Eight patients were examined by magnetic resonance imaging (MRI) at 1.0 T; seven had an angiographically proved spinal intradural arteriovenous malformation and one had a hemangioblastoma of the spinal cord. Myelography was also performed in five and computed tomography (CT) in four patients. The clinical and radiological findings are presented. MRI revealed the location and extent of the lesion. Myelomalacia, edema, and hematomyelia were demonstrated in three patients. In our opinion MRI is the method of choice for the diagnosis of spinal arteriovenous malformation and facilitates spinal angiography, whereas myelography and CT do not provide any further information.

Adolescent↗

PubMedDate not supplied

[Technique and value of imaging methods in the assessment of the elbow joint].

Roentgenography is the standard diagnostic tool for study of skeletal injuries and diseases around the elbow. The basic x-ray examination of the elbow includes the two standard static positions (frontal and lateral). If necessary oblique views are required to evaluate the radial head and the coronoid process. Dynamic examination (flexion-extension, ulnar-radial deviation) is indicated when instabilities are suspected. Indication, technique and interpretation of these images should be of general knowledge in the common practice of the orthopaedic surgeon. For further evaluation in unclear conditions the patient should be referred to a specialized orthopaedic surgeon, who has not only to decide about the indication of further imaging techniques but also has to establish a concept for the different treatment options (e.g. arthroscopy, open surgery).

Arthrography↗

PubMedDate not supplied

[Early diagnosis of postoperative discitis].

This study demonstrates that infection of the retro- and intradiscal space is probable, when the temperature rises above over 37 degrees and CRP exceeds 2.0 mcg/ml 5 days postoperatively. MRI of 4 patients confirmed a retrodiscal infection that was indicated by a hyperintense band shaped structure in PS-sequences and which was space occupying with respect to the dural sac. Discitis was demonstrated by intradiscal hyperintensity in STIR images and by enhancement in T1 weighted images following the application of Gadolinium DTPHA. Diagnosis is simplified by comparison of pre- and postoperative MR-examination. Infection can be cured by treatment with antibiotics (Tobramycin and Clindamycin) bedrest and plaster cast.

Blood Sedimentation↗

PubMedDate not supplied

[Long-term changes in proton spin tomography following chemonucleolysis].

6.5 years after lumbar chemonucleolysis (CNL) we examined 40 patients by MRI. All MRI studies were performed by a 1.0 tesla MRI. We documented the height of the discs, the chondrosis, the intradiscal MRI signal, as well as the intraosseous signal within the vertebral bodies (end plate reaction). Preoperative MRI studies (Tvor) and/or postoperative MRI studies within the first postoperative year (T1) of 18 patients were available. We found an overall reduction of the sagittal disc height of 26%. This reduction was 19% in the male patients and 45% in the female patients (p < 0.02). Comparing the T1-studies with the T6.5-studies, we could still reveal a proceeded reduction of 13%. In those patients who underwent three MRI studies, there was a reduction of 20% between Tvor and T1. Among one half of the patients we found a further decrease in disc height of 15% between T1 and T6.5, whereas the other half showed an increasing disc volume of 15%. At time of follow up (T6.5) all treated discs showed a reduced MRI signal (STIR) within the disc. The signal further decreased comparing the MRI signal (STIR) preoperatively with the follow up evaluation in 64.3% of the cases. However, we found an increase of the signal in 70% of the cases between T1 and T6.5. 6.5 years after CNL we documented an end plate reaction in almost 70% of all patients. There was no correlation between end plate reaction and age of the patients, level of CNL, amount of injected chymopapain or the clinical outcome.

Adolescent↗

PubMedDate not supplied

[Significance of nuclear magnetic resonance tomography for the diagnosis of degenerative diseases of the lumbar spine].

The authors report on the diagnosis value of magnetic resonance imaging (MRI) in diseases of the lumbar spine, assessed on the basis of 960 cases treated at Düsseldorf University Orthopedic clinic since 1982. Diseases can be differentiated by changes in shape (vertebral collapse due to tumors, spondylitides, disk prolapse etc.) as well as by structural and pathomorphologic changes (disk degeneration, upper plate reactions etc.). Seventy-four patients were examined for upper plate reactions, which were detected in particular with the partial saturation and the short-time inversion recovery sequences. On the basis of prospective studies the authors comment on the value of MRI as compared to computerized tomography for diagnosing disk prolapses and disk sequestra. It can be shown that the sensitivity and specificity of MRI are very good.

Humans↗

PubMedDate not supplied

[Intravenous administration of gadolinium DPTA in proton spin tomography of the knee joint].

UNLABELLED: In a prospective study we evaluated the benefits of iv-application of gadolinium-DPTA examining 25 patients with degenerative disease of the knee joint by MRI (1.0 Tesla). All patients were scanned with standard spin echo sequences (SE 500/20), short time inversion recovery sequences (STIR 1600/100), and FEDIF sequences (FEDIF 500/10). After gadolinium-DPTA application (0.1-0.35 mmol/kg BW) the patients were scanned with spin echo sequences (SE SE 500/20), and FEDIF sequences (FEDIF 500/10). After iv-Gadolinium the synovial membrane of joints with inflammation show significant increase of the signal. Due to this effect a differentiation between joint effusion and hypertrophic synovia is possible. Small areas of local synovitis not visible before the use of gadolinium can be documented. A differentiation between degenerative subchondral cysts and cysts due to an inflammatory process is possible. CLINICAL RELEVANCE: The use of iv-application of gadolinium-DPTA in patients with degenerative joint disease seems to offer additional information. With iv-application all shortcomings of intraarticular use can be avoided. The differentiation between degenerative and inflammatory processes is possible.

Contrast Media↗

PubMedDate not supplied

[Significance of imaging techniques (roentgen, scintigraphy, MRI) in the diagnosis and therapy planning of Perthes disease].

The value of MRT, bone scintigraphy and conventional radiographs were studied for early stage diagnosis of Perthes' disease. Our experience in a series of 28 patients showed MRI to have a 100% sensitivity and specificity compared with bone scintigraphy (68.1% and 66.7%) and normal radiographs (58.3% and 100%). MRT often demonstrates changes while the conventional radiographs or bone scans appear normal. This might reflect the ability of MRT to detect the histopathologic changes before a measurable bone mineral change occurs.

Child↗

PubMedDate not supplied

[The value of nuclear magnetic resonance tomography in diseases of the knee joint].

In a prospective study we examined 107 patients suffering from an acute trauma or a chronic disease of the knee joint by MRI. The MRI results were compared to the results of arthroscopy. Normal anatomical structures can be differentiated and there is a high diagnostic reliability for lesions of the medial (accuracy: 91%, predictive value: 84%) and lateral (accuracy: 93%, predictive value: 79%) meniscus, complete tears of the anterior cruciate ligament (accuracy: 93%, predictive value: 75%), chondropathia of the patella, and osteochondritis dissecans. Partial ruptures of the ACL as well as small cartilage defects could usually not be demonstrated.

Arthritis, Rheumatoid↗

PubMedDate not supplied

[Effect of bradykinin on pressure changes in the femur head epiphysis--an experimental and magnetic resonance tomography study].

AIM OF THE STUDY: The aim of this study was to evaluate the response of the femoral head to intraosseous pressure increases and to document blood flow of periarticular soft tissue after infusion of vasoactive substances. Beside that the value and imagery of native MRI after induced intraosseous pressure increase should be estimated for early detection of femoral head necrosis. METHODS: The alteration of intraosseous pressure and peripheral blood flow of the femoral head of beagle dogs was examined after administration of bradykinin as a vasoactive substance followed by subsequent magnetic resonance imaging (MRI). Bradykinin was injected into the arteriae circumflexae femoris lateralis and medialis of six beagle dogs. The administrations were made using a standard protocol with simultaneous measurement of venous blood flow and intraosseous pressure distribution in the epiphysis of the femoral head. Bradykinin was applied in regular time intervals followed by MRI. RESULTS: At a mean epiphyseal pressure 14.66 mmHg (sigma: 2.42) in the femoral head, a mean flow of 91.6 ml/min (sigma: 16.08) was measured in the vena femoralis. After an administration of a defined concentration of bradykinin an increased epiphyseal pressure was recorded in the measured area. An average increase blood flow of the vena femoralis was observed at the beginning of the bradykinin-injection, followed by a circulatory volume reduction. The post-experimental MRIs showed massive oedema in the femoral musculature after bradykinin-application, however without osseous signal alterations in T1- or STIR-weighted images. CONCLUSION AND CLINICAL RELEVANCE: Our results indicate that acute intraosseous pressure increases are not accompanied by signal alterations in MRI. Obviously more extensive pressure induced lesions are necessary for detectable signal alterations, as these have already been demonstrated in patients with diagnosed femoral head necrosis.

Animals↗