MR of the normal and ischemic hip.
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Femur Head Necrosis↗
Biomedical subjects
D G Mitchell
Publications and source records attributed to D G Mitchell.
Development of standard materials for use with the hematofluorometer.
Two methods for preparing erythrocytes were evaluated for the purpose of developing stable, blood-based standard materials for the hematofluorometer. Erythrocytes washed with citrate-phosphate-dextrose solution and reconstituted with platelet-free plasma were stable for 12 weeks. Plasma-free erythrocytes washed with isotonic saline and resuspended in citrate-glycerol solution were stable for 18 weeks when stored at 4 degrees C. Consequently, plasma-free erythrocytes were successfully used as proficiency test specimens in the New York State Department of Health's Clinical Laboratory Evaluation Program for hematofluorometer users.
Animals↗
Acute toxicity of Roundup and Rodeo herbicides to rainbow trout, chinook, and coho salmon.
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Animals↗
The superior mesenteric artery fat plane: is obliteration pathognomonic of pancreatic carcinoma?
Obliteration of the fat plane surrounding the superior mesenteric artery has been described as characteristic of pancreatic carcinoma. To determine the specificity of this and other computed tomography findings in the pancreas and peripancreatic region, scans of 86 patients were reviewed without clinical history. Diagnoses included pancreatitis (26 patients); pancreatic adenocarcinoma (14 patients); lymphoma (17 patients); metastatic nonpancreatic carcinoma (14 patients); and normal findings (15 patients). Confluent adenopathy could not be reliably differentiated from a pancreatic mass except when adenopathy separated the common bile duct from the duodenum. Retrocrural adenopathy was unusual with pancreatic carcinoma. The fat plane surrounding the superior mesenteric artery was obliterated with pancreatic carcinoma (36%), nonpancreatic carcinoma (29%), and lymphoma (24%), but not with pancreatitis, although perivascular edema was seen in 19%. Evaluation of the celiac axis was less rewarding. Obliteration of the superior mesenteric artery fat plane is a sign of malignancy, but it is not specific for pancreatic carcinoma. We propose that the superior mesenteric artery origin be considered within a paraaortic space, separate from the anterior pararenal space. This explains its characteristic lack of involvement by pancreatitis.
Adipose Tissue↗
Adnexal masses: MR imaging observations at 1.5 T, with US and CT correlation.
To assess the role of 1.5-T magnetic resonance (MR) imaging in evaluation of the adnexa, 43 consecutive examinations that revealed 61 adnexal masses were retrospectively reviewed. T1- and T2-weighted images in coronal, axial, and/or sagittal planes were included. Available ultrasound (US) (n = 30) and/or computed tomographic (CT) (n = 9) scans were then correlated with the MR images. On T2-weighted images at least part of all adnexal masses was of higher signal intensity than surrounding muscle and adipose tissue, and therefore the adnexal masses were best seen with these sequences. T1-weighted imaging improved tissue characterization by revealing signal characteristics of fat in teratomas and characteristics of blood in endometriomas or hemorrhagic cysts, pelvic inflammatory disease, ovarian carcinomas, serous cystadenomas, and teratomas. MR imaging provided additional information or increased diagnostic confidence in 25 of 30 patients who underwent US or CT. MR imaging is a promising problem-solving modality after US in the study of adnexal abnormalities.
Adenoma↗
Femoral head avascular necrosis: correlation of MR imaging, radiographic staging, radionuclide imaging, and clinical findings.
To better correlate the appearance of avascular necrosis (AVN) of the femoral head on magnetic resonance (MR) images with the stage of disease, MR images of 56 proved AVN lesions were compared with staging from corresponding radiographs (n = 56), Tc-99m scans (n = 41), and grade of symptoms (n = 28). Fractures complicating AVN were seen in 28 (50%) of 56 radiographs (radiographic stages III-V). With long repetition (TR) and echo delay (TE) times, a characteristic "double line sign" consisting of high signal intensity inside a low-intensity peripheral rim was seen in 45 lesions (80%). The central region within the rim was isointense with marrow fat on both short and long TR and TE images in 20 (71%) of 28 lesions uncomplicated by fracture (stages I-II) but in only four (14%) of 28 stage III-V lesions (P less than .001). Symptoms were least severe in lesions isointense with fat and most severe in lesions with low-signal central regions at short and long TRs and TEs. The peripheral double line sign on long TR/TE images may add specificity to the diagnosis of AVN by MR imaging. A chronologic pattern of central MR signal features is presented which may allow staging of AVN by MR imaging.
Female↗
Complicated first-trimester pregnancies: evaluation with endovaginal US versus transabdominal technique.
Endovaginal ultrasound (US) was performed in 38 pregnant women at 5-12 menstrual weeks, when the initial transabdominal sonograms had been considered inconclusive or equivocal. Clinical follow-up disclosed 32 intrauterine pregnancies (12 living, 18 spontaneous incomplete abortions, and two embryonic demises) and six ectopic pregnancies. In the 32 intrauterine pregnancies (normal and abnormal), the correct diagnosis was made in all cases with endovaginal US. The endovaginal images demonstrated the intrauterine embryo, its heart motion, and the yolk sac more clearly and more often when these structures were not apparent on the transabdominal scans. Abnormal gestational sacs were better resolved. In the six cases of ectopic pregnancy, while an extrauterine ectopic sac was visualized in only three, absence of an intrauterine gestational sac was confirmed in all cases with endovaginal scanning. No endovaginal study yielded less information than its transabdominal counterpart. Endovaginal sonography is likely to be diagnostic when transabdominal images fail to yield a definitive diagnosis in early pregnancies.
Abdomen↗
Femoral artery pseudoaneurysm: diagnosis with conventional duplex and color Doppler US.
Three patients with clinically suspected pseudoaneurysm as a complication of femoral puncture were referred for ultrasound (US) evaluation with both conventional duplex Doppler US and color Doppler imaging. Pseudoaneurysm (n = 2) and simple hematoma (n = 2) were depicted with both Doppler systems, and a separate pseudoaneurysm and a hematoma were found in one patient. These diagnoses were confirmed surgically. Distinctive Doppler spectral waveforms and color Doppler findings enabled confident diagnoses. Color Doppler imaging allowed faster detection of intraaneurysmal flow, and the track between the injured artery and the pseudoaneurysm was identified only with color Doppler imaging. Duplex Doppler US with color Doppler imaging allows for the rapid, unequivocal diagnosis of pseudoaneurysm, thus enabling prompt treatment without the need for invasive diagnostic modalities.
Aneurysm↗
Chemical-shift MR imaging of the femoral head: an in vitro study of normal hips and hips with avascular necrosis.
To study the conventional and chemical-shift MR images of fatty, hemopoietic, and ischemic bone marrow, four normal femurs from autopsies and six femoral heads from total hip replacement done for avascular necrosis (AVN) were imaged with a small-bore 1.4-T MR unit. T1- and T2-weighted spin-echo images, fat- and water-selective spin-echo images, and out-of-phase images were obtained. The specimens were then sectioned, radiographed, and studied histologically. The capital epiphysis and greater trochanter in normal femurs had the highest signal on T1-weighted, fat-selective, and out-of-phase images owing to their high fat content. Fat-selective and water-selective images accurately depicted regions of fat and water, whereas T1-weighted, T2-weighted, and out-of-phase images were misleading in some cases. On T2-weighted images, a double line consisting of a rim of low signal with a high-signal inner border was noted surrounding AVN lesions. Histologic correlation showed that the low-signal outer rim was due to sclerotic bone, while the high-intensity inner border was due to granulation tissue and/or chondroid metaplasia. Fractures within the six AVN lesions were best seen on T2-weighted images, but these could not be distinguished from granulation tissue. On T2-weighted images, the weight-bearing cartilage had lower signal in five of six femoral heads with AVN. We conclude that the MR appearance of AVN reflects its complex histopathology. Direct spin-echo chemical-shift imaging can help correlate MR images with histology by providing information not available from conventional or out-of-phase images.
Adult↗
The biophysical basis of tissue contrast in extracranial MR imaging.
So that radiologists can understand better the differences between tissues that determine MR image contrast, the biophysical basis of proton-MR tissue contrast is reviewed. Differences in the molecular sizes of water, fat, and protein macromolecules affect the rate of molecular motion, which in turn influences relaxation times. Differences in the physical state of water within tissues determine the extent to which the motion of water is restricted by binding to hydrophilic macromolecules (e.g., protein), which in turn causes variable amounts of T1 and T2 shortening. Understanding these concepts and knowing the location in the body of free water, cellular tissues, fat, collagen, bone, and tissue iron improve the radiologist's ability to extract useful information from MR images.
Adipose Tissue↗
Prominent fetal breasts. A normal variant.
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Adolescent↗
Incidentally discovered carcinoma of the pancreas: a potentially indolent lesion.
As examples of unusually indolent behavior of pancreatic carcinoma, two cases are discussed in which the diagnosis was made serendipitously, without symptoms referable to the pancreas. In both cases dystrophic calcification was noted, and pleomorphic giant cells were aspirated from the tumor. In one case, the patient survived 2 yr after diagnosis, dying from unrelated causes. Findings from ultrasound, computed tomography, and magnetic resonance imaging are discussed. Incidental discovery of a pancreatic carcinoma does not preclude a protracted asymptomatic course.
Aged↗
Individual and combined toxicity of manganese and molybdenum to mussel, Mytilus edulis, larvae.
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Animals↗
Analysis of lead effects on in vivo antibody-mediated immunity in several mouse strains.
The effect of administration of lead acetate (10 mM in the drinking water) for 8 weeks on the in vivo sheep red blood cell (SRBC) specific plaque-forming cell (PFC) responses of inbred A, BALB/c, C57Bl/6, DBA/1, SJL, and NZW/NZB F1 mice and outbred CFW mice was examined to determine if lead was immunomodulatory in a genetically related manner. Lead did not suppress the SRBC-specific PFC/10(6) splenocytes or PFC/spleen response in any mouse strain when compared to the responses of strain-matched control mice. In addition, 10 mM lead-treated BALB/c mice manifested augmented PFC/10(6) splenocytes (17%; p less than .05) but unchanged PFC/spleen responses. Correspondingly, serum concentrations of SRBC-specific antibody (measured by radioimmunoassay) and serum immunoglobulin G, M, or A isotypes were also unchanged by lead acetate treatment in all tested mouse strains. There were no observable lead-related histopathological changes or deposition of immune complexes or antibasement membrane antibody in the kidneys of treated mice. Further, splenocytes from lead-treated, SRBC-immunized mice cultured with T-independent antigens (TNP-LPS, TNP-Ficoll) or with a T-dependent antigen (SRBC) exhibited direct and indirect specific PFC responses that were unchanged from those of control mice. The H-2K/D haplotypes of the outbred CFW mice were determined by microcytotoxicity to include r, q, u, and s. These results suggest that lead acetate (10 mM) administered po for 8 weeks does not suppress the primary direct humoral immune response to SRBC in inbred and outbred mice of several H-2 haplotypes (k/d; d; b; q; d,z; s; r; and u).
Administration, Oral↗
Serous carcinoma of the ovary: CT identification of metastatic calcified implants.
The metastasis along peritoneal surfaces of serous cystadenocarcinoma, the most common ovarian malignancy, occurs early and is present in most patients at the time of clinical diagnosis. In many patients, however, computed tomography (CT) is unable to demonstrate peritoneal metastases because of their small size and similarly has been unable to demonstrate metastases in normal sized lymph nodes. Serous cystadenocarcinoma contains histologic calcification in approximately 30% of cases; thus, CT scans were retrospectively reviewed in 15 patients with pathologically proved stage III or IV disease to detect calcified peritoneal metastases. Six patients had calcified peritoneal implants, five of which had perihepatic calcifications. One of the five also had calcified lymphatic metastases, some of which were in normal sized nodes. In three of these five, the examination was otherwise normal. Search for these calcifications should improve the sensitivity of CT in diagnosing metastases from ovarian carcinoma.
Calcinosis↗
Polycystic ovaries: MR imaging.
To determine the characteristic appearance of polycystic ovaries on magnetic resonance (MR) images, seven women with polycystic ovarian disease (PCOD) underwent MR examination of the pelvis. These MR images were compared with sonograms. Histologic material was available in two patients. Six of the seven women had characteristic, small peripheral cysts, best seen on T2-weighted MR images; these cysts were seen sonographically in only one case. The centers of nine of 14 ovaries were of low intensity with all MR pulse sequences; this low intensity corresponded with low echogenicity in six cases. Histologically, these areas correlated with hypertrophic cellular stroma. Coexisting central teratomas were seen in three ovaries. The ability of MR to display the findings of PCOD better than ultrasound and its ability to demonstrate coexisting pathologic conditions are valuable in imaging the female pelvis.
Adult↗
Hematopoietic and fatty bone marrow distribution in the normal and ischemic hip: new observations with 1.5-T MR imaging.
The conversion of hematopoietic to fatty marrow is known to correlate with physiologic decreases in intramedullary blood flow. To determine whether the chronology of conversion is altered in patients with hip ischemia, T1-weighted magnetic resonance (MR) images of the hips in 50 healthy people and 27 with documented avascular necrosis (AVN) were reviewed. The distribution of fatty (high-signal) versus hematopoietic (low-signal) marrow was noted with respect to age. All patients had fatty marrow in the femoral capital epiphysis and greater trochanter. Hematopoietic intertrochanteric marrow was seen in 95% (80 of 84) of femurs in control subjects less than 50 years old, but in only 12.5% (two of 16) of those in control subjects older than 50 years (P less than .005). Only 33% (19 of 57) of patients less than 50 years with AVN had predominantly hematopoietic intertrochanteric marrow (P less than .005). The early conversion to fatty marrow in most patients with AVN as depicted by MR imaging may be an effect of decreased vascularity of the proximal femur and may allow the identification of patients at increased risk for AVN.
Adult↗
Painful sickle cell crisis: bone marrow patterns observed with MR imaging.
Eleven patients with homozygous sickle cell anemia (SCA) undergoing painful crisis were studied with magnetic resonance (MR) imaging. The signal intensity of bone marrow was diffusely decreased in the axial and peripheral skeleton on short repetition time (TR)/echo time (TE) images and long TR/TE images, which suggested hematopoietic marrow hyperplasia and was confirmed by isotope marrow scans in five patients. Focal areas of further decrease in signal intensity were seen on short TR/TE images in 12 of the 14 (86%) painful joints and three of the five (60%) painless joints. In the painful joints, these focal areas converted to high signal intensity on long TR/TE images, presumably due to edema, which suggested acute marrow infarction. In the painless joints, these low-intensity focal areas remained as low signal on long TR/TE images, which suggested absence of edema and thus areas of old infarction or fibrosis. These results indicate that MR imaging may enable differentiation between acute and chronic marrow infarcts in patients with SCA and serve as a useful guide in monitoring and directing therapy.
Adult↗