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Biomedical subjects

M Reiser

Publications and source records attributed to M Reiser.

At least 487 records · Page 27Linked to original sources
PubMed1994

[High resolution magnetic resonance tomography of the temporal bone].

Computed tomography (CT) has long been the method of choice for investigations of the temporal bone. Advances in high resolution magnetic resonance imaging (MRI) enabled MRI of the temporal bone. The purpose of this study was to assess detailed reconstruction of the anatomy of the temporal bone by MRI. Healthy volunteers were examined on a 1T MR whole body scanner (Impact, Siemens, Erlangen, Germany). A Helmholtz-configurated head coil was used. A T1-weighted 2D-FLASH sequence (TR = 400 ms, TE = 10 ms, 90 degrees flip angle, 2 mm slice thickness, 180* 256 matrix, 160 mm FOV) was performed pre- and postcontrast as well as a T2-weighted turbo spin echo sequence (TR = 6300 ms, TE = 112 ms, 3 mm slice thickness, 200 mm matrix, 200 mm FOV). A sagittal and an angulated paraxial projection, parallel to the nasopharyngeal edge of the clivus, were chosen. We suceeded in imaging the facial nerve along its entire course, including the geniculate ganglion and the greater superficial petrosal nerve, the cochlear nerve and the vestibular nerve (superior and inferior part). The facial nerve was visualised continuously from the cerebellopontine angle to the foramen stylomastoideum. The delineation of the different turns of the cochlea, the vestibule and the semicircular canals was excellent. High resolution MRI promises to be of great value in the diagnosis of the temporal bone.

Cochlea↗
PubMed1994

[3-D CT reconstruction of fractures of the skull base and the facial skeleton].

3-D reconstructions of the skull base, temporal bone, and skull fractures were compared to 2-D- CT to evaluate the diagnostic value in traumatized patients. 38 patients with 22 fractures of the facial skeleton (orbita, zygomatic, Le Fort), 12 temporal bone, and 4 skull fractures were investigated. Subjective grading was performed by two physicians (ENT/RAD) in respect of quality diagnostic validity and estimated clinical impact. The average image validity and quality were graded good. In the temporal bone the average information supplied by 3-D was of inferior value; here, the lack of information regarding the inner ear structures was responsible for the lack of clinical impact. In fractures of the facial skeleton and the skull base a good to very good image quality was seen and clinical relevance was high. 3-D CT is capable of demonstrating fractures, which is of little value in the temporal bone, but of high value in the skull base and the facial skeleton, especially if surfaces are involved or fragments are displaced.

Facial Bones↗
PubMed1994

[Hemophiliac arthropathy of the knee joint. Gd-DTPA-enhanced MRI; clinical and roentgenological correlation].

17 patients with hemophilic arthropathy of the knee joint were studied with static and dynamic MRT before and after i.v. bolus injection of Gadolinium-DTPA (0.1 mmol/kg body weight). After contrast enhancement, synovial proliferations exhibited an increase of signal intensity (SI) on FFE and SE images of 47.7% and 37.4% respectively, whereas muscle and fatty tissue, tendons, bone marrow and joint effusion revealed only minor increase in SI. The gradient of signal intensity (ratio SI/time) of pannus was 39.6%/min. Gd-DTPA enhanced MRI studies delineate and quantify the synovial proliferations in hemophilic arthropathy. Dynamic studies in hemophilic arthropathy do not provide qualitative assessment of the inflammatory process.

Adult↗
PubMed1994

[The role of MRT in detecting the cause of therapy-refractory partial complex epilepsy].

MRT is of considerable significance in the investigation of epilepsy because of its ability to render soft tissue contrast for the demonstration of structural lesions. The present retrospective study consists of an analysis of MRT findings in operatively confirmed, circumscribed temporal tumours and in hippocampal sclerosis. The examinations were performed under standard conditions using T1- and T2-weighted spin-echo sequences of the head and coronal T2-weighted gradient-echo sequences of the brain stem. The diagnosis of tumours was extremely accurate (22/23) and specific (18/23) whereas hippocampal sclerosis could not be satisfactorily demonstrated (5/18). The use of intravenous contrast medium did not provide any advantages.

Adolescent↗
PubMed1994

[Fat-suppressing STIR sequences with and without contrast media in the MRT of ENT tumors].

Fat-suppressed STIR (short TI inversion recovery) sequences were compared to plain and contrast-enhanced T1-weighted SE sequences of head and neck tumors. 19 patients underwent MR imaging on a 0.5 Telsa system (T5-II, Philips). STIR imaging parameters: TR/TE = 1000/20 ms, inversion pulse 100 ms. All films were read by four radiologists. The image quality was graded: score from 0 to 5, by means that grade 5 = optimal quality. Sensitivity was 89% in STIR, 96% in SE sequences. Tumor delineation was graded good in the enhanced T1-weighted and enhanced fat suppression images. The unenhanced imaging was superior in STIR (STIR/T1 = 2.8/2.43). The tumor contrast was best in contrast enhanced and plain STIR sequences (STIR contrast = 3.41), and in the contrast enhanced T1-weighted SE (3.33). STIR almost equaled T1 post-contrast in respect of tumour conspicuity, but the sensitivity was lower. STIR can be a supplement to SE, but cannot substitute T1 postcontrast. The combined use is expected to have the highest assessment value.

Adipose Tissue↗
PubMed1994

[MR tomography and bone marrow scintigraphy in the screening of skeletal metastases in patients with breast carcinoma].

46 patients with recently diagnosed carcinoma of the breast were included in a prospective comparative study of MRI and bone marrow scintigraphy. The aim of the study was to compare these procedures within a histologically unified patient collective. It was shown that MRI was superior to bone marrow scintigraphy in respect of sensitivity (92% vs 58%) and specificity (97% vs. 85%), although only about three quarters of the marrow spaces are examined by MRI screening. Bone marrow scintigraphy suffered particularly from a relatively high number of false positive findings (haemangiomas, degenerative changes). MRI remains the method of choice for investigating the bone marrow.

Bone Marrow↗
PubMed1994

[MRT of the female pelvis: turbo-spin-echo (TSE) sequences compared to conventional spin-echo sequences at 0.5 tesla].

Markedly T2-weighted MR images of the pelvis can be obtained with TSE sequences using short acquisition times. In order to determine whether TSE sequences at 0.5 Tesla produce diagnostically valuable images, 9 normals and 53 patients with suspected gynaecological tumours were examined with TSE and SE sequences. Visual comparison showed a considerable superiority of the TSE sequences in most respects. The quality of the TSE images was regarded as very good in 82% and good in 18% (SE sequences: 27% very good, 55% good, 18% moderate), delineation of anatomical structures 81% very good and 19% good (SE sequence: 31% very good, 53% good, 16% moderate). TSE sequences were also superior in the detection of pathological changes (87% very good, 13% good) compared with SE sequences (56% very good, 37% good, 7% moderate). Venous plexuses in the parametrium were better demonstrated by SE sequences. There were significantly higher signal to noise ratios (SNR) with TSE sequences for fat, bone marrow (each p < 0.001), and urine (p < 0.05). Using muscle as reference tissue, there were significantly higher signal-difference to noise ratios (SDR) for fat (p < 0.001), and bone marrow (p < 0.0001), the other pelvic organs and tumours showed no significant differences between the SNR and SDR. TSE sequences are well suited to replace SE sequences in the MR diagnosis of gynaecological tumours.

Adolescent↗
PubMed1994

Mitochondrial encephalomyopathy: correlation of P-31 exercise MR spectroscopy with clinical findings.

PURPOSE: To evaluate the sensitivity of standardized exercise phosphorus-31 magnetic resonance (MR) spectroscopy in screening for subclinical muscle involvement in mitochondrial encephalomyopathy and to estimate if changes seen at biopsy have functional consequences. MATERIALS AND METHODS: Exercise MR spectroscopy was performed in 52 examinations of 18 healthy volunteers and 14 patients with defects of mitochondrial respiratory chain enzymes. Calculation and kinetic analysis of the phosphocreatine (PCr) index and pH time courses were standardized with a microcomputer program. RESULTS: PCr index scores and conventional test scores matched in 10 of 14 cases. No obvious correlation existed between pH parameters and clinical score. Muscle affection, according to pH parameter score, was rated moderate (n = 3), severe (n = 1), or maximum (n = 2) in six of 14 cases in which clinical test scores showed only mild affection. CONCLUSION: Exercise MR spectroscopic PCr index parameters provide diagnostic information on skeletal muscle involvement in patients with mitochondrial encephalopathy. The sensitivity of the PCr index parameter seems equal or superior to that of conventional diagnostic tests. The role of pH parameters, however, has yet to be defined.

Adult↗
PubMed1994

Thyrotropin receptor and leukocyte adhesion molecules in autoimmune thyroid disease: a study of their gene expression by northern blot analysis and in situ hybridization.

In order to characterize the role of leukocyte-activating antigens and other immunological parameters in autoimmune thyroid disease, mRNA levels of intercellular adhesion molecule 1 (ICAM-1), endothelial leukocyte adhesion molecule 1 (ELAM-1, E-selectin), invariant chain (Ii) and the thymic hormone thymosin beta (T beta 4) were investigated in 18 human thyroid glands, including eight Graves' thyroids, two Hashimoto's thyroids, two endemic goiters and six healthy controls. Northern blot analysis showed that in autoimmune thyroid disease, expression of ICAM-1 and T beta 4 was correlated to transcript levels of Ii, whereas in the healthy controls, expression of T beta 4, ICAM-1 and ELAM-1 was low or nearly absent. ELAM-1 and TSH receptor (TSH-R) expression, the latter serving as a thyroid specific marker, was increased in some diseased gland but showed no relation to the immunological parameters mentioned above. Localization of the specific mRNAs by in situ hybridization demonstrated a cell-specific expression of TSH-R (thyrocytes), ELAM-1 (vascular endothelial cells) and T beta 4 (cells of hematopoietic origin). In contrast, transcripts of Ii and ICAM-1 were found in thyrocytes, leukocytes and endothelial cells. Our results implicate a coordinate expression of ICAM-1, T beta 4 and Ii in autoimmune thyroid disease, yielding distinct cellular expression patterns. Differential expression of ICAM-1, Ii and the TSH-R in thyroid epithelial cells indicates active regulatory events within the thyrocyte.

Autoimmune Diseases↗
PubMed1994

[MR tomography in staging of carcinomas of the uterus].

Magnetic resonance imaging (MRI) has proven to be a suitable imaging modality for the evaluation of uterine neoplasms. In contrast to computed tomography and ultrasound, MRI allows multiplanar observer-independent imaging of the whole female pelvis with high tissue-specific contrast. This article reviews the advantages and limitations of MRI in the staging of endometrial and cervical carcinoma, focusing on MRI with reference to other imaging modalities. New technical developments are discussed and an imaging approach for these tumor types is suggested.

Cervix Uteri↗
PubMed1994

[MRI in orthopedics: diagnosis of joint disorders].

For the visualization of joint structures, magnetic resonance imaging (MRI) has definite advantages over other imaging modalities. High soft tissue contrast and multiplanar capabilities contribute to adequate representation of the joints. With surface and special coils as well as high gradient field strengths, superior spatial resolution can be achieved, thus allowing for depiction of fine anatomical details. Newly developed pulse sequences, especially with fat suppression techniques and utilization of paramagnetic contrast agents (gadolinium complexes) have improved image contrast. Examination techniques, results and diagnostic value of MRI in various joints are discussed. Close cooperation between orthopaedic surgeons and radiologists is mandatory for effective and economically acceptable use of MRI in the diagnosis of joint disorders.

Ankle Joint↗
PubMed1994

[MR angiography of the heart and thoracic blood vessels. Use of rapid ECG-triggered techniques with multiplanar reconstruction capability].

Segmented 2D times-of-flight (TOF) magnetic resonance angiography (MRA) with ECG gating is a suitable adjunct to conventional magnetic resonance tomography. Based on our experience with 106 patients, cardiovascular MRA primarily aids in the diagnosis of congenital heart disease, but is of minor importance for the evaluation of acquired cardiovascular disease, such as aortic aneurysms. Changes in flow dynamics as a result of spin dephasing may render partial signal loss. Due to flow turbulence and resulting signal loss distal to stenoses, difficulties may arise in correctly determining the degree of stenosis and differentiating between partial thrombosis and slowly flowing blood. The most promising approach for optimizing 2D TOF MRA is enhancement of the intravascular signal and suppression of background signal. For the equipment we use with a 0.5 Tesla scanner, the most powerful combination to enhance intravascular signal and suppress back-ground noise was applying a flip angle of 65 degrees and a short inversion prepulse. The influence of the flip angle and prepulse on the intravascular signal varies, dependent on the flow velocities and heart rates. Secondary reconstructions, such as the MIP technique, contribute to better spatial orientation by using rotating projection views. To avoid overprojection artifacts and loss of diagnostic information, 2D single slices should be the primary source of image analysis.

Aortic Diseases↗
PubMed1994

[MRI of the coronary arteries: possibilities and limits. A comparative presentation with reference to coronary angiography, echocardiography and electron beam tomography].

The depiction of coronary arteries with magnetic resonance angiography has become possible during the last few years. Powerful magnetic field gradients with short ramp times and improved RF components and pulse sequences, such as derivatives of FLASH and echoplanar imaging, have led to high expectations. Because spatial resolution is still restricted and the signal-to-noise ratio (SNR) limited as it cannot be increased easily, and because the data acquisition times are relatively long compared to the respiratory and cardiac cycle, the diagnostic value currently appears to be limited. Electron beam tomography constitutes an alternative to MRI. This computer tomographic method affords acquisition times of 50-100 ms with good SNR and high spatial resolution through deflection of an electron beam onto a ring anode and by using a stationary detector. Together with transoesphageal ultrasound, these non-invasive alternative methods for the depiction of coronary arteries are compared with the "gold standard" of conventional coronary angiography, and an overview of current results is given.

Coronary Angiography↗
PubMed1994

Cerebral MR in ophthalmoplegia plus.

PURPOSE: To evaluate MR patterns in ophthalmoplegia plus and correlate them with clinical symptoms. METHODS: MR was performed on a 1.5-T whole-body scanner with T2-weighted gradient-echo and spin-echo images. The retrospective analysis included 19 patients with clinically established diagnoses of ophthalmoplegia plus. RESULTS: Two types of cerebral MR abnormalities were found in ophthalmoplegia plus: brain atrophy and hyperintensities restricted to the white matter and basal ganglia, which appeared as either focal or diffuse areas of high signal intensity and were of strictly supratentorial location. No specific distribution was found. These findings differ markedly from infarction-like lesions found in mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes. CONCLUSIONS: MR is sensitive for the detection of central nervous system involvement in ophthalmoplegia plus, but findings are nonspecific. However, cerebral MR in ophthalmoplegia plus is different from other mitochondrial encephalomyopathies and underlines the clinical differentiation of mitochondrial encephalomyopathies.

Adolescent↗