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E Lundorf

Publications and source records attributed to E Lundorf.

At least 19 recordsLinked to original sources
PubMed2003

Response, relapse and mucosal immune regulation after infliximab treatment in fistulating Crohn's disease.

BACKGROUND: Infliximab reduces mucosal inflammation in some, but not all, patients with Crohn's disease. AIM: To monitor clinical data and changes in mucosal cytokine levels after infliximab treatment to identify differences between responders and non-responders. METHODS: Twenty-six patients with fistulating Crohn's disease received three infliximab infusions at weeks 0, 2 and 6. Follow-up was for 1 year and included clinical examination, colonoscopy, ano-rectal ultrasound and magnetic resonance imaging. Biopsies were taken at weeks 0, 8, 26 and 52. Cell cultures were established and analysed for tumour necrosis factor-alpha, interferon-gamma and interleukin-10 levels, and related to clinical status and fistula healing. RESULTS: Eleven of 15 patients (73%) with active disease (Crohn's disease activity index > 150) obtained remission (Crohn's disease activity index < 150) at 8 weeks. In in vitro cell cultures, there was reduced tumour necrosis factor-alpha and interleukin-10 production at week 26, with the latter persistent throughout the study period. When the disease deteriorated or relapsed, there was increased interferon-gamma production in in vitro cell cultures. Fistula healing was associated with reduced production of interferon-gamma, tumour necrosis factor-alpha and interleukin-10. CONCLUSIONS: Infliximab down-regulates mucosal immune activation in Crohn's disease. Monitoring of mucosal cytokine levels after infliximab treatment by whole biopsy cultures may be useful as interleukin-10, tumour necrosis factor-alpha and interferon-gamma production are different in responders and at relapse.

Adolescent↗
PubMed2001

Accuracy of magnetic resonance imaging in the diagnosis of deep vein thrombosis in asymptomatic patients with injuries of the lower extremity. A pilot study.

This is a prospective comparative study of magnetic resonance imaging (MRI) of the deep veins versus contrast venography in consecutive patients treated for various injuries to their lower extremities, showing no clinical symptoms of deep vein thrombosis. The majority of examinations referred to in this study were performed according to the following methodology: First, the patient was subjected to MRI. Subsequently, within a 24-h interval, he/she was subjected to contrast venography. The acquired results were compared in a blinded manner. The diagnostic indices for MRI were calculated on the assumption that the results of contrast venography were sure to give an accurate indication of either presence or absence of thrombosis. Thirty-six patients were included in the study, of which 27 (15 males) completed it. The overall incidence of distal deep venous thrombosis (DVT) was 22% (6/27). One patient showed extension of a crural thrombus into the popliteal vein. MRI did not detect any of the thrombi. This lack of result was ascribed to failure to fully demonstrate all segments of the crural veins. However, MRI did show three proximal thrombi in the superficial femoral vein, which were not shown by the venograms. Thus, both the sensitivity and specificity of MRI were 0%, so MRI proved to be of no value in the diagnosis of asymptomatic deep venous thrombosis in this study.

Adult↗
PubMed2001

Evaluation of the uterine cavity with magnetic resonance imaging, transvaginal sonography, hysterosonographic examination, and diagnostic hysteroscopy.

OBJECTIVE: To evaluate and compare the diagnostic accuracy of magnetic resonance imaging (MRI), transvaginal ultrasonography (TVS), hysterosonographic examination (HSE), and hysteroscopy in the evaluation of the uterine cavity. DESIGN: Independent double-blind study. SETTING: University medical hospital. PATIENT(S): One hundred six consecutive premenopausal women who underwent hysterectomy for benign diseases. INTERVENTION(S): Results of MRI, TVS, HSE, and hysteroscopy were compared with the results of histopathologic examination at hysterectomy (the gold standard). RESULT(S): The overall sensitivity was MRI 0.76, TVS 0.69, HSE 0.83, and hysteroscopy 0.84. The specificity was MRI 0.92, TVS 0.83, HSE 0.90, and hysteroscopy 0.88 (MRI, HSE, hysteroscopy vs. TVS <0.05). Polyps were missed in 9 of 12 cases at MRI, 7 at TVS, 4 at HSE, and 2 at hysteroscopy (MRI vs. hysteroscopy, and TVS vs. hysteroscopy <0.05). The sensitivity for identification of submucous myomas was MRI 1.0, TVS 0.83, HSE 0.90, and hysteroscopy 0.82; the specificity was MRI 0.91, TVS 0.90, HSE 0.89, and hysteroscopy 0.87 (MRI vs. TVS, and MRI vs. hysteroscopy). Magnetic resonance imaging was significantly more precise than TVS, HSE, and hysteroscopy in determining submucous myoma in-growth (2-way ANOVA <0.05). CONCLUSION(S): For exclusion of abnormalities in the uterine cavity, MRI, HSE, and hysteroscopy were equally effective and slightly superior to TVS. Magnetic resonance imaging and TVS missed endometrial abnormalities such as polyps, but MRI and HSE were most accurate for the evaluation of submucous myomas, and MRI was superior in evaluation of exact submucous myoma in-growth.

Adult↗
PubMed2001

Magnetic resonance imaging and transvaginal ultrasonography for the diagnosis of adenomyosis.

OBJECTIVE: To compare the diagnostic potential of magnetic resonance imaging (MRI) and transvaginal ultrasonography (TVS) in the diagnosis of adenomyosis. DESIGN: Double blind set-up. SETTING: University medical school. PATIENT(S): We studied 106 consecutive premenopausal women who underwent hysterectomy for benign reasons. INTERVENTION(S): Transvaginal ultrasonography and MRI were compared with histopathologic examination as the golden standard. MAIN OUTCOME MEASURE(S): Adenomyosis. RESULT(S): Twenty-two (21%) patients had adenomyosis. The sensitivity and specificity were as follows: sensitivity: MRI 0.70 (0.46-0.87) and TVS 0.68 (0.44-0.86) (P=.66); specificity: MRI 0.86 (0.76-0.93) and TVS 0.65 (0.50-0.77) (P=.03). The combination of MRI and TVS was most sensitive (0.89 [0.64-0.98]), but produced the lowest specificity (0.60 [0.44-0.73]). Adenomyosis was not detected by either MRI or TVS at uterine volumes >400 mL. Exclusion of uteri >400 mL from the analysis improved the diagnostic precision of MRI, but not that of TVS. The diagnostic accuracy at MRI was improved by calculating the maximum difference between the thinnest and thickest junctional zone (JZdif) (i.e., > or =5-7 mm). CONCLUSION(S): Magnetic resonance imaging was superior to TVS for the diagnosis of adenomyosis. Magnetic resonance imaging had a higher specificity than TVS, but their sensitivities were in line. The diagnostic accuracy of MRI, as that of TVS, was at an intermediate level, but the diagnostic accuracy of the former improved by exclusion of uteri >400 mL. The combination of MRI and TVS produced the highest level of accuracy for exclusion of adenomyosis, but the low specificity may necessitate further investigation of positive findings. Measurement of the difference in junctional zone thickness may optimize the diagnosis of adenomyosis at MRI.

Adult↗
PubMed2001

Peripheral vascular surgery and magnetic resonance arteriography--a review.

OBJECTIVES: to review the current status of lower limb MRA. DESIGN: a literature review based predominantly on a MEDLINE database search of English-language publications from January 1991 to October 2000. MATERIALS AND METHODS: twenty-eight articles, concerning non-enhanced MRA (13), gadolinium-enhanced MRA (14) or both (1), met the predefined requirement for quality. Results gadolinium-enhanced MRA (CE-MRA) seems to be more accurate, quicker and associated with fewer problems than non-enhanced (TOF) MRA. TOF-MRA has a sensitivity and specificity of 93% (range 64-100%) and 88% (range 57-100%) respectively, and CE-MRA presents values of 96% (range 71-100%) and 96% (63-100%), respectively, using conventional arteriography as the gold standard. Some articles report a substantial incidence of runoff vessels suitable for distal bypass visible on MRA but invisible on conventional arteriography. Gadolinium contrast is given intravenously and is generally well tolerated and has no known nephrotoxicity. CONCLUSION: CE-MRA is accurate compared to conventional arteriography, has the potential to increase the limb salvage rate for selected patients, is non-invasive and well tolerated.

Arterial Occlusive Diseases↗
PubMed2000

[MR-cholangiography in patients suspected with choledochus calculi].

To test a new non-invasive imaging method, magnetic resonance cholangiography (MRCP), we compared MRCP with intraoperative cholangiography (IOC) or endoscopic retrograde cholangiography (ERC). In 55 patients with 11 common bile duct stones MRCP identified all 11 stones and incorrectly found stones in seven additional patients. Predictive value of positive test was 61%, predictive value of negative test was 100%. As a consequence of MRCP, ERC or IOC can be avoided in 67% of the patients.

Adult↗
PubMed2000

[Magnetic resonance imaging of patients with perianal fistulas].

Magnetic resonance imaging (MRI) of the anal canal was retrospectively evaluated during a three year period in 67 patients with suspected perianal fistulae. In six cases the surgeon, who knew the results of the MRI, found a fistula not seen on MRI while MRI showed a fistula in one patient which could not be found at surgery. We recommend MRI in cases where an experienced surgeon has difficulties mapping the fistula tract.

Adolescent↗
PubMed2000

Incidence and growth pattern of vestibular schwannomas in a Danish county, 1977-98.

During a period of 21 years 162 acoustic neuromas or vestibular schwannomas (VS) were diagnosed in the county of Aarhus. During this period the incidence increased gradually, probably due to improvement of the quality of computed tomography imaging (CTI), and more widely available access to magnetic resonance imaging (MRI). Sixty-four patients were followed up by repeated CTI or MRI, whereas the remaining patients were referred for immediate operation. Six of the observed patients had their tumours removed after demonstration of continuous tumour growth. The observation of 64 tumours over periods between 5 months and 15 years provided useful information on the natural history of sporadic VS. Our results showed that 14 VS (22%) regressed, 35 VS (55%) did not grow or had only minimal growth (growth rate up to 1 mm/year), whereas 15 VS (23%) grew > 1 mm/year. All VS with positive growth had regular growth patterns.

Adult↗
PubMed2000

Diagnostic importance of magnetic resonance angiography in arterial reconstructive surgery.

Magnetic resonance angiography (MRA) permits the non-invasive visualisation of blood flow in arteries and veins. It has an enormous potential in imaging of various vascular pathologies and it has been establishing itself as a reliable alternative to widespread contrast X-ray methods explaining morphology of vascular system. This advanced and safe diagnostic method is very rarely used in the clinical practice of vascular surgeons in Slovak republic. The aim of this report is to outline a clinical importance of MRA for arterial reconstructive surgery, its advantages, limitation as an imagine technique and its practical application in different anatomical areas of the human body which are related to operative activity of vascular surgeons. It is intended for briefly comparing MRA with other vascular imagine techniques more common used in clinical practice of our surgical and vascular surgery departments and outpatient clinics.

Aortic Diseases↗
PubMed1999

Investigations into the natural history of vestibular schwannomas.

In the period from 1977 to 1996 143 vestibular schwannomas were diagnosed in 138 patients in the County of Aarhus, Denmark. The natural history of vestibular schwannomas was observed in 50 patients with 52 tumours who did not undergo immediate surgical removal of their tumour due to small tumour size, advanced age, poor general health and the patients' refusal of surgery. The management included serial CT- or MR-imaging and complete otoneurological evaluation. The imaging interval was between 6 months and 2 years and depended on the recorded growth rate. Thirty-three (64%) of the tumours showed continuous growth with a mean growth rate of 1.6 mm/year. In 11 (21%) of the tumours the size was unchanged and eight (15%) remitted. The last group consisted mainly of the largest tumours. Among the tumours with positive growth, 15 (45%) had a growth rate of 1 mm/year or less. Generally, our findings showed that approximately two-thirds of all the tumours did not grow, were getting smaller or had a growth rate sufficiently small to be simply watched. Additionally, our results suggest that some symptomatic tumours will grow to a certain point whereupon stagnation or remission occurs.

Denmark↗
PubMed1998

Clinical magnetic resonance imaging and arthroscopic findings in knees: a comparative prospective study of meniscus anterior cruciate ligament and cartilage lesions.

We compared the diagnostic and predictive value of magnetic resonance imaging (MRI) and clinical findings with arthroscopy in 61 knees in a prospective study. In meniscal tears, the accuracy and positive predictive value of MRI was found to be nearly twice that of clinical examination. The sensitivity, specificity, and negative predictive value of MRI were comparable to the figures found in other studies. We recommend MRI as a clarifying diagnostic tool when a clinical examination indicates a lesion of the meniscus. In our study, the clinical relevance of MRI in anterior cruciate ligament lesions and especially in cartilage lesions was more doubtful. The combination of clinical and MRI findings would reduce the number of blank arthroscopies to 5%. MRI is a valuable diagnostic tool in planning the type of anesthesia and treatment, and could significantly reduce the need for a second arthroscopy.

Adult↗
PubMed1997

[Intracranial lipomas].

Intracranial lipomas are rare lesions that should be regarded as congenital malformations. They are usually asymptomatic and incidental findings during neuroradiological investigations. Other brain malformations are often seen in association with intracranial lipomas. The most common is hypoplasia of the corpus callosum. An attempt at surgical removal is not advisable. Lipomas are strongly adherent to the surroundings and typically enclose both vessels and nerves. Magnetic resonance imaging is capable of differentiating lipomas from dermoid cysts and teratomas, making this the diagnostic method of choice.

Adult↗
PubMed1997

The size of acoustic neuromas: CT and MRI.

The growth rate of acoustic neuromas is very variable: some tumours grow rapidly, some do not grow and some even get smaller. When making treatment decisions, it may be important to have an idea of the growth rate of the individual tumour, and this is only possible when there are comparable examinations. We performed both CT and MRI on 15 patients. Two radiologists estimated the size of their acoustic neuromas. There was a significant difference between the two examiners' calculations of tumour volumes on CT and between the first examiner's CT and MRI volume calculations. No difference was found between the two MRI volume estimations or the second examiner's estimation of volumes on CT and MRI. Measurements of the maximal tumour diameter along the pyramid showed good concordance. We conclude that measurement the size of acoustic neuromas is reproducible with MRI and the measurement of the maximal tumour diameter is in practice a better parameter for comparison than calculation of real volume.

Adult↗
PubMed1997

Tumour oxygenation assessed by polarographic needle electrodes and bioenergetic status measured by 31P magnetic resonance spectroscopy in human soft tissue tumours.

The purpose of this study was to evaluate the feasibility of polarographic oxygen electrode measurements and phosphorus magnetic resonance spectroscopy (31P-MRS) in extravisceral soft tissue tumours, designated to receive preoperative radiotherapy. Pretreatment tumour oxygenation was determined in 41 cases and 31P-MRS was amenable to lesions in 34 patients. Biopsies were characterized histopathologically as 25 primary soft tissue sarcomas (STS), 2 recurrent STS, 9 benign and 5 other malignancies. Evaluation of phosphorus (31P) spectra was possible in 11 cases. The oxygenation status of normal tissue was higher than that of tumours, whereas no difference was found between oxygenation status of benign lesions and that of STS. There was substantial variation between tumours in the median pO2 and the bioenergetic status (beta-NTP/Pi). No correlation was found between tumour pO2 and volume (n = 25). Moreover, there was no correlation between beta-NTP/Pi and the median tumour pO2, the fraction of pO2 values < or =2.5 mmHg or tumour volume (n = 10), respectively. In conclusion, oxygen electrode assessment was found to be a clinically applicable and feasible technique for measuring tumour oxygenation status, whereas the success of 31P-MRS in human neoplasms was limited by a very poor resolution in the phosphorus signal that allowed analysis of 31P spectra in 11 tumours out of 34 cases.

Adult↗
PubMed1996

[Can magnetic resonance imaging differentiate between benign and malignant conditions in patients with skeletal or soft tissue tumors?].

The records of 437 patients referred preoperatively for magnetic resonance imaging (MRI) due to clinical or radiological suspicion of a bone or soft-tissue malignancy were examined retrospectively in order to evaluate how good MRI is at distinguishing malignant from benign lesions. The MR-examination tends to overestimate malignancy. In all cases, the preoperative MR-examination correctly identified all malignant tumours as malignant, but also estimated a number of benign lesions as malignant. Sensitivity, specificity and predictive value was 100%, 71.2% and 76.4% respectively. In case of bursa/ganglion and pseudotumour, MR was able to correctly identify these lesions as benign. MR could not differentiate between the different types of sarcomas.

Diagnosis, Differential↗
PubMed1996

Hemifacial spasm: magnetic resonance angiography.

Twenty-three consecutive patients with hemifacial spasm were studied. Magnetic resonance imaging angiography of the brain was performed in 20 patients and 15 controls. The angiograms were evaluated by two independent observers and blinded for side-location of the spasm. Contact between an artery from the vertebrobasilar circulation and the intracranial part of the facial nerve was observed ipsilaterally to the spasm in 17 patients (85%) and in two of 30 control half-brains (7%), respectively. Treatment is discussed. The study confirms that arterial relation to the facial nerve root is the most frequent cause of hemifacial spasm. Magnetic resonance imaging is recommended to exclude mass lesions in the posterior cranial fossa, and magnetic resonance angiography is recommended in preoperative evaluation and in research.

Adult↗