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Biomedical subjects

M Kunnen

Publications and source records attributed to M Kunnen.

At least 55 records · Page 3Linked to original sources
PubMed1997

Pulmonary and mediastinal lesions in children with Langerhans cell histiocytosis.

Langerhans cell histiocytosis (LCH) is an uncommon group of disorders affecting mainly children and young adults. In children, pulmonary involvement occurs mostly in the disseminated forms; isolated pulmonary lesions are unusual. A retrospective study was undertaken on a group of 42 children diagnosed with LCH over a 19-year period. Eight children (19 %) had radiological evidence of pulmonary involvement. The lung lesions were either present at the time of diagnosis or, when appearing during the course of the disease, always coinciding with exacerbation or recurrence of the disease in other sites. Lung involvement did not appear to be an unfavourable prognostic factor. However, the toxic effects of treatment on the lungs might lead to important pulmonary sequelae.

Adolescent↗
PubMed1997

Current status and imaging of allograft meniscal transplantation.

The authors present an overview of the current indications, techniques, results and complications of allograft meniscal transplantation. The radiologist's role in pre- and postoperative imaging is described. The spectrum of magnetic resonance imaging findings of meniscal allografts are illustrated.

Arthroplasty↗
PubMed1997

Non-operative management of a splenic laceration in a patient with the Proteus syndrome.

An adult patient with the Proteus syndrome sustained a grade III splenic laceration after falling off a horse. Clinical features of this rare disorder include subcutaneous and visceral hamartomatous tumours. The patient also suffered from chronic intravascular coagulation associated with extensive haemangiomatosis (Kasabach-Merritt syndrome). Considering the visceral anomalies and abnormal coagulation, a non-operative approach was preferred despite considerable transfusion requirement, and the patient successfully underwent embolisation of the splenic artery. This is the first reported case of splenic injury in a patient with Proteus syndrome.

Adult↗
PubMed1997

Ultrasound and CT changes of liver parenchyma in acute schistosomiasis.

Acute schistosomiasis in travellers to endemic regions often remains unrecognized. Early diagnosis is important to avoid progression to chronic disease. Diagnosis is based on clinical, epidemiological and laboratory data. The role of imaging techniques as diagnostic tools remains to be established in acute clinical schistosomiasis. We describe hypodense nodules in the liver on ultrasound and CT scanning in a patient with acute schistosomiasis (Katayama syndrome). To our knowledge this is the first description of nodular hepatic lesions in acute schistosomiasis.

Acute Disease↗
PubMed1997

Lesion detection in breast carcinoma.

Early detection and identification of infraclinic breast lesions are a challenge for the radiologist. Diagnostic accuracy relies on careful analysis of some important mammographic clues, which are discussed in this paper. In particular, asymmetric breast tissue, focal asymmetric density, nonpalpable solid masses, stellate lesions and calcifications are reviewed.

Breast↗
PubMed1997

Pericystic emphysema in pulmonary hydatid disease.

The case of a 12-year-old Caucasian boy, living in a non-endemic area, with two intrapulmonary masses is presented. Conventional X-rays and computed tomography images were highly suggestive of pulmonary Echinococcus disease because of the presence of pericystic emphysema in one of both masses, a finding known as the "crescent" or "meniscus" sign. This radiological feature and other highly suggestive imaging findings of pulmonary hydatid disease are presented and discussed.

Child↗
PubMed1996

Lusoria dysphagia in a patient with retroperitoneal fibrosis and Riedel's thyroiditis.

The case history of a 68-year-old woman with progressive dysphagia caused by extrinsic compression of the oesophagus by an aberrant right subclavian artery or arteria lusoria is presented. Previous history mentioned a Riedel's thyroiditis, idiopathic retroperitoneal fibrosis and an aortic sclerosis. The authors want to report the case because it is an example of an association between lusoria dysphagia and retroperitoneal fibrosis, the connective tissue disease responsible for Riedel's thyroiditis, and perhaps, aortic sclerosis. This is the first report of this particular association.

Aged↗
PubMed1996

[Embolization of traumatic hemorrhages].

This retrospective study of 17 patients evaluates the effectiveness of angiographic embolization as a treatment for traumatic hemorrhage. Bleeding was caused by external trauma in 8 patients and by iatrogenic trauma in 9 patients. Embolization was only performed if contrast-extravasation or a pseudoaneurysm could be visualized. In 16 of 17 patients immediate technical and clinical success was achieved. Over a 30-day follow-up period 3 patients died of multi-organ failure, toxic hepatitis and neurotrauma. In conclusion, embolization is a highly efficient and safe technique.

Adolescent↗
PubMed1995

Static, dynamic and first-pass MR imaging of musculoskeletal lesions using gadodiamide injection.

Forty-five patients with known or suspected musculoskeletal tumors were examined with static and dynamic MR imaging to evaluate the safety, tolerability and diagnostic utility of gadodiamide injection and to assess the diagnostic value of dynamic MR imaging and parametric "first-pass" (FP) images. The proportion of patients presenting more diagnostic information on the contrast-enhanced compared to the precontrast spin-echo examinations was determined. The dynamic enhancement characteristics were evaluated with time-intensity curves and parametric images of the FP enhancement rate. The tolerance of gadodiamide injection was good. Contrast enhancement was useful for delineating tumor from muscle, and differentiating viable from necrotic tissue and cystic from solid lesions. Malignant tumors showed a significantly higher slope value, earlier onset of enhancement, and higher maximum enhancement than benign lesions. However, slope values could not be used to predict the malignant potential of a lesion, due to overlap between highly vascular benign and low vascular malignant lesions. By displaying highly vascular areas, parametric FP images provided useful information on the most active part in a tumor before biopsy and for assessing the incorporation of bone-chip allografts. Static, dynamic and FP MR imaging using gadodiamide injection appears safe and provides useful information for diagnosis, biopsy and follow-up of musculoskeletal lesions.

Adult↗
PubMed1995

[Breast calcifications].

Calcifications are found in many women undergoing mammography. The majority of these calcifications are benign. Calcifications suggestive for malignancy prove to be cancer in about 30% of cases after biopsy. Study and personal experience should result in ready recognition of characteristically benign calcifications. Calcifications suggestive for malignancy should be biopsied and the ratio of malignant over benign biopsies should be as high as possible. The purpose of this paper is to present a practical approach to the evaluation of breast calcification, by means of a survey of the pattern of calcifications in breast pathology. We describe six types of typically benign calcifications and six criteria that entail an increased risk of malignancy.

Breast Diseases↗
PubMed1995

[Stereoradiography].

The first attempts at stereography date back to the early days of radiography itself; already at the turn of the century, a series of papers on this subject had been published. This is not surprising, as the problem of reading correctly a plain X-ray film was rapidly recognized. A plain X-ray film is a summation of all the more or less opaque structures contained in the different planes of an object. Stereoradiography not any copes with this problem, but enables a three-dimensional localization of all these structures. Stereofluorography and stereocineradiography may also be performed. The different stages in the development of hard and soft ware to achieve these goals are described and an example is provided.

Belgium↗
PubMed1994

The mechanical characteristics of the human heel pad during foot strike in running: an in vivo cineradiographic study.

The compressive properties of the heel pad during the heel strike when running (barefoot and shod, two subjects, 4.5 m s-1) were studied by means of a high-speed two-dimensional cineradiographic registration (150 frames s-1) of an actual running step. Vertical ground reaction forces were measured with a force platform. In barefoot running the heel pad deforms to a maximal percentage deformation of 60.5 +/- 5.5%. In shod running the heel pad deforms only 35.5 +/- 2.5% and the nonlinear force-deformation relationship reflects an increasing stiffness when deformation rises. Although the amplitudes of the vertical ground reaction forces do not differ notably in both conditions, barefoot running implies a maximal deformation to the fatty heel tissue, reducing its functional role from shock reduction towards local protection of the heel bone. It is argued that embedding the foot in a well-fitting shoe increases the effective stiffness of the heel pad.

Adipose Tissue↗
PubMed1994

First-pass images of musculoskeletal lesions: a new and useful diagnostic application of dynamic contrast-enhanced MRI.

The purpose of this study was to evaluate the diagnostic value of parametric images which display the first-pass of Gd-DTPA after intravenous bolus injection. Single slice dynamic contrast-enhanced MRI (Turbo-FLASH) with a temporal resolution of 2.41 s was performed in 40 benign and malignant musculoskeletal lesions. Parametric 'first-pass' images were obtained by using a new postprocessing technique, derived from a home written computer program, which calculated the steepest slope of the time-intensity curve pixel by pixel. First-pass images provided qualitative and quantitative information, which was useful for diagnosis and therapy. Demonstration of the areas with the highest vascularization was very helpful in planning the best biopsy site in 6 patients and to delineate tumor from peritumoral muscle edema in 4 patients. In 10 patients the first-pass images provided additional information, which was not visible on the conventional spin-echo images. The most promising application was the ability to evaluate the response to preoperative chemotherapy in a patient with Ewing's sarcoma. Although a highly statistically significant difference (p < 0.001) was found between the first-pass slope values of benign and malignant lesions, the sensitivity (77%) and specificity (71%) of this method were too low to permit a definite differentiation of highly vascular benign from malignant lesions. Pathologic examination of 17 lesions, performed in the plane of the first-pass image, showed a good correlation between the first-pass slope values and the vascularization of the tissues.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1994

Benign and malignant musculoskeletal lesions: dynamic contrast-enhanced MR imaging--parametric "first-pass" images depict tissue vascularization and perfusion.

PURPOSE: To assess the diagnostic value of parametric magnetic resonance images that display the first pass (FP) of gadopentetate dimeglumine. MATERIALS AND METHODS: Dynamic, contrast material-enhanced, fast low-angle shot MR imaging was performed of 100 musculoskeletal lesions in 36 female and 64 male patients (aged 9-81 years [mean, 34 years]). The highest slope value of the time-intensity curve was calculated pixel by pixel and displayed on the FP image, with a gray-scale value equal to the slope value. Tissue vascularization and perfusion were evaluated at pathologic and angiographic examinations in 33 lesions. RESULTS: A significant difference (P < .001) was found between the FP slope values of benign (mean, 36.2% per second) and malignant (mean, 67.4% per second) lesions. FP images depicted tissue vascularization and perfusion rather than benignity or malignancy, because there is an overlap in the slope values of highly vascular benign lesions and malignant lesions. CONCLUSION: FP images provide diagnostically useful information by depicting tissue vascularization and perfusion.

Adolescent↗
PubMed1993

Digital subtraction in multi-compartment arthrography of the wrist.

In a series of 23 patients with chronic and unexplained painful wrist, three-compartment arthrography was carried out using digital subtraction. Pathologic conditions were disclosed in 19 patients. Digital subtraction both allowed for a stronger diluting of the dye and for the demonstration of a larger amount of lesions of smaller size than conventional wrist-arthrography, as long as motion artefacts had been avoided. Obtaining successive views without having to wait for complete contrast resorption in the injected compartments represents a significant advantage. The importance of three-compartment injection is stressed and the best way to perform the technique is discussed. As it proved to be a fast and reliable examination procedure the authors advocate using digital subtraction arthrography of the wrist whenever the method is available. However, this relatively new technique does not rule out careful correlation between arthrographic findings and clinical complaints.

Adolescent↗