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Biomedical subjects

J Hodler

Publications and source records attributed to J Hodler.

191 records · Page 11Linked to original sources
PubMedDate not supplied

Fatty degeneration of the muscles of the rotator cuff: assessment by computed tomography versus magnetic resonance imaging.

Forty-one patients scheduled for shoulder surgery underwent computed tomography (CT) and magnetic resonance imaging (MRI) examination of their affected shoulder to verify whether fatty degeneration of the rotator cuff muscles could reproducibly be assessed by CT or by MRI and whether the grading with the 2 methods was comparable. In addition, rotator cuff muscle cross-sectional areas were measured on parasagittal MRI scans to establish a possible correlation between rotator cuff muscle atrophy and fatty degeneration. Interobserver reproducibility for grading fatty degeneration was good to excellent for CT and for MRI. The correlation between MRI and CT was fair to moderate and remained unsatisfactory, even if the classification system was simplified with only a 3- rather than a 5-grade scale as originally proposed. The degree of fatty degeneration was significantly related to the amount of atrophy of the respective muscles.

Adult↗
PubMedDate not supplied

[Computerized tomography in paleopathology].

Paleopathology is the study of human ailments in bygone times of which written records are non-existent or inadequate. Essentially, it is based on osteological findings. Radiologic examination, which reveals the inner structure of the bones, plays an important role. Additional information can be obtained with CT, primarily because there is no superimposition of the bones. The very detailed radiologic demonstration of a periosteal reaction on a tibia in a case of acquired syphilis is illustrated.

Bone and Bones↗
PubMedDate not supplied

[Magnetic resonance imaging of the foot].

We evaluated the diagnostic value of magnetic resonance imaging retrospectively in 72 patients (76 examinations). 10 examinations were normal, 2 showed normal variants, 21 inflammatory disease, 2 osteoarthritis, 7 neoplasia, 21 traumatic changes, 3 pathology in systemic disease, 5 avascular necrosis, 5 iatrogenic changes. When considering the original reports, accuracy had been 72.4%, sensitivity 75%, specificity 62.5%. After review of the hard copies several diagnoses were revised, improving the values to 86.6%, 84.4% and 100% respectively. Compared with other radiologic examinations the main advantages of magnetic resonance imaging were its high contrast resolution and the free choice of the imaging plane. The main disadvantages were the reduced spatial resolution compared to CT and the significantly worse definition of calcification and cortical bone. In conjunction with other radiologic and clinical examinations magnetic resonance imaging played an important role in the examination of avascular necrosis, inflammation, tendon pathology and neoplasia.

Adolescent↗
PubMedDate not supplied

[Arthroscopy and MRT of the shoulder--a comparative retrospective analysis].

MR Imaging is proving to an effective means for evaluating the shoulder. The use of a surface coil and high resolution scanning techniques have allowed detailed analysis of normal anatomy and suspected pathology of the shoulder. On the other way arthroscopic inspection provides a more extensive visualization of the joint in different positions. 31 patients, well documented, were studied with MR Imaging and correlated with findings in arthroscopy and open revision in some cases. The MR studies were retrospective interpreted without the knowledge of the results of other diagnostic procedures. For the evaluation of rotator cuff tears MRI proved to have a sensitivity of 83.3% and an accuracy of 90.3%. When Arthroscopy was correlated with open revision the sensitivity was 61.8% and the accuracy 78%. Labral pathology and Hill-Sachs lesions will be better evaluated in arthroscopy as in MRI (sensitivity of arthroscopy 100% and of MRI 69%, accuracy of arthroscopy 100% and of MRI 87.1%). With the high resolution scanning technique and a surface coil MRI has been shown to be useful in the evaluation of rotator cuff tears and impingement syndrome but not in diagnosis of labral pathology and Hill-Sachs lesions.

Adolescent↗
PubMedDate not supplied

[Fatigue fracture as a tumor-simulating lesion. Differential diagnostic delimitation using proton spin tomography].

Fatigue (stress) fractures are due to increased repetitive stresses. The onset of clinical symptoms and the pain characteristic usually are vague; furthermore the radiographic picture shows lesions of different age and therefore may mimic a pattern typical of bone tumors. While for malignant bone tumors early diagnosis, biopsy and initiation of the appropriate treatment is of importance, the biopsy of a fatigue fracture is not only unnecessary, but also may interfere with the healing process. The value of magnetic resonance imaging in the differential diagnosis between tumors and fatigue fractures has therefore been analysed. Five consecutive cases of fatigue fractures have been evaluated from the onset of symptoms for a mean of 19 month (range 3-45 month) of follow-up. The signal pattern with low intensity in the area of the lesion in T1- and T2-weighted images seen in 2 cases has lead to observe the process under immobilization of the affected limb, while because of an increase of the signal intensity from T1- to T2-weighted images as seen in almost all malignant bone tumors biopsy has been performed in 2 cases. In 1 cases no biopsy but close-meshed clinical examinations were performed although there was an increase of the signal. From these observations we conclude that the MRI in fatigue fractures may either show a 'chronic' type of reaction with low signal intensity allowing for the caution observation while in cases with the rather 'acute' reaction with increased signal biopsy usually cannot be avoided in order not to miss a malignant tumor.

Adolescent↗
PubMedDate not supplied

Gadolinium-DOTA enhanced MR imaging of adnexal tumors.

We conducted a retrospective study to assess the potential of contrast enhanced magnetic resonance (MR) imaging in evaluating adnexal tumors. Sixty patients with a total of 77 pelvic lesions underwent MR imaging at 1.5 T and transabdominal ultrasound (US). Precontrast T1- and T2-weighted and Gd-DOTA enhanced T1-weighted MR images were obtained. Diagnoses were proved by surgery in 57 patients. Of the 77 lesions, 54 masses were of ovarian origin, including 12 malignant disorders. Ultrasound demonstrated the lesions in 92%, whereas the sensitivity of unenhanced T2-weighted and postcontrast MR images was 98 and 96%, respectively. Compared to the T2-weighted images, postcontrast MR imaging showed superior overall tumor delineation, assessment of intratumoral architecture, and definition of tumor origin. Contrast enhancement of tumors did not differ significantly between normal ovary and benign and malignant lesions. All modalities were unable to predict malignancy of complex lesions. Based on our study, US remains the screening modality of choice in the evaluation of adnexal tumors. Contrast enhanced MR imaging may be valuable for assessing complex lesions or when the origin of the mass cannot be determined by US. Using contrast enhanced T1-weighted images instead of T2-weighted images may lead to a significant reduction in acquisition time.

Adnexal Diseases↗
PubMedDate not supplied

Knee joint hyaline cartilage defects: a comparative study of MR and anatomic sections.

The value of routinely used MR sequences in the detection of focal changes of femorotibial articular cartilage was studied. T1-weighted, proton density, and T2-weighted SE as well as gradient echo images were acquired in 20 cadaveric knees (56-88 years old, mean 73.8 years). Three hundred five coronal and sagittal (3 mm) anatomic sections were prepared, and 82 areas of cartilage defects were identified. Initially, in an unblinded fashion, correlation of MR scans and anatomic sections was performed. Fifty-nine lesions (72.0%) were detectable on T1-weighted images, 57 (70.0%) with meniscal windowing, 49 (60.0%) on proton density images, 56 (68.3%) on T2-weighted images, and 54 (65.9%) on gradient echo images. Sixty-eight (83.0%) were visible on at least one type of imaging sequence. Most defects presented as a focus of abnormal signal. Subsequently, images of a subset of 35 pathologic and 35 normal cartilage surfaces were blindly evaluated by two osteoradiology fellows. Sensitivity was 71.4% for the detection of focal cartilage changes, specificity was 68.6%, and accuracy was 70.0%. We conclude that the value of those MR sequences that are routinely used in the analysis of internal derangements of the knee in the detection of focal defects of the hyaline cartilage is limited.

Aged↗
PubMedDate not supplied

MR arthrography of the elbow: normal anatomy and diagnostic pitfalls.

PURPOSE: Our goal was to determine the normal MR arthrographic appearance of the elbow and to identify the potential diagnostic pitfalls of this technique. METHOD: MRI with intra-articularly administered gadopentetate dimeglumine was performed in seven elbow joints derived from cadavers. Coronal, sagittal, and axial SE T1-weighted images with fat suppression and coronal 3D SPGR images with fat suppression were obtained in each elbow. The elbows were then sectioned. RESULTS: This technique allowed depiction of the cartilaginous surfaces of the elbow joint as well as clear delineation of the inner surface of the collateral ligaments. Potential diagnostic pitfalls included fat pads projecting into the joint, synovial folds, and cartilaginous pseudoerosions. CONCLUSION: MR arthrography allows clear delineation of the intraarticular structures of the elbow. However, diagnostic pitfalls exist that increase the difficulty of interpreting MR arthrographic images.

Aged↗
PubMedDate not supplied

MRI of the common peroneal nerve: normal anatomy and evaluation of masses associated with nerve entrapment.

The objective of this pictorial essay is to illustrate the MR appearance of the common peroneal nerve and the appearance of masses that have been associated with peroneal nerve entrapment. Four human cadaveric knees underwent axial MRI utilizing a T1-weighted SE sequence. One knee was dissected by an orthopedic surgeon and three knees were transversely sectioned, and the gross morphology of the common peroneal nerve and the perineural structures was evaluated and correlated with the MR images.

Adolescent↗
PubMedDate not supplied

[Possibilities and relevance of three-dimensional reconstruction of the sacroiliac joint].

The sacroiliacal joint is difficult to evaluate clinically due to its complex form and its topographical position, deep in the body and surrounded by other skeletal structures. We evaluated the potential role of three-dimensional reconstruction and segmentation of CT data of this joint. A total of five patients were examined (age range 24-60 years). In three of these only surface reconstructions were obtained; in the other two, segmentation was obtained as well in order to directly visualize the joints surfaces of the sacroiliacal joint. Compared to conventional radiographs and standard CT, three-dimensional reconstruction and segmentation of the sacroiliac joint did not add significant information. The subtle skeletal findings occurring in inflammatory and degenerative disease were obscured by the process of segmentation. Therefore, radiographs and, in selected cases, CT remain the imaging methods of choice for the evaluation of sacroiliac pathology.

Adult↗