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Biomedical subjects

J Brismar

Publications and source records attributed to J Brismar.

95 records · Page 6Linked to original sources

Maple syrup urine disease: findings on CT and MR scans of the brain in 10 infants.

Ten infants with classical maple syrup urine disease (MSUD) and two with variant MSUD had a total of 26 CT scans and 13 MR examinations of the brain during different stages of their disease. We found that inter- and intrapatient analyses of CT and MR findings at times ranging from 3 days to 7 months were typical enough to suggest the MSUD diagnosis. Imaging studies showed the natural course of the disease and, in a few cases, illustrated the effects of therapy. CT scans typically are negative during the first few days of life, then a marked, generalized, diffuse edema appears. In addition, a localized, more severe edema (the MSUD edema) is seen, which involves the deep cerebellar white matter, the dorsal part of the brainstem, the cerebral peduncles, and the dorsal limb of the internal capsule. Both the generalized and the MSUD edema subside during the second month of life, then may disappear totally or leave a well-defined, low-density zone around the lateral ventricles and small, low-attenuation lesions within the brainstem, respectively. With the disappearance of the edema, some loss of brain substance becomes obvious.

Brain↗

Skeletal scintigraphy of the wrist in suggested scaphoid fracture.

Skeletal scintigraphy was performed in 187 patients with clinical suspicion of a scaphoid fracture but with normal radiographic findings. In 85 patients focally moderately (12 patients) or markedly to intensely (73 patients) increased radionuclide uptake was seen, over either the distal radius or carpal bones. A fracture corresponding to markedly increased uptake was eventually verified in 15 out of 26 patients in the distal radius, in 21 out of 28 in the scaphoid but in only 6 out of 18 in other carpal bones. One fracture of the body and one of the hook of the hamate were found, one fracture of the capitate and three of the triquetrum. Not a single fracture was verified in 10 patients with markedly, often intensely, increased activity over the trapezium/trapezoid. It is concluded that scintigraphy is of value in carpal trauma not only to exclude scaphoid fracture but also to direct the attention to the possibility of other carpal fractures, otherwise usually missed.

Carpal Bones↗

Bone scintigraphy in staging of bladder carcinoma.

The role of bone scintigraphy in the staging of bladder carcinoma before attempted radical therapy was evaluated from a personal series of 71 consecutive cases. The results from this were correlated to previous reports--accumulated data from a total of 458 staging bone scans were thus obtained. In this accumulated material metastases were diagnosed in 4.6 per cent--in 2.8 per cent true positive and in 1.7 per cent false positive findings. The effect of the bone scanning results on therapy was minimal: cystectomy was performed in spite of the diagnosis of metastases in 16 out of 21 patients. In only 4 patients (0.9%) surgery was avoided because of scintigraphy results. Scintigraphy thus has no place in the routine preoperative staging of bladder carcinoma.

Aged↗

Radiography and scintigraphy in the assessment of early gonarthrosis.

The radiographic and scintigraphic appearances in early gonarthrosis were compared in 62 knees. Early femorotibial osteoarthrosis was found to be confined to one compartment (medial or lateral) of the joint. However, concomitant patellofemoral osteoarthrosis was common. 99Tcm-MDP scintigraphy was consistently positive when the joint space (femorotibial and patello-femoral) was reduced by 75 per cent or more. Joint space narrowing by as much as 50 per cent could be observed in a scintigraphically normal knee. The inconsistency between the radiologic and scintigraphic findings in the earliest stages of gonarthrosis points to the importance of appropriate radiographic technique.

Aged↗

Technetium-99m-methylenediphosphonate scintimetry after femoral neck fracture. A three-year follow-up study.

Thirty-nine patients with femoral neck fractures were followed up clinically and radiographically by technetium-99m-methylenediphosphonate (99mTc-MDP) scintimetry two to 20 days and four, eight, 12, 24, and 36 months after surgery or until redisplacement, pseudarthrosis, or segmental collapse occurred. The scintimetric data were calculated by selecting regions of interest on the fractured and intact sides over the femoral head, neck, greater trochanter, and shaft; ratios of fractured/intact side were obtained for each region. Bone metabolism after femoral neck fracture was expressed and analyzed numerically. Prognosis regarding the course of healing could be made with precision by studying femoral head isotope activity shortly after surgery, preferably one to three weeks after operation. Intact femoral head uptake (ratio greater than 1.0) was connected with uneventful healing, while defective uptake (ratio less than 1.0) was observed with healing complications. The vast majority of femoral heads with primary uptake defects showed increased uptake (greater than 1.0) after four months, often as early as six to eight weeks, indicating revascularization. Segmental collapse, as well as redisplacement and pseudarthrosis, appear to be related to femoral head vascular injury. Femoral head uptake in patients in whom healing complications developed secondary to avascularity differed significantly from that in patients with normal healing, except at investigations performed four to eight months after operation. 99mTc-MDP uptake in the femoral neck, trochanter, and shaft areas was increased for all femoral neck fractures. Subsequent normalization was considerably slower in patients with healing complications. A significant difference from normal healing did not occur until 12-24 months after operation. For patients with contralateral hip disease affecting the femoral head ratio, the prognosis regarding complications was made with the aid of the femoral head/shaft ratio on the fracture side.

Adolescent↗