster analysis strikingly confirmed these results. The differences could not be related to the age of the patients, the disease duration, or the level of education. Extensive lesions in the white matter of the frontal lobes, thinning and lining of the corpus callosum, and bilateral involvement of the anterior cingulate gyrus had no bearing on the neuropsychological results. These findings indicate that bilateral demyelination in the hippocampal regions is the most likely explanation for the impairment of anterograde memory in such patients.

Adult↗
PubMed1988

Transcranial Dopplersonography of the vertebro-basilar system.

This is the first investigation of distances, angles and locations of the vascular system in the posterior fossa. The distances from the skin surface of the neck, where a Doppler probe is positioned for transforaminal insonation, to the brainsystem have been measured in sagittal MRI pictures. The mean distance from the insonation point to the beginning of the basilar artery (BA) is 66.6 mm in males, 58.8 in females. The distance to the end of the BA is 90.0 and 80.4, respectively. These distances are relevant for locating the vertebral and basilar arteries. The insonation angles to the VA and BA range from 20 degrees to 30 degrees. Correlations with Doppler findings are discussed.

Adult↗
PubMed1988

[Focal fatty deposits in spinal bone marrow--MR findings. MRI of focal fatty deposits].

MR tomograms of the spines of 121 patients were reviewed in order to assess the incidence and distribution of focal fat deposits in axial bone marrow. In addition, three cadaver spines were examined and cut with a band saw for macroscopic and histologic correlation. Yellow areas, histologically representing fatty replacement of hematopoetic marrow, were found macroscopically; their location was in precise correspondence to areas of focal enhanced signal intensity on T1-WI as well as T2-WI. The incidence of those focal fat spots was related to age, but not to sex; in different diseases like scoliosis, porosis and after cytostatic therapy of different malignomas they were found more frequently than in the average of the sample. Focal fatty replacement of hematopoetic bone marrow is obviously a normal phenomenon and should not be misinterpreted as a pathologic condition.

Bone Marrow Diseases↗
PubMed1988

Magnetic resonance imaging of the lower vertebral column in patients with multiple myeloma.

Eighteen patients with multiple myeloma (clinical stages 1-3) and a control group of 21 persons underwent magnetic resonance imaging (MRI) studies of the lower thoracic and lumbar spine. This was done to determine the potential benefit of MRI in addition to conventional radiographs, tomograms, computed tomography and nuclear scans. In addition to focal fatty replacement of normal hematopoietic marrow, which presented as focal hyperintense lesions on T1-weighted images (T1-WI) and on T2-weighted images (T2-WI), two types of myelomatous lesions were found: (1) focal areas with reduced signal intensity when compared with normal bone marrow on T1-WI and enhanced signal intensity on T2-WI, mainly found in untreated myelomas; and (2) focal areas of decreased signal intensity on T1-WI and on T2-WI, which were predominantly detected after previous radiation therapy. MRI surpassed conventional radiography in detecting abnormal focal marrow infiltration in 41 of 247 vertebrae. Radiographs identified only 11 of the 41 as pathologic, based on shape and structure of the vertebral bodies; however, 15 other collapsed vertebrae showed no signal abnormalities of the marrow on MR images. Discrimination of normals and abnormals by statistical analysis of intensity measurements of the bone marrow was not possible.

Adult↗
PubMed1987

[Therapy of multi-infarct dementia with nicergoline: double-blind, clinical, psychometric and EEG imaging studies with 2 dosage schedules].

In a double-blind study, clinical, psychometric and neurophysiological changes were investigated in patients with MID treated by two different drug administration schedules of nicergoline (20 mg evenings versus 10 mg b.i.d.). 24 hospitalized patients (4 males, 20 females) with a mean age of 78 years were included according to the criteria of DSM-III, an Ischemic-Score of at least 7 points and a specific computed tomogram (CT). After a placebo-period of 2 weeks all patients were randomly assigned to an 8-weeks-treatment with either 20 mg nicergoline h.s. or 2 x 10 mg b.i.d. The evaluation of the detailed psychopathology by means of SCAG, CGI, NOSIE, Hamilton-Depressions-Scale and Mini-Mental-Status, as well as psychometric investigations by means of the Nuremberg-Aging-Inventory (NAI), thymophysic and psychophysiological measurements showed a significant improvement in both groups as compared with pre-treatment. This improvement was observed slightly earlier in patients with 20 mg h.s. than in those on the b.i.d. schedule. However inter-group-differences reached the level of statistical significance in only 2 variables. Neurophysiological investigations by means of topographic brain-mapping showed interesting relations between functional EEG-images and morphological CT-images. Vigilance-improving patients showed a better therapeutic response than those who did not show neurophysiological changes indicative of improvement in vigilance. Our findings suggest, that a single dose once daily was at least equal to the b.i.d. administration as far as therapeutic efficacy was concerned, even more so in the light of an expected improvement of compliance.

Aged↗