Problems related to the administration of ACTH.
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Biomedical subjects
Publications and source records attributed to C Hamburger.
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Forty-eight patients with skull base tumors were evaluated prospectively with T1-weighted spin-echo two-dimensional (2D) magnetic resonance (MR) sequences, a three-dimensional (3D) MR TurboFLASH (fast low-angle shot) sequence, and a 3D reconstruction window technique. All patients underwent surgery with histopathologic correlation, and the three MR imaging techniques were compared to assess representation of tumor margins and the topographic relationship of tumor to surrounding tissue and adjacent vasculature. The best results were obtained with standard 2D spin-echo sequences after administration of the paramagnetic contrast agent gadopentetate dimeglumine. The 2D MR sequences gave the highest contrast-to-noise ratios, with decreasing values for 3D sequences and 3D reconstructions, respectively. Nevertheless, 3D MR imaging, by virtue of its good representation of adjacent structures, aided surgeons in planning surgical intervention. This study presents the technical features of 3D imaging of the skull base, the choices involved in its implementation, and its potential clinical applications.
Localized proton NMR spectroscopy in vivo allows focal studies of cerebral metabolites in both man and laboratory animals from image-defined regions as small as 1 mL or 64 microL, respectively. Although brain tumours lead to remarkable spectral alterations relative to normal brain, a number of problems may compromise the interpretation of the results. Potential complications arise from the chosen experimental conditions (method, TE, size and location of volume of interest), from regional metabolic heterogeneity in and around tumours, from differences between human tumours and animal models, and from discrepancies between in vivo and in vitro findings. Strategies and pitfalls are illustrated with use of selected examples from primary brain tumours, a rat tumour model and perchloric acid extracts of resected specimens.