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Biomedical subjects

H Henkes

Publications and source records attributed to H Henkes.

At least 73 records · Page 4Linked to original sources
PubMed1991

[Cerebral MRT in x chromosome linked adrenoleukodystrophy].

Adrenoleukodystrophy (ALD) is a rare lipid storage disease, characterized among other symptoms by a progressive demyelinization of white matter. Changes are well demonstrated by MRT: Leukencephalopathy begins symmetrically in the occipital lobes of the cerebrum and involves furthermore the splenium of the corpus callosum, the nucleus dentatus and the descending tracts. As neurologic signs may precede signs of adrenal insufficiency, MRT may be important to suspect the diagnosis of ALD, which generally is diagnosed by biochemical tests.

Adrenoleukodystrophy↗
PubMed1991

[MRT and 99mTc-HM-PAO SPECT of the brain in myasthenia gravis].

Fourteen patients suffering from myasthenia gravis underwent cranial MRI and 99mTc-HM-PAO SPECT examinations. T2-WI revealed solitary white matter and/or basal ganglia lesions in four, multiple lesions in eight patients. The evaluation of the rCBF demonstrated a circumscript decrease of cortical perfusion in one patient whereas eight patients showed multiple cortical areas of hypoperfusion. In the context of an increased incidence of intrathecal immune reaction as well as of a constantly impaired cognitive performance of these patients, imaging findings might be a correlate of a primary cerebral manifestation of myasthenia.

Adult↗
PubMed1991

[Venous anomalies of the brain. The clinical significance of the so-called venous angioma].

In contrast to angiography, MRI not only allows the diagnosis of DVA (developmental venous anomaly, so-called venous angioma), but also shows up cavernomas and other angiographically occult vascular malformations. It also differentiates between DVAs and occult true malformations. This has completely changed the pathological assessment of DVAs. In a retrospective study on 31 patients with angiographically proven DVAs neighbouring cavernoma was a frequent finding (15 patients, 48% group I). Symptoms caused by cavernoma were present in 6 (40%) of these 15 patients. The following associations were also found: cerebral arterial aneurysm (2), spinal arterio-venous dural fistula (1), dermal haemangioma (1), Klippel-Trénauny syndrome (1). Only 16 (52%) of the 31 cases with DVA were free of associated cavernoma (group II). Only 3 (19%) of these patients with a solitary DVA were symptomatic. In our series we have seen no case of bleeding from a DVA. A DVA is a vascular anomaly characterized, like other anomalies, by reduced resistance and limited capacity for regulation and adaptation. In rare cases this can result in haemodynamic disturbances, thrombosis and ischaemia. Wall rupture with bleeding does not occur in DVA. It must be assumed that bleeding reported in patients with DVAs before the availability of MRI resulted from an associated true vascular malformation in most cases.

Adolescent↗
PubMed1991

[Sturge-Weber syndrome. Diagnostic imaging relative to neuropathology].

Clinical presentation of a child with port-wine stain and seizures leads to the suspicion of Sturge-Weber disease (SWD). This diagnosis can be confirmed by the detection of a meningeal angiomatosis. In rare cases, early detection of meningeal pathology by ultrasound has been reported. Key findings are brain atrophy, gyriform cortical calcifications demonstrated by skull radiographs after the first year of life or earlier by cranial CT, and dys- or aplasia of the deep cerebral veins on angiography. Radionuclide imaging shows focal or diffuse tracer accumulation over the affected brain regions. MR demonstrates an abnormal appearance of the affected meninges, especially thickening and pathologically increased signal intensity after Gd-DTPA application. This, in association with the demonstration of abnormal enhancement in deep medullary veins, is the most characteristic finding. Contrast-enhanced MR allows early and non-invasive diagnosis of SWD, mainly by revealing leptomeningeal angiomatosis and abnormal venous vessels.

Adolescent↗
PubMed1991

[Radionuclide cisternography: SPECT- and 3D-technique].

Radionuclide cisternography is indicated in the clinical work-up for hydrocephalus, when searching for CSF leaks, and when testing whether or not intracranial cystic lesions are communicating with the adjacent subarachnoid space. This paper demonstrates the feasibility and diagnostic value of SPECT and subsequent 3D surface rendering in addition to conventional rectilinear CSF imaging in eight patients. Planar images allowed the evaluation of CSF circulation and the detection of CSF fistula. They were advantageous in examinations 48 h after application of 111In-DTPA. SPECT scans, generated 4-24 h after tracer application, were superior in the delineation of basal cisterns, especially in early scans; this was helpful in patients with pooling due to CSF fistula and in cystic lesions near the skull base. A major drawback was the limited image quality of delayed scans, when the SPECT data were degraded by a low count rate. 3D surface rendering was easily feasible from SPECT data and yielded high quality images. The presentation of the spatial distribution of nuclide-contaminated CSF proved especially helpful in the area of the basal cisterns.

Adult↗
PubMed1990

"Meningeal sign": a characteristic finding of meningiomas on contrast-enhanced MR images.

In meningiomas, a flat, contrast-enhancing, probably dural structure adjacent to the tumor can occasionally be observed on Gadolinium-DTPA enhanced MR images. This so called "meningeal sign" was evaluated with respect to the differential diagnosis of meningiomas in MR imaging. The study included 29 patients with intracranial meningiomas and 24 patients with non-meningeal brain tumors. In all meningiomas, MR studies included T2-weighted as well as unenhanced and Gadolinium-DTPA-enhanced T1-weighted images. In all non-meningeal tumors, Gd-DTPA-enhanced MR images were available. All images were evaluated with respect to the presence of the "meningeal sign". In meningiomas, a "meningeal sign" was seen in 15/29 cases on Gadolinium-DTPA-enhanced images. No abnormalities corresponding to the areas of contrast enhancement were found on unenhanced T2- and T1-weighted MR images. In non-meningeal tumors only 2/24 cases showed a "meningeal sign". In conclusion, with a sensitivity of 52% and a specificity of 92%, the demonstration of the "meningeal sign" improved the differential diagnosis of intracranial meningiomas in contrast-enhanced MR imaging.

Adult↗
PubMed1990

Intracranial meningiomas. Comparison of plain and contrast-enhanced examinations in CT and MRI.

Fifty patients with intracranial meningiomas underwent plain and contrast-enhanced examinations with CT and MRI. Each of the MR studies consisted of three plain (T1, proton density and T2-weighted) and a post-contrast series (0.1 mmol Gd-DTPA/kg body weight). All techniques (plain CT, plain MRI, contrast-enhanced CT, contrast-enhanced MRI) proved to be highly efficient as regards tumour detection: depending on the technique, an intracranial lesion was demonstrated in 47-50 cases. The image contrast was assessed as good or excellent in 21 cases having plain CT and in 33 cases having plain MRI, but in 46 and 50 of the contrast-enhanced CT and MRI studies respectively. Adequate tumour delineation was achieved in 18 cases with plain CT, in 35 cases with plain MRI and in 46 and 50 cases of the contrast-enhanced CT and MRI examinations. The contrast-enhanced studies proved to be superior to the plain CT and MRI studies as regards image contrast and tumor delineation. Because of the methodological advantages of the MRI technique, contrast-enhanced MRI was judged to be slightly superior to contrast-enhanced CT.

Adult↗
PubMed1990

Multiple slice FLASH imaging: an improved pulse sequence for contrast enhanced MR brain studies.

A multisclice gradient echo sequence (FLASH) was compared with a conventional spin-echo (SE) technique with regard to its value for contrast enhanced brain studies. In 50 patients with contrast enhancing intracranial lesions, MR studies (0.5 Tesla MR tomograph) were performed with SE images (SE 400/30; four images/3.4 min) and FLASH scans (FLASH 315/14, 90 degrees; 15 images/1.4 min) before and after Gd-DTPA. Based on visual and quantitative assessment diagnostic results of postcontrast SE- and FLASH images were equivalent with respect to contrast enhancement, lesion/brain-contrast, lesion/edema-contrast, and lesion delineation. Although image quality generally was excellent on postcontrast FLASH images, susceptibility artifacts were more severe on FLASH scans than on SE images. However, with the exception of postoperative patients with artifacts due to metal remains, diagnostic information was not decreased by artifacts on postcontrast FLASH images. In conclusion, because of the clearly higher efficiency of the multisclice FLASH technique, this pulse sequence offers the opportunity to speed up contrast enhanced brain imaging.

Adult↗
PubMed1990

Focal-unilateral accentuation of changes observed in the early stage of Creutzfeldt-Jakob disease.

We report on a 67-year-old male patient with progressive right-sided hemiparesis predominating in the arm and right-sided myoclonias. The EEG showed periodic delta activity in the left hemisphere. The patient died of pulmonary embolism 10 weeks after the onset of the symptoms. The neuropathological examination was indicative of Creutzfeldt-Jakob disease: distinct spongiform changes, nerve cell loss and proliferation of astroglia in the left hemisphere were found; in the right hemisphere, however, only a few circumscribed spongiform foci were seen. There was a clear correlation between the unilateral predominance of the EEG abnormality and neuropathological changes. The hypothesized spread of infection along commissural projection pathways is supported by this pattern of lesions.

Aged↗
PubMed1990

[Mini-septoplasty--for function and form].

Septoplasty often provokes aesthetic and unaesthetic sequelae of the anterior third and the tip of the nose. In a retrospective study of 100 patients these changes and sequelae have been analysed preoperatively and six months postoperatively. The postoperative changes are systematically referred to the surgical steps described in the operation notes. The dynamics of sculpturing the anterior border of the quadrangular cartilage, the effects of septal realignment, the influence on the tip support structures are outlined. The importance of minimum surgical touch is stressed. Examples of aesthetic and unaesthetic sequelae caused by functional septoplasty are presented.

Esthetics↗
PubMed1990

[Cerebral and meningeal manifestations of AIDS: sensitivity of CT and T2-weighted MRT (129 patients)].

We studied 129 AIDS patients with suspected or proved intracranial manifestations of the disease. The purpose of this study was to compare the diagnostic sensitivity of unenhanced and contrast enhanced CT and unenhanced T2-weighted MR. In 35/129 patients CT and MR findings were normal. In 37/129 patients equivalent findings were obtained with both methods. Although CT and MR demonstrated intracranial pathology in 25 cases, MR was clearly superior. Six of these cases had solitary lesions in CT, while MR demonstrated multiple lesions. MR detected more foci than CT. In 24 patients with normal CT, MR detected intracranial manifestations of AIDS, namely solitary lesions in 8, multiple lesions in 12 and meningeal alterations in 4 patients. In only 8 patients with normal MR findings, CT revealed pathological contrast enhancement in 2 and parenchymal calcifications in 6 patients. Thus, in 20% of our patients MR but not CT was diagnostic. In another 20% MR provided additional diagnostic information. In conclusion, MR is recommended as the imaging modality of choice in AIDS patients with non-conclusive cranial CT.

Acquired Immunodeficiency Syndrome↗
PubMed1990

MR-imaging findings in children with Sturge-Weber syndrome.

Intracranial extent and distribution of leptomeningeal angiomatosis, visualized by magnetic resonance imaging (MRI) with Gadolinium-DTPA (Gd-DTPA) enhancement, is demonstrated in four children with Sturge-Weber syndrome (SWS). Aged 7, 9, 11 and 19 months, they presented with cutaneous, neurologic and ocular symptoms at the time of MRI examination. Angiomatous alteration of the skull, atypically located and congested intracerebral and basal veins as well as intracerebral changes secondary to the leptomeningeal angiomatosis are demonstrated with T2 weighted images. Gd-DTPA enhanced T1 weighted images exhibit clearly the regional distribution of angiomatosis in the skull, meninges and within the brain. Before calcifications in children with SWS are detectable by CT, MRI is the method of choice to detect intracranial involvement. Enhancement with Gd-DTPA improves the diagnostic value of MRI, before neurological symptoms appear. Follow-up studies with Gd-DTPA enhanced MRI can be applied to recognize thrombotic changes of leptomeningeal angiomatosis as well as subsequent intracerebral impairment.

Atrophy↗
PubMed1990

[Magnetic resonance tomography of adrenoleukodystrophy].

Adrenoleucodystrophy (ALD) is an uncommon, sex-linked disease, characterised by the accumulation of very long-chain fatty acids in various tissues. There is a great predilection for young boys between the age of three and ten years. The disease ends fatally after a clinical course of several years. The clinical and MR findings of a child with typical ALD are presented. T2-weighted MR demonstrates confluent, symmetrical, hyperintense lesions of the occipital white matter bilaterally. After the application of Gd-DTPA, contrast enhancement is seen in the margins of the lesions indicating active demyelination. MR is recommended as imaging modality of choice in patients with suspected or confirmed diagnosis of adrenoleucodystrophy.

Adrenoleukodystrophy↗
PubMed1989

A comparative study of CT and MRI in midline tumors of childhood and adolescence.

In order to compare the validity of CT and MRI, we evaluated results of these studies in 40 children and adolescents suffering from supratentorial and infratentorial midline tumors. Plain and enhanced CT scans were compared with MRI for sensitivity, specificity and capacity to delineate the tumor. These parameters were evaluated by three independent investigators on a scale with four grades of accuracy. The results demonstrate greater sensitivity and better delineation of the tumor with MRI, but greater specificity in diagnosis of tumors with CT studies.

Adolescent↗
PubMed1989

[Psychomotor epilepsy--a comparison of CT and MR in 100 patients].

The value of CT and MR was studied in 100 patients with temporal lobe epilepsy. Axial CT scans were obtained before and after contrast injection. Coronary MR scans were carried out with T1-(SE 400/30, GE 315/14) and T2-weighted sequences (SE 1600/30 + 70). A circumscribed lesion was demonstrated in fifteen patients by CT and in 25 patients by MR. With the exception of a small area of calcification, all lesions seen on CT could also be recognized on MR. In four patients CT, MR and pathologic specimen could be compared following partial resection of temporal lobe. Localized glial reactions, which were not seen on CT, produced a signal difference on MR. Better sensitivity and improved demonstration of the temporal lobes makes MR the method of choice in the diagnosis of temporal lobe epilepsy.

Adolescent↗
PubMed1989

[Subacute cerebral infarct: native and contrast medium-enhanced MRT].

Twenty-five patients with clinical and CT findings indicating supratentorial cerebral infarct were prospectively studied with MR. MR examinations were performed between the 3rd and 150th day after stroke. T2-weighted axial images were compared with T1-weighted sequences after i.v. administration of Gd-DTPA. T2-weighted images demonstrated parenchymal lesions in all 25 patients. Postcontrast T1-weighted images, however, displayed pathologic contrast enhancement in only 19 areas of infarction. In 5 of the 25 patients, the use of Gd-DTPA provided additional diagnostic information by demonstrating gyral contrast enhancement as a pattern typical for ischemia. In 2 of the 25 patients, pathologic contrast enhancement was observed in an area that was isointense to the surrounding brain tissue on the T2-weighted images. In one patient, Gd-DTPA improved differentiation between areas of subacute and chronic infarction. At present, in the patient with suspected cerebral infarction, MR imaging after i.v. administration of Gd-DTPA appears recommended when clinical findings and CT are equivocal.

Acute Disease↗
PubMed1989

[MRT in primary and tumor-induced syringomyelia].

The MRI findings in 26 patients with primary syringomyelia and eight patients with a syrinx due to an intramedullary tumour were studied retrospectively. In general, the syrinx in the tumour cases resembled the appearance of primary syringomyelia. However, a specific and sensitive sign of tumour-induced syringomyelia was irregularity of the spinal cord close to the tumour (eight cases of eight), eccentric position of the lumen (seven of eight), and a diffuse increase of signal intensity on T2-weighted images (eight of eight). Primary syringomyelia also showed increased signal intensity on T2-weighted images outside the lumen, but this was closely related to the cavity. The use of Gd-DTPA improved demarcation of the tumour from the syrinx in all cases. Widening of the spinal canal and ectopia of cerebellar tonsils was a typical finding in primary syringomyelia. MRI proved a reliable method for distinguishing between a tumour-induced syrinx and primary syringomyelia.

Adolescent↗