[Magnetic resonance tomography of the cervical spine in complete paraplegia].
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Biomedical subjects
Publications and source records attributed to H K Beyer.
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We report the results of magnetic resonance imaging (MRI) of the liver in 46 patients with various previously confirmed focal lesions. A characteristic signal pattern was found in hemangiomas (n = 11), with marked signal hyperintensity on T2 and proton weighted images as compared to normal liver tissue. Cysts (n = 7) also showed marked hyperintensity on T2 images, but could easily be differentiated by a lesser intensity on proton weighted images and signal hypointensity on T1 weighted images. Primary liver tumors (n = 4), metastatic liver disease (n = 18), focal nodular hyperplasia (n = 5), and liver adenoma (n = 1) revealed a weak signal hyperintensity on T2 images, with varying signals in T1 and proton weighted modalities. These data combined with other recent communications in the literature indicate that MRI is a promising diagnostic technique in the detection of focal liver lesions and that it may offer a high degree of specificity in the diagnosis of hepatic hemangiomas and benign cysts.
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The most frequent cause of contrast media extravasation from the renal pelvis is a nephrourolithiasis. There are frequent causes enumerated in the literature, that are also characterized by a mechanical obstruction of the contrast media excretion. The presented case reports are characterized by a technical dependency, namely a long angiographic investigation and an overfilling of the urinary bladder without any indication of an organical excretory impediment. The clinical consequence of such observations should be discussed. 150 ml contrast media should not be exceeded during one examination.
DSA of the supraaortal extracranial arteries and intracranial arteries was performed in 568 patients suffering from cerebrovascular insufficiency. The results of this study showed a relationship between the atherosclerotic stenosis of the extracranial arteries and the occlusion of the A 1 segment of the anterior cerebral artery.
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Magnetic resonance tomography (in three planes) was performed on 21 patients in whom echocardiography, angiocardiography or a chest X-ray had indicated or was suspicious of intra- or paracardiac space-occupying lesions. MR imaging demonstrated bronchial carcinoma with aortic displacement in two (one of them also with vena cava occlusion); hypernephroma with displacement of the right atrium in one; paracardiac teratoma in two and lipoma in one; aortic aneurysm in two; atrial tumour in five; atrial thrombi in one; ventricular thrombi in four; and exclusion of intra-cardiac lesions in two. Thus the method distinguished between vascular and tumourous paracardiac space-occupying lesions and demonstrated origin and structural relationship of paracardiac tumours, especially to the great vessels. Size, shape and mobility of intracardiac tumours was also demonstrated. For both intra- and paracardiac space-occupying lesions there were the beginnings of structural differentiation.
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We examined 21 patients with tumours of the mouth, one with tumour involvement of the facial skeleton and three with lymph node involvement in the upper neck, by nuclear tomography. Twenty patients with carcinomas of the mouth were also examined by CT. Nuclear tomography was superior to CT in showing the extent of the tumour; in ten patients the extent of the tumour could not be accurately determined, since there was no clear demarcation from normal tissue. Amongst our patients, nuclear tomography was also superior for showing lymph node metastases. Computed tomography is better at showing bone infiltration. Our results indicate that nuclear tomography is better than CT for showing the tumour and lymph nodes. If there is a suspicion of bone involvement, CT should be used in addition.
Discs of 23 patients and volunteers were examined for the purpose of obtaining T1 and T2-relaxation times. First of all, the signal characteristics of the surface coil were evaluated. The relaxation times of 100 discs were then measured by using standard spin echo sequences. There was a correlation between age and T2-values for healthy discs (R = -0.744). This was not found in case of degenerated discs. The mean value of T1 for healthy discs was found to be 825 ms. The results show a possibility of using relaxation measurements in routine diagnosis for the early identification of disc degeneration.
Twenty patients who had suffered spinal trauma were examined by magnetic resonance tomography. Fifteen patients with first degree trauma in Erdmann's classification showed no abnormality. Magnetic resonance tomography of the cervical spine appears to be a suitable method for investigating patients with whiplash injuries. It is indicated following severe flexion injuries with subluxations and neurological symptoms, since it is the only method that can demonstrate the spinal cord directly and completely and show the extent of cord compression. For patients with thoracic trauma and rapidly developing neurological symptoms, magnetic resonance tomography is ideal for showing post-traumatic syringomyelia. Magnetic resonance tomography following whiplash injuries is recommended if plain films of the cervical spine show any abnormalities, as well as for the investigation of acute or sub-acute neurological abnormalities. The various findings are discussed.
MR imaging (MRI) possesses good sensitivity in diagnosis of carcinoma of the prostate. It is often not possible to distinguish clearly between carcinoma of the prostate and prostate hypertrophy. MRI can assess the local extension of a prostate carcinoma with a high degree of accuracy (85%); this applies in particular to periprostatic infiltration. MRI possesses only moderate sensitivity in diagnosis of regional lymph node metastases in the minor pelvis.
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The authors report on the application of intraarterial renal digital subtraction angiography in 82 patients and more than 122 conventional angiographies. The radiological criteria of renal carcinoma are discussed. The value of angiography in relation to other imaging methods is assessed and compared.