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J Lissner

Publications and source records attributed to J Lissner.

At least 37 records · Page 2Linked to original sources

Gadobenate dimeglumine--a new contrast agent for MR imaging: preliminary evaluation in healthy volunteers.

Gadobenate dimeglumine (formerly known as Gd-BOPTA) is a recently developed paramagnetic contrast agent that undergoes biliary as well as renal excretion. It may, therefore, be useful in MR imaging of the liver. Its safety, tolerance, and usefulness in visualizing hepatobiliary structures were studied in eight healthy subjects. Axial abdominal images were obtained with T1-weighted spin-echo and gradient-echo sequences at 1.5 T before and after IV administration of gadobenate dimeglumine in doses of 0.005, 0.05, 0.1, and 0.2 mmol/kg body weight. Two subjects received each dose. Administration of 0.1 mmol/kg resulted in a maximum liver enhancement of 149% on the gradient-echo sequence and of 90% on the T1-weighted spin-echo sequence 60 min after injection. The contrast enhancement of the liver remained virtually constant for 2 hr. The signal-to-noise ratio of the biliary tract increased from 38 to 121 after 2 hr on gradient-echo images. In addition, there was significant contrast enhancement of the kidneys. Optimal visualization of the liver parenchyma was achieved with doses of 0.05 and 0.1 mmol gadobenate dimeglumine/kg. Mild to moderate side effects such as nausea and retching, a sense of warmth at the infusion site, and transient pruritus lasting 1 min were reported by three (38%) of the subjects. The initial results of the first application of gadobenate dimeglumine in humans are encouraging because the contrast agent appears to be reasonably well tolerated at the doses appropriate for hepatobiliary imaging. Further clinical studies of this contrast agent are warranted to assess its effect on liver lesion conspicuity and the frequency with which side effects occur.

Acetates↗

MR angiography in children with cerebral neurovascular diseases: findings in 31 cases.

OBJECTIVE: We evaluated the suitability of MR angiography for routine use in children with suspected intracranial vascular disease. SUBJECTS AND METHODS: Thirty-one children, 6 months to 14 years old, with intracranial lesions or clinically suspected vascular malformations were studied prospectively with conventional MR imaging and time-of-flight MR angiography. In nine cases, MR angiographic findings were verified with digital subtraction angiography or conventional angiography. All MR studies were performed on a 1.5-T MR system using a circularly polarized head coil. RESULTS: Arterial MR angiography, performed in 24 cases, revealed congenital abnormalities of the arterial vessels in 20 cases. Vessel stenosis was observed in nine patients, and displacement of intracranial arteries due to tumors could be seen in 10 patients. Seven children had no abnormal findings. Venous MR angiography was performed in seven children, with depiction of sinus thrombosis in six cases. The comparative analysis of MR angiography and digital subtraction angiography showed equivalent results in nine patients; in one patient the degree of stenosis was overestimated with MR angiography. CONCLUSION: MR angiography, when combined with MR imaging, reveals information about soft-tissue and vascular structures in a single setting. At this point, MR angiography can replace invasive conventional angiography or digital subtraction angiography only in selected cases because of software and hardware limitations. Arterial or venous MR angiography can be helpful as an additional scan in MR examinations of children with suspected cerebral neurovascular diseases, and its noninvasive nature makes it well suited for routine use in children.

Adolescent↗

[Magnetic resonance tomography of the hepatobiliary system: indications, limitations and outlook].

In a prospective study we examined the diagnostic value of MRI and MR cholangiography (MRC) in patients suffering from hepatobiliary disease. By using hepatobiliary contrast media (Mn-DPDP, Gd-BOPTA), sensitivity and specificity of MRI were significantly increased. In 65 patients we comparatively analyzed the diagnostic results of MRI and MRC versus ultrasound, CT and invasive techniques such as ERCP. We conclude that the use of MRI and MRC improves the diagnostic evaluation of patients with hepatobiliary disease.

Biliary Tract Diseases↗

[Results of photon therapy of malignant tumors of the parotid gland].

Between 1971 and 1982 86 patients have been treated because of a malignant tumor of the parotid gland. 64 patients have been irradiated after complete (n = 49) or incomplete (n = 15) first resection. 12/64 (19%) relapsed locally. The loco-regional tumor control rate five and ten years after postoperative radiotherapy is 72%, 85% after complete resection, and 22% after incomplete resection (p less than 0.01). Tumor size and nodal disease are of prognostic value. Disease-free survival in patients without lymph nodes is 53%, with lymph node metastases 31% after five years (p less than 0.05). Small tumors (T1, 2) have a better local control rate compared to locally advanced tumors (five years: 83% vs. 53%, p less than 0.05). No difference was found neither for the total dose nor the histology of the tumor. Distant metastases became apparent after median eleven months.

Adenocarcinoma↗

MRI in tracheal stenosis by innominate artery in children.

Pediatric airway obstruction due to anomalies of the course of the innominate artery may produce respiratory distress. MR imaging of the trachea was performed after bronchoscopy on forty-one children with congenital tracheal stenosis. Bronchoscopy only allows the evaluation of the lumen of the trachea, and the degree and location of collapse, and it may be difficult to determine the etiology of the tracheal narrowing. In eighteen out of the forty-one patients MR imaging showed a compression of the trachea by the innominate artery. The MR imaging diagnoses were subsequently compared for accuracy with the diagnoses determined by direct surgical observations. MR imaging of the trachea, the surrounding tissue and vessels allows the evaluation of the cause of tracheal compression and the degree and location of collapse. For evaluation of the cause of airway obstruction. MRI is an ideal method depicting detailed anatomic structure without employing ionizing radiation or intravenous contrast medium.

Brachiocephalic Trunk↗

[Magnetic resonance tomography of the oropharynx and oral cavity with Gd-DTPA. An optimized study technic and its diagnostic value].

In the evaluation of space-occupying lesions of the oropharynx it is necessary to perform modern imaging methods, such as magnetic resonance imaging additionally to clinical and endoscopical methods. 126 patients were examined using T1-weighted (TR = 500 ms, TE = 25 ms) and T2-weighted (TR = 3000 ms, TE = 25/90 ms) spin-echo-sequences before and after i.v. application of Gd-DTPA. Superficially growing lesions of stage T1 could not be delineated from isointense mucosa. The preoperative staging of T2-T4 lesions can be markedly improved by using T1- and T2-weighted sequences in combination with Gd-DTPA. MR imaging with Gd-DTPA is recommended as the primary diagnostic tool for diagnosing lesions in the region of the oropharynx.

Adenoma↗

[Diffuse liver parenchymal diseases: the value of MRI compared to sonography and CT].

29 patients with diffuse liver disease were examined by ultrasound, CT and MRI. MRI imaging was performed using T1-and t2-weighted spin-echo-sequences and fast gradient-echo-sequences. The paramagnetic contrast agent Gd-DTPA was applied intravenously (0.1 mmol/kg). In all patients with hepatitis MRI enabled exact liver biopsy by delineation of inflammatory changes in cases of chronic or focal hepatitis. CT and ultrasound were superior to MRI in the detection of focal or diffuse fatty degeneration. However, MRI enabled an exact differentiation of fatty changes from neoplasm. In cases of fibrotic changes the most accurate findings could be shown by MRI. In patients suffering from hemochromatosis MRI supplied additional information compared to CT and ultrasound revealing significant reduction of signal intensity due to reinforced enhancement of iron. Concerning Wilson's disease MRI showed a characteristic pattern of parenchymal changes. The application of Gd-DTPA in cases of diffuse liver disease adds supplementary information about perfusion of liver parenchyma, but its value for diagnostic accuracy is only secondary.

Contrast Media↗

[NMR tomographic diagnosis with Gd-DTPA in HIV-associated diseases in the head-neck area].

In a prospective study 21 patients suffering from HIV-1 infection underwent MR imaging. The following tumours were found: eight Kaposi's sarcomas, four lymphomas, two squamous-cell carcinomas, and three cases of lymphoid hyperplasia. Furthermore, three cases with lymphoepithelial cysts and one case of inflammatory changes of the parotid glands were studied. Optimal diagnostic results were obtained by using T1- and T2-weighted sequences plain and Gd-DTPA enhanced. Different signal intensities enabled the differentiation of lesions such as inflammation, lymphomas and lymphoid hyperplasia. Besides clinical examination modalities, MR imaging proves to be an important tool in investigating solid, cystic or inflamed processes in HIV-positive patients in the head and neck area.

Carcinoma, Squamous Cell↗

[The clinical value of Mn-DPDP: a new paramagnetic hepatobiliary contrast medium for magnetic resonance tomography of the liver].

In an open prospective study the tolerance and diagnostic value of the new hepatobiliary contrast agent Mn-DPDP in MR imaging was evaluated in 20 patients suspected of having focal liver lesions. T1- and T2-weighted spin-echo sequences and T1-weighted gradient-echo sequences were obtained before and after intravenous application of Mn-DPDP. In all patients the signal to noise (S/N) values of normal liver tissue increased significantly after application of Mn-DPDP. All focal lesions could be better localized and differentiated due to increased contrast to noise ratios of lesion to liver. Pathological examination revealed in 14 patients malignant and in 5 patients benign liver lesions; one patient had no pathological findings. In metastatic disease of the liver 25-120% more lesions could be detected in MRI after Mn-DPDP-application, compared with the unenhanced images. In 5 patients the lesions showed significant enhancement of Mn-DPDP (2 cirrhotic nodules, 2 hepatocellular carcinomas, 1 focal nodular hyperplasia). Our preliminary results indicate that Mn-DPDP is a well-tolerated contrast agent useful for the detection and differentiation of liver lesions in MR imaging.

Adult↗

Influence of magnetic resonance imaging on evoked potentials and nerve conduction velocities in humans.

The authors investigated the influence of a 1.0-T magnetic field of a magnetic resonance (MR) imaging device, as well as the possible effects of the changing magnetic field and the RF field, on somatosensory, visual, and auditory evoked potentials and on peripheral nerve conduction velocities. The neural potentials outside and inside the static magnetic field were recorded before and after MR imaging. The measured latencies before and after MR imaging were within the normal range for healthy volunteers. The magnetic field did not significantly alter central or peripheral conduction velocities.

Adult↗

[MR tomographic diagnosis of internal derangement of the temporomandibular joint].

On the basis of MR imaging studies in 150 temporomandibular joints (TMJ) a classification system for internal derangement of the TMJ was defined. Clinically, internal derangement is characterized by disc displacement and disorders of the mandibular condyle. MR imaging enables a differentiation of early stages (I,II) with disc displacement, the intermediate stage (III), and the later stages (IV,V) with osseous destruction. Optimal diagnostic results (n = 140) allowed the use of proton-density sequences in both open and closed joint positions (TR/TE = 1000/28). Dynamic imaging of the TMJ was performed using fast-gradient echo sequences and a self-developed hydraulic opening device (n = 20). MR imaging has proved to be the method of choice for the pre- and post-therapeutic evaluation of internal derangement of the TMJ.

Adult↗

[Nuclear magnetic resonance tomography of children's thorax].

Magnetic Resonance Imaging of the pediatric chest was performed in 53 patients. All examinations were performed using a 1.0 and 1.5 Tesla superconducting MR imager. 80% of the children were examined using anesthesia with a ventilation of 20% inspiration and 80% expiration. After performing the MR examination in 55% of the cases an operation was performed. In 29 patients anomalies of the brachiocephalic trunc were found. In four patients MR detected a doubled aortic arch, in four patients we found a dilated arch. In eight children a dilated pulmonary artery was diagnosed. In combination with eight tracheobronchoscopy, MR imaging proved to be the diagnostic method of choice for the evaluation of anomalies of the mediastinum. New developments like fast imaging techniques and 3D acquisition promise a further diagnostic improvement in the mediastinum.

Aorta, Thoracic↗

Digital imaging and picture archiving and communication systems.

Great progress has been made in digital imaging of the chest. Most studies are dealing with computed radiography. Chest radiography in the intensive care unit may, in most cases, be performed using computed radiography. However, subtle pulmonary interstitial disease can be demonstrated less confidently using computed radiography. Significantly better detection of calcified lung nodules can be obtained by using simplified single-exposure dual-energy technique that uses storage phosphor. The wide latitude of computed radiography permits images of high quality in areas other than chest radiography. Encouraging results are presented especially in the diagnostic evaluation of scoliosis and other musculoskeletal abnormalities. An important technical innovation in digital radiography is an improved method for single-exposure dual-energy digital imaging using prefiltration with gadolinium, a cassette consisting of four photostimulable phosphor plates, spatially dependent scatter and beam hardening corrections, and noise reduction algorithm. Other groups tested algorithms for enhancement of digital images that allowed significant data compression. The implementation of picture archiving and communication systems (PACS) is inevitable; the question concerning PACS implementation is not why, but when. A comparison of the cost-effectiveness of PACS with conventional film archiving and communication systems shows that PACS should provide indirect savings when regarding the hidden costs of conventional systems. Much more experience will be needed before there is general agreement on the best design for the radiologist's workstation. Teleradiology should contribute to radiologic consultation for remote locations, because it improves the efficacy of management of patients in such locations.

Child↗

[3D-MRT-reconstructions of space-occupying lesions in the head and neck regions].

3-D reconstructions in the head and neck were carried out on 21 normals and 11 patients with space-occupying lesions, both before and after the administration of Gd-DTPA. The 3-D reconstructions were obtained by the "ray-tracing" method. For the 3-D reconstructions, portions of the skull surface image were removed to permit views of the deeper tissues. The 3-D reconstructions included an hypoglossus neurinoma, a glomus tumour, two carcinomas of the maxillary antra, three naso-pharyngeal carcinomas, a parotid adenoma, an oro-pharyngeal haemangioma and two lesions in the neck. The 3-D reconstructions provided a better understanding of the morphology than was obtained from the two-dimensional images. 3-D reconstructions of lesions in the head and neck will become a valuable diagnostic method for demonstrating space-occupying lesions, particularly with regard to surgical planning.

Adenoma↗

[MRT of tumors of the larynx and hypopharynx using Gd-DTPA: clinical value].

Thirty one patients with tumours of the larynx and hypo-pharynx were studied by MRI, both with and without the para-magnetic contrast medium, GD-DTPA. The results were compared with pre-operative laryngoscopy and the final pathological tumour classification. The most accurate results were obtained by comparing T1-weighted sequences before and after the use of GD-DTPA. Because of the relatively rapid mode of examination and the specific enhancement, the method proved ideal for evaluating tumours of the larynx and hypo-pharynx. MRI is a valuable diagnostic technique for staging and treatment planning of patient with tumours of the larynx and hypo-pharynx.

Contrast Media↗

Parotid gland: plain and gadolinium-enhanced MR imaging.

The purpose of this study was to show the typical appearance of lesions of the parotid gland with plain MR imaging and MR imaging enhanced with gadopentetate dimeglumine. Seventeen patients with inflammatory changes and 43 with benign and malignant tumors were studied. The examinations were carried out with plain T1-weighted sequences with a repetition time (TR) of 500 msec and an echo time (TE) of 25 msec (TR/TE = 500/25), T2-weighted sequences (1,600/90), and gadolinium-enhanced T1-weighted sequences in axial, coronal, and sagittal orientations. For identifying normal anatomic structures such as the facial nerve and the main duct, the administration of gadopentetate dimeglumine was helpful. In inflammatory changes, gadolinium-enhanced images showed no diagnostic advantages. Gadopentetate dimeglumine proved helpful in delineating tumorous lesions and in differentiating benign and malignant lesions. However, an exact differentiation of the different histologic types was not possible. Post-operative fibrosis could be differentiated from recurrent tumors after administration of gadolinium. If a question regarding infiltration or definition of the boundaries of a lesion cannot be answered with non-enhanced MR imaging, gadopentetate dimeglumine administration is advised. However, for routine imaging of the parotid gland, its use is not recommended.

Contrast Media↗

Tumors of the nasopharynx and adjacent areas: MR imaging with Gd-DTPA.

The purpose of this study was to describe our experience with Gd-DTPA-enhanced MR imaging in the evaluation of the most common nasopharyngeal tumors. Forty-two patients with tumors of the nasopharynx and adjacent spaces had MR imaging before and after IV injection of Gd-DTPA. Images were obtained with a 1.0-T superconducting magnet imaging system in transverse, coronal, and sagittal planes with T1- and T2-weighted sequences. MR images were compared with CT scans and tumor histology. The studies were categorized by using a grading system with grades ranging from unsatisfactory (grade 0) to optimal (grade 3). Contrast-enhanced MR enables better identification of small anatomic details such as both palatini muscles and the pharyngobasilar fascia. MR after Gd-DTPA was superior to CT in all cases except for tumors of the maxillary sinuses. MR with Gd-DTPA is recommended for tumors that are small and difficult to detect on the initial nonenhanced MR examination or that show subtle infiltrations. Because of the increased cost and longer examination time, MR with Gd-DTPA does not need to be done when large tumors are well delineated.

Carcinoma, Adenoid Cystic↗

[Current status of radiotherapy in treatment of esophageal cancer].

An improvement of the quality of life by alleviating pain, improving swallowing and increasing weight is achieved in about 80% of patients with esophageal cancer. With survival rates of 41%, 21% and 11% after 1, 2 and 5 years, respectively the curative potential of radiotherapy is considered low. Survival is significantly better in patients with small tumors than with large tumors. Radiochemotherapy must still be considered an experimental modality. Afterloading may be helpful for palliation. Postoperative and postradiation results are relatively positive due to improved local control and patient selection.

Combined Modality Therapy↗