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J V Crues

Publications and source records attributed to J V Crues.

54 records · Page 3Linked to original sources
PubMed1988

Tears of the anterior cruciate ligament and menisci of the knee: MR imaging evaluation.

In 242 of 3,000 patients who underwent magnetic resonance (MR) imaging of the knee between September 1986 and August 1987, original MR imaging reports were compared with subsequent arthroscopic reports to determine the value of MR imaging in the evaluation of suspected meniscal and complete tears of the anterior cruciate ligament. The overall accuracy for the menisci was 93% (sensitivity, 95%; specificity, 91%) with a false-negative rate of 4.8%. For the anterior cruciate ligament the overall accuracy was 95%. T2-weighted sequences were associated with greater sensitivity, specificity, and accuracy than were T1 sequences; the false-negative rate was 0% in the T2-weighted group. MR imaging of the knee is an extremely accurate means for noninvasive assessment of the integrity of the menisci and anterior cruciate ligament, and the accuracy exceeds that usually reported for arthrography.

False Negative Reactions↗
PubMed1988

Corneal temperature changes induced by high-field-strength MR imaging with a head coil.

High-field-strength/high-frequency magnetic resonance (MR) imaging systems can cause tissue heating. Since the eye is particularly susceptible to temperature elevations because of its relatively poor blood supply, the authors measured corneal temperatures in 33 patients immediately before and after MR imaging performed with a 1.5-T (64-MHz) imager and a transmit/receive head coil at estimated peak specific absorption rates (SAR) ranging from 2.54 to 3.05 W/kg. There was a statistically (P less than .001) significant increase in the average corneal temperature (32.7 degrees C +/- 0.7 before imaging, 33.2 degrees C +/- 0.5 after). The changes in corneal temperature ranged from 0.0 degrees C to 1.8 degrees C (mean, 0.5 degrees C), and the highest corneal temperature measured after imaging was 34.4 degrees C. In animal models, the eye temperature threshold for radio frequency-induced cataractogenesis is between 41 degrees C and 55 degrees C. The authors conclude that clinical MR imaging with use of a head coil at the SARs studied causes relatively minor increases in corneal temperature that do not appear to pose any thermal hazard to ocular tissue.

Adolescent↗
PubMed1988

High-field-strength MR imaging and metallic biomedical implants: an ex vivo evaluation of deflection forces.

Ferromagnetic biomedical implants are considered a contraindication for MR imaging primarily because of the potential hazards associated with their movement or dislodgment. Many metallic biomedical implants are composed of nonferromagnetic materials and do not present a danger to patients during MR imaging. Therefore, to evaluate the ferromagnetic qualities of 36 different metallic biomedical implants (four aneurysm clips, six hemostatic clips, four dental implants, seven prosthetic heart valves, eight orthopedic prostheses, one artificial urinary sphincter, three contraceptive diaphragms, and three cerebral ventricular shunt tube connectors) not previously evaluated with a high-field-strength MR system, we measured deflection forces at the portal of the magnet of a 1.5-T MR system. Fourteen of the 36 metallic biomedical implants were determined to be ferromagnetic as indicated by their deflection in the static magnetic field. However, only the four aneurysm clips (Drake, Mayfield, McFadden, and Sundt-Kees) had sufficient ferromagnetism to warrant exclusion of patients with these implants from imaging with a 1.5-T MR system because of the possibility of movement or displacement. The calculated deflection forces for these aneurysm clips were comparable with previously reported values of certain aneurysm clips that have been designated to present a risk for patients undergoing MR imaging. Patients with 32 of 36 metallic biomedical implants tested can be safely imaged with high-field-strength MR systems.

Ferric Compounds↗
PubMed1988

The painful shoulder: diagnosis and treatment.

The shoulder is one of the most complex joints in the body requiring coordinated, functioning muscles and joints to have a fluid, rhythmic motion. The shoulder consists of the glenohumeral (GH) joint, the acromioclavicular (AC) joint, the scapulothoracic (ST) joint, and the sternoclavicular (SC) joint. This article will examine the shoulder anatomy, clinical syndromes, and treatment for common shoulder disorders.

Humans↗
PubMed1987

Temperature, heart rate, and blood pressure changes associated with clinical MR imaging at 1.5 T.

Temperature, heart rate, and blood pressure responses to high-field-strength magnetic resonance (MR) imaging were studied in 50 patients who underwent procedures at exposures to radiofrequency radiation above the present recommended whole-body average specific absorption rate (SAR) of 0.4 W/kg. Body temperature significantly increased an average of 0.2 degrees C. The highest body temperature recorded after MR imaging was 37.5 degrees C. There was no significant correlation between the change (before and after imaging) in body temperature and whole-body average SARs. Changes in skin temperatures were variable, depending on anatomic site. The largest change was 3.5 degrees C, and the highest skin temperature recorded after imaging was 35.1 degrees C. There was a modest correlation between the change in skin temperatures and whole-body average SARs. Average heart rate and average mean blood pressure measured immediately before imaging were not significantly different afterward. High-field-strength MR imaging at the whole-body average SARs of 0.42-1.2 W/kg studied was not associated with any temperature- or hemodynamic-related deleterious effects.

Blood Pressure↗
PubMed1987

Meniscal tears: pathologic correlation with MR imaging.

Menisci from 12 autopsies and above-knee amputations were imaged with magnetic resonance (MR) at 1.5 T and then sectioned for gross and histologic examination. A histologic staging system was developed and showed a one-to-one correlation with corresponding grades of MR signal intensities. Histologic stages 1 and 2 represented a continuum of degeneration culminating in stage 3 fibrocartilaginous tears, seen most frequently in posterior-horn segments of the medial meniscus. Correlation of histologic stages with MR signal intensity allows for an improved diagnostic reading of MR images.

Aged↗
PubMed1987

Meniscal tears of the knee: accuracy of MR imaging.

Before surgery, 277 menisci in 144 knees were examined with magnetic resonance (MR) imaging. They were then examined directly with arthroscopy or arthrotomy. Menisci were graded on a scale of 1-3 according to the character of the intrameniscal MR imaging signal. At surgery, 137 of 154 (89%) menisci exhibiting only grade 1 or grade 2 signal were found to be normal. One hundred sixteen of 123 (94%) menisci exhibiting intrameniscal signal communicating with a meniscal articular surface (grade 3 signal) had tears. If only a grade 3 signal is considered consistent with meniscal tears, then MR findings and surgical findings agreed in 91.3% of menisci. MR imaging can separate surgically significant from nonsignificant meniscal lesions and is useful in the noninvasive preoperative screening of suspected meniscal tears.

Humans↗
PubMed1986

MR imaging of pulmonary emboli: an experimental study in dogs.

Experimental pulmonary emboli, consisting of tantalum-labeled autologous blood clots and barium-labeled 3-mm plastic spheres that did not produce an MR signal, were introduced through the femoral vein into each of five dogs. The sensitivity of MR to detect autologous clots of known size was assessed, and the size of the clot on MR was compared with its actual size. Emboli were localized by using chest radiographs made in multiple projections. Cardiac-synchronized MR imaging was performed on a 0.35-T superconducting magnet and was followed by a 99mTc macroaggregated lung scan. All 12 blood clots larger than 3 mm, and three of 20 clots less than 3 mm in transverse diameter were correctly visualized with MR. Five of the 15 clots seen on MR were larger than 150% of the actual size. There were nine false-positive emboli on MR. Two of six plastic spheres resulted in an abnormal signal on MR. MR signal from pulmonary emboli results from the thrombus itself and probably also from slow blood flow proximal to the obstruction. MR may be of value in detecting pulmonary emboli; clinical trials to evaluate its usefulness should be carried out.

Animals↗
PubMed1986

Thermal effects of high-field (1.5 tesla) magnetic resonance imaging of the spine. Clinical experience above a specific absorption rate of 0.4 W/kg.

Current safety guidelines recommend limiting the exposure to radiofrequency (RF) radiation used for clinical magnetic resonance imaging to a whole body average specific absorption rate (SAR) of 0.4 W/kg. Since it may be desirable to image with SARs that exceed this level during MRI of the spine, we evaluated the thermal responses associated with these procedures. Body and skin temperatures were determined in 25 patients immediately before and after MRI. Since the eye is particularly susceptible to thermal injury, corneal temperature was also measured. High-resolution thermography was performed on three subjects to evaluate the surface heating pattern and identify potential thermal 'hot spots'. A 1.5 tesla/64 MHz MRI system with quadrature transmission and reception was used iN this study. The whole body average specific absorption rate ranged from 0.5 to 1.3 W/kg. Ambient conditions were room temperature 20-24 degrees C and relative humidity between 40 and 50 per cent. There was a slight but statistically significant (p less than 0.01) increase in body temperature after MRI (36.5 +/- 0.4 to 36.7 +/- 0.4 degrees C). Temperatures of the hand (30.4 +/- 1.4 to 31.2 +/- 1.0 degrees C), positioning isocenter (32.1 +/- 0.6 to 32.9 +/- 0.5), and cornea (32.5 +/- 0.6 to 32.9 +/- 0.5 degrees C) also increased a statistically significant amount. Thermographic imaging revealed normal heating patterns with no surface 'hot spots'. We conclude that the temperature changes associated with MRI of the spine at the SARs we studied were well below known thresholds for adverse effects and do not appear to be harmful to patients.

Adult↗
PubMed1985

Central nervous system high-resolution magnetic resonance imaging: effect of increasing spatial resolution on resolving power.

Resolving power is a useful measure of the magnetic resonance (MR) imager-determined ability to discriminate subtle disease. Optimizing the resolving power produces the best MR images. The resolving power improves with higher spatial resolution, signal-to-noise ratio, and object contrast. Resolving power degrades with increased patient motion, which can be associated with prolonged imaging times. High and low object contrast 0.35-T MR images of the central nervous system are compared at different levels of spatial resolution and signal-to-noise ratios. In systems that have a marginal signal-to-noise ratio, the resolving power can actually decrease when higher spatial resolution is used due to further lowering of signal-to-noise ratio and to increased motion resulting from longer imaging times. This decreases the conspicuity of small, low contrast lesions.

Adenoma↗
PubMedDate not supplied

Sonographic diagnosis of thoracic gastroenteric cyst in utero.

A case of prenatal sonographic detection of a posterior mediastinal cyst in an otherwise normal fetus is presented. Following surgical excision 5 days after birth, histological examination confirmed the cyst to be gastroenteric. The differential diagnosis and clinical value of prenatal detection are discussed.

Adult↗
PubMedDate not supplied

Temperature changes caused by MR imaging of the brain with a head coil.

Tissue heating caused by exposure to RF radiation is a primary safety concern in MR imaging. Therefore, to determine temperature changes caused by high field strength MR imaging of the brain with a head coil, we measured body and skin temperatures in 35 patients immediately before and after clinical MR imaging. MR imaging was performed with a 1.5 T MR system using a 28-cm, open-bore RF transmit/receive head coil specifically designed for examinations of the brain. The average body temperature was 36.6 +/- 0.2 degrees C before MR imaging and 36.6 +/- 0.2 degrees C immediately afterward (mean +/- SD, p = not significant). The average forehead skin temperature increased from 32.6 +/- 0.6 to 32.8 +/- 0.5 degrees C (p less than .01), and the average outer canthus skin temperature increased from 32.1 +/- 0.6 to 32.7 +/- 0.6 degrees C (p less than .01) after MR imaging. The highest skin temperature recorded was 34.2 degrees C, and the largest temperature change was +2.1 degrees There were no statistically significant changes in the average skin temperatures of the upper arm and hand. We conclude that patients undergoing MR imaging of the brain with a head coil at the RF radiation exposure we studied experience no significant changes in average body temperature and statistically significant increases in local (i.e., areas within the head coil) skin temperatures. The observed elevations in skin temperatures were physiologically inconsequential.

Body Temperature↗