Fast gradient echo (GE) MR imaging during breathhold was performed in 73 abdominal MR examinations in order to determine the value of GE technique in the reduction of movement artefacts and improvement of image quality. The results were compared with conventional spin-echo (SE) technique. T1-weighted SE images consistently demonstrated normal anatomy and pathology. T2*-weighted and intermediate GE technique proved to be superior to T2-weighted SE technique in a considerable number of cases providing not only better delineation of normal structures but also better lesion detection. At this stage GE technique should be considered as an adjunct to T1-weighted SE technique. If the artefacts presently inherent to GE imaging could be reduced or compensated for, this technique of rapid MR imaging during suspended respiration could become an important tool being one of the fastest techniques for abdominal MR imaging.

Abdomen↗

PubMedDate not supplied

Rapid deterioration of diabetic retinopathy during treatment with continuous subcutaneous insulin infusion.

The effect of continuous subcutaneous insulin infusion (CSII) on diabetic retinopathy was studied in 19 patients with insulin-dependent diabetes mellitus (IDDM). All had diabetes before age 30. Three patients had no retinal abnormalities at the start of the study, 12 had minimal or mild background retinopathy, and 4 had a preproliferative retinopathy. The follow-up period was 12-14 mo. Fundus photography and fluorescein angiography was performed every 2-6 mo. Despite marked improvement of metabolic control, none of the patients with retinopathy showed reversal of the fundal abnormalities. In seven patients with background retinopathy the abnormalities remained unchanged; in five patients a slight worsening was noted. Four patients with moderate-to-severe background retinopathy showed a rapid and severe progression of the fundal abnormalities into a florid proliferative diabetic retinopathy 3-6 mo after initiation of CSII. A higher incidence of hypoglycemic episodes could not be demonstrated in this group. Two of these patients showed a marked reduction in glomerular filtration rate (GFR), 34% and 38%, respectively, during the course of their follow-up. This is compared with a decrease in GFR by only 5.6% for the group as a whole. The four patients with rapidly progressive retinopathy all had long-standing poorly controlled diabetes with preproliferative retinal changes, diabetic neuropathy, and, with the exception of one patient, signs of nephropathy at the start of CSII. The incidence of these features was nil or very low in the remaining 15 patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗